Pediatrics
-
Comparative Study
Health care provider and caregiver preferences regarding nasogastric and intravenous rehydration.
Despite evidence supporting its use, nasogastric rehydration is rarely used in North America. We conducted a prospective, cross-sectional, 3-phase study to evaluate current perspectives. ⋯ In keeping with caregiver desires, health care providers in a Canadian emergency department employ intravenous rehydration when oral rehydration fails. Enhanced change management strategies will be required for nasogastric rehydration to become adopted in this environment.
-
To determine the self-reported practices and attitudes surrounding concussion diagnosis and management in a single, large pediatric care network. ⋯ Although pediatric primary care and emergency medicine providers regularly care for concussion patients, they may not have adequate training or infrastructure to systematically diagnose and manage these patients. Specific provider education, decision support tools, and patient information could help enhance and standardize concussion management.
-
Review Practice Guideline
A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders.
This report describes the development of a practice pathway for the identification, evaluation, and management of insomnia in children and adolescents who have autism spectrum disorders (ASDs). ⋯ The insomnia practice pathway may help health care providers to identify and manage insomnia symptoms in children and adolescents who have ASD. It may also provide a framework to evaluate the impact of contributing factors on insomnia and to test the effectiveness of nonpharmacologic and pharmacologic treatment strategies for the nighttime symptoms and daytime functioning and quality of life in ASD.
-
In rural America, pediatricians can play a key role in the development, implementation, and ongoing supervision of emergency medical services for children (EMSC). Pediatricians may represent the only source of pediatric expertise for a large region and are a vital resource for rural physicians (eg, general and family practice, emergency medicine) and other rural health care professionals (physician assistants, nurse practitioners, and emergency medical technicians), providing education about management and prevention of pediatric illness and injury; appropriate equipment for the acutely ill or injured child; and acute, chronic, and rehabilitative care. In addition to providing clinical expertise, the pediatrician may be involved in quality assurance, clinical protocol development, and advocacy, and may serve as a liaison between emergency medical services and other entities working with children (eg, school nurses, child care centers, athletic programs, and programs for children with special health care needs).