Pediatric emergency medicine practice
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Pediatr Emerg Med Pract · Jul 2019
ReviewDiagnostic point-of-care ultrasound: assessment techniques for the pediatric trauma patient
Emergency ultrasound is performed at the point of care to quickly answer focused clinical questions. Over the last 25 years, the use of this technique has expanded rapidly. ⋯ Utilizing diagnostic point-of-care ultrasound for pediatric trauma patients in the emergency department can facilitate diagnosis at the bedside rather than sending the patient out of the department for another study. This supplement focuses on some of the common indications for diagnostic POCUS that may be useful in the setting of trauma, as found in the pediatric literature, or extrapolated from adult literature where pediatric evidence is scarce.
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Pediatr Emerg Med Pract · Jul 2019
ReviewEvaluation and management of the febrile young infant in the emergency department
Among young infants presenting with fever, untreated serious bacterial infections can have severe outcomes, so a full sepsis workup is often recommended but may not be necessary. This issue reviews the use of novel diagnostic tools such as procalcitonin, C-reactive protein, and RNA biosignatures as well as new risk stratification tools such as the Step-by-Step approach and the Pediatric Emergency Care Applied Research Network prediction rule to determine which febrile young infants require a full sepsis workup and to guide the management of these patients in the emergency department. The most recent literature assessing the risk of concomitant bacterial meningitis with urinary tract infections and the role for viral testing, specifically herpes simplex virus and enterovirus, are also reviewed.
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Pediatr Emerg Med Pract · Oct 2016
ReviewSevere Traumatic Brain Injury In Children: An Evidence-Based Review Of Emergency Department Management.
More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. ⋯ The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes. This issue discusses methods to maintain adequate oxygenation, maximize management of intracranial hypertension, and optimize blood pressure in the emergency department to improve neurologic outcomes following pediatric severe traumatic brain injury.
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Pediatr Emerg Med Pract · Jun 2016
Review Case ReportsProcedural ultrasound in pediatric patients: techniques and tips for accuracy and safety.
Point-of-care ultrasound is becoming more prevalent in pediatric emergency departments as a critical adjunct to both diagnosis and procedure guidance. It is cost-effective, safe for unstable patients, and easily repeatable as a patient's clinical status changes. ⋯ This issue will review the adult literature and the available pediatric literature comparing ultrasound guidance to more traditional approaches. Methods for using ultrasound guidance to perform various procedures, and the pitfalls associated with each procedure, will also be described.
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Pediatr Emerg Med Pract · Aug 2015
ReviewEndotracheal Intubation In Pediatric Patients Using Video Laryngoscopy: An Evidence-Based Review.
Endotracheal intubation of pediatric patients is an infrequent, though high-risk, procedure in emergency medicine. Emergency clinicians should be aware of available approaches to assist with successful intubation in pediatric patients. Video laryngoscopy involves the utilization of optical and video technology to facilitate indirect visualization of laryngeal structures during intubation. ⋯ A number of pediatric devices are now available, each with benefits as well as limitations and nuances in technique for use. This evidence-based review describes the emergence of video laryngoscopy into the pediatric and emergency medicine settings. A summary of the existing data on video laryngoscopy use in routine and difficult airways is included, and practical instruction on the use of 3 specific devices approved for use in pediatric patients is provided.