Pediatric emergency care
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Pediatric emergency care · Jan 2024
"The Cost in the Individual": Longitudinal Burnout Prevalence Among Pediatric Emergency Physicians Through 9 Months of the COVID-19 Pandemic.
Emergency medicine (EM) confers a high risk of burnout that may be exacerbated by the COVID-19 pandemic. We aimed to determine the longitudinal prevalence of burnout in pediatric EM (PEM) physicians/fellows working in tertiary PEM departments across Canada and its fluctuation during the pandemic. ⋯ Our study suggests that increased COVID-19 case burden was correlated with EE levels during the third and fourth waves of the pandemic. Emotional exhaustion was worsened by systemic factors, and interventions must target common themes of unsustainable workloads and overwhelming lack of control.
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Pediatric emergency care · Jan 2024
Smartphone App PACOM to Provide Advice Regarding Self-Triage for the Acute Primary Care Needs of Children: Accuracy of Algorithms.
We developed a phone app, PACOM (Parents Application Conseils et Orientation Médicale), to provide medical advice to caregivers based on several algorithms and a series of binary questions related to children's symptoms. We compared the recommendations of the PACOM algorithms and clinicians for children visiting the emergency department (ED). ⋯ The PACOM algorithms has high sensitivity but low specificity for reducing ED visits and calls for urgent medical support.
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Pediatric emergency care · Jan 2024
Do We Need a Strictly Lateral Radiograph for Fracture Management of Forearm Buckle Fractures in Children?
Buckle fractures of the distal forearm are a common fracture entity in children treated conservatively. Diagnostics primarily include radiographs in 2 planes. Inadequate images may occur in the mostly very young patients. Therefore, additional lateral radiographs are often obtained to assess a possible angular tilt. The aim of this study is to investigate whether a strictly lateral x-ray image has an influence on fracture management. ⋯ Based on our results, the acquisition of additional lateral radiographs seems to be unnecessary in the diagnostic procedure of buckle fractures of the distal forearm, in case a possible palmar or dorsal angulation cannot be entirely assessed on the initial set of radiographs. An additional lateral image had no influence on fracture management, which was chosen conservatively in every case and led to excellent clinical results.Level of evidence: level III.
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Pediatric emergency care · Jan 2024
Review Case ReportsPoint-of-Care Ultrasound-Guided Arthrocentesis of a Pediatric Septic Ankle.
Septic arthritis is one potential cause of pediatric joint effusion and pain that may lead to significant morbidity. We present a case where point-of-care ultrasound was used to identify and aspirate a joint effusion in a pediatric patient with septic arthritis of the ankle, facilitating timely diagnosis and care. We review the technique for arthrocentesis of the ankle and literature on point-of-care ultrasound in the diagnosis of pediatric septic arthritis.
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Pediatric emergency care · Jan 2024
Development and Internal Validation of a Multivariable Prediction Model to Predict Repeat Attendances in the Pediatric Emergency Department: A Retrospective Cohort Study.
Unplanned reattendances to the pediatric emergency department (PED) occur commonly in clinical practice. Multiple factors influence the decision to return to care, and understanding risk factors may allow for better design of clinical services. We developed a clinical prediction model to predict return to the PED within 72 hours from the index visit. ⋯ We developed and internally validated a clinical prediction model for unplanned reattendance to the PED using routinely collected clinical data, including markers of socioeconomic deprivation. This model allows for easy identification of children at the greatest risk of return to PED.