Pediatrics
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Accurate recognition of pediatric concussion in the emergency department (ED) is important to ensure appropriate management for safe recovery. The study objective was to determine whether the Centers for Disease Control and Prevention's Acute Concussion Evaluation (ACE) tools, modified for ED use, improved patient follow-up and post-injury behaviors. ⋯ The ACE tools, modified for ED use, were successfully implemented in the pediatric ED. Post-implementation, increased patient follow-up and improved recall of and adherence to ED discharge recommendations was demonstrated.
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Moderate hypothermia (temperature <36°C) at birth is common in premature infants and is associated with increased mortality and morbidity. ⋯ The practice plan was associated with a significant increase in DR and admitting axillary infant temperatures and a corresponding decrease in the number of infants with moderate hypothermia. There was an associated reduction in intubation at 24 hours. These positive findings reflect increased compliance with the practice plan.
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Observational Study
Feasibility of critical congenital heart disease newborn screening at moderate altitude.
Consensus guidelines have recommended newborn pulse oximetry screening for critical congenital heart disease (CCHD). Given that newborn oxygen saturations are generally lower at higher altitudes, the American Academy of Pediatrics and others recommend additional evaluation of the screening algorithm at altitude. Our objective was to evaluate the feasibility of newborn pulse-oximetry CCHD screening at moderate altitude (Aurora, CO; 1694 m). We hypothesized the overall failure rate would be significantly higher compared with published controls. ⋯ Pulse oximetry screening failure rates at moderate altitude are significantly higher than at sea level. Larger studies with alternative algorithms are warranted at moderate altitudes.