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Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. Pediatric patients have unique bony anatomy and physiology compared to the skeletally mature. J Pediatr Orthop. Pediatr Emerg Care. Pediatrics.
To begin, a 2012 prospective pediatric study found a failure rate of 16.9 A 2016 multicenter prospective study evaluated 1,036 pediatric patients for shunt failure who received CSF shunts over a four-year period. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study.
One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. The aim of TTM is to control the body and brain’s temperature, thus reducing secondary brain injury and improving the neurological outcome. What do the guidelines recommend?
St.Emlyn's - Emergency Medicine #FOAMed The blog highlights the updated 2024 guidelines from the Royal College of Radiologists (RCR) on imaging in pediatric trauma. It emphasizes critical changes from the previous 2014 guidelines, focusing on the judicious use of imaging to minimize ionizing radiation exposure in children.
We have mentioned the Glasgow Coma Scale in multiple delicious morsels: Minor closed head injuries in <3 month olds and in the rebaked morsel , Blunt cerebrovascular injury , Cerebral edema in DKA , Pediatric Trauma Pitfalls , and Carbon monoxide poisoning. When is it useful and what does it tell us?
To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Unfortunately, there are numerous other pitfalls that can be encountered during the management of pediatric trauma patients.
Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. Pediatr Diabetes. Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Commitee. Then we’ve likely got DKA.
National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC. Reference: Remick KE, et al. JAMA Netw Open. Reference: Remick KE, et al.
Higher titers in both CSF and serum were associated with poor outcomes. Make sure to consult your friendly neighborhood pediatric neurologist and/or rheumatologist! Earlier diagnosis leads to better outcomes. Younger Age at Onset Is Associated With Worse Long-term Behavioral Outcomes in Anti-NMDA Receptor Encephalitis.
The concurrent circulation of influenza, respiratory syncytial virus (RSV), COVID-19, and norovirus during peak viral seasons presents a diagnostic challenge in pediatric emergency settings. nausea, vomiting) occur more frequently in pediatric populations. References Boktor SW, Hafner JW.
A single cadaveric study from the 1950s showed that the pediatric subglottic space approximated a circular funnel with the narrowest portion at the cricoid level This study included only 15 children aged 4 months–14 years But why was this a problem? Front Pediatr. Cuffed endotracheal tubes in pediatric intensive care.
Unlike traditional methods that rely on periodic fingerstick tests, CGM offers real-time insights into glucose levels, trends, and fluctuations, empowering proactive management and improving patient outcomes. However, to maximize its benefits, healthcare providers must be well-versed in the technology.
She is also a member […] The post SGEM #417: Everybody’s Changing…the Reference Ranges for Pediatric Vital Signs first appeared on The Skeptics Guide to Emergency Medicine. Background: We have looked at pediatric vital signs on the SGEM back in 2014 with PedEM superhero Dr. Anthony Crocco ( SGEM#98 ). Reference: Brennan L et al.
Treatment failure, the primary outcome, was defined differently for each group: A need for subsequent appendectomy in the antibiotic group and negative appendectomy for the controls. An RCT measures an intervention’s effect on a single outcome. In this study, different outcomes were assessed for each group.
Peggy Greco, Chief Patient Experience Officer at Nemours Children’s Health, and NRC Health Customer Success Manager Cami Mitelman to discuss what diversity, equity, and inclusion outcomes look like in patient experience. The post The interesting connection between pediatricoutcomes and DEI appeared first on NRC Health.
2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC. Cochrane Database Syst Rev. Do you think he injured his neck?”
A few months ago, a sensational letter came out in JAMA Pediatrics. Given the low risks to children from COVID‐19 and a potential for stigmatization, we questioned whether there was minimal risk to children participating in a recent study published in JAMA Pediatrics. Then a dog sniffed them to see if they had COVID19.
One of the most difficult and most satisfying parts of pediatric emergency medicine is using one’s history, exam and clinical tools to make an informed decision and spare children from unnecessary pain , uncomfortable exams, painful procedures and medical imaging. Low Risk Inta-Adbominal Trauma: Pediatric Trauma is Dangerous!
Acute Esophageal Variceal Bleeding: Basics Pediatric liver disease may be due to numerous causes. Banc-Husu, 2023 ] Cholestastis Inflammatory conditions Genetic and Metabolic diseases Pediatric cirrhotic liver disease has many complications. Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics.
Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). 7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Antiemetics as needed.
Pediatrics. Findings: The primary outcome of recurrence of UTI within 30 […] The post Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial appeared first on EMOttawa Blog. Methodology: 3.5/5 5 Usefulness: 2.5/5 5 Montini G, et al. 2024 Jan 1;153(1):e2023062598.
JAMA Pediatr. JAMA Pediatr. Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences.
Ultrasonography or radiography for suspected pediatric distal forearm fractures. Ultrasonography or radiography for suspected pediatric distal forearm fractures. Background: We have covered pediatric wrist fractures a few times on the SGEM. Ultrasonography or radiography for suspected pediatric distal forearm fractures.
Pediatric submersion injuries are one of the leading causes of preventable morbidity and mortality in the pediatric population. 1,2 Clinical outcomes in submersion injuries are largely dependent on the degree of hypoxic injury experienced by the victim, making prehospital care of paramount importance. Ital J Pediatr.
Pediatric transverse myelitis.” Clinical Approach to Pediatric Transverse Myelitis, Neuromyelitis Optica Spectrum Disorder and Acute Flaccid Myelitis.” Pediatric acute transverse myelitis overview and differential diagnosis.” ALWAYS rule out a compressive lesion, this is a medical emergency! first sign of MS). Neurology vol.
Systematic Review of CT Angiography in Guiding Management in Pediatric Oropharyngeal Trauma. March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital and George Washington University. Laryngoscope. Reference: Curry SD, et al.
Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. Background: Pediatric sepsis is a major global health concern, causing an estimated 3.3 The 2005 International Pediatric Sepsis Consensus Conference (IPSCC) criteria were established based on expert consensus and used for diagnosis.
A pediatric multi-center study of study on adherence to activity restrictions was published last year. Ten Level I pediatric trauma centers in the US tabulated their experience with solid organ injuries over 3.75 And the more people I poll on what they do, the more and very different answers I get. Until now. years from 2013 to 2016.
Olivia Ostrow, Pediatric Emergency Physician at Hospital for Sick Children, Assistant professor at the University of Toronto and a Medical Safety Leader with an academic focus in quality improvement, discusses a case that exemplifies how indiscriminate work up of pediatric UTI can lead to over-testing, over-treating and even worse outcomes.
The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%
It is useful to know that there are two kinds of weight curves: Descriptive , in which nearly all mothers and their children are included with few exclusion criteria, and Prescriptive , in which groups of women with pathologies that affect neonatal morbidity and mortality outcomes have been excluded. J Pediatr 2018;196:71-6.
A few months ago, a sensational letter came out in JAMA Pediatrics. Given the low risks to children from COVID‐19 and a potential for stigmatization, we questioned whether there was minimal risk to children participating in a recent study published in JAMA Pediatrics. Then a dog sniffed them to see if they had COVID19.
In this episode, Sam Ashoo, MD, interviews Ami Shah, MD, MPH, and Don Walker, MD, about eye injuries in the pediatric population. Why ocular injuries? Topical anesthetics Visual acuity apps In this episode, Sam Ashoo, MD, interviews Ami Shah, MD, MPH, and Don Walker, MD, about eye injuries in the pediatric population.
Excluded: Pediatric patients, COVID-19 patients, non-diagnostic studies (ie studies evaluating only the prognostic role of MDW), non-English studies and case reports and reviews. Outcome: Diagnostic accuracy of MDW for early sepsis detection, measured by pooled sensitivity, specificity, and likelihood ratios.
When a healthcare team respects a patient’s uniqueness, the patient, in turn, receives the safest care with the best outcomes. During October’s Becker’s Healthcare podcast, two prominent pediatric leaders discussed the critical nature of intentional practices and the importance of family-centered care.
Elbow Interpretation Roadmap: CRITOE More pragmatic and utilitarian than a prosaic mnemonic, CRITOE helps us to remember the order of ossification of the pediatric elbow. Acute compartment syndrome of the upper extremity in children: diagnosis, management, and outcomes. J Pediatr Orthop. Pediatrics. Ann R Coll Surg Engl.
The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research.
The current analysis showed that EVT was superior in functional outcomes across a variety of ischemic severities and penumbra profiles on imaging. 3: Could Teleconsultation Reduce Pediatric Transfers? Source Pediatric Patients Discharged After Transfer to a Pediatric Emergency Department: Opportunities for Telehealth?
Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. She is the cofounder of FOAMcast and is a pulmonary embolism […] The post SGEM#363: View Master – Virtual Reality Immersion Tool to Reduce Pediatric Anxiety first appeared on The Skeptics Guide to Emergency Medicine.
Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma. Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma.
A 2008 Cochrane review found adult depression screening does not improve outcomes. The last two trials convincingly demonstrate that when patients with postpartum depression have better access to mental health services, outcomes improve. Screening had no impact on depression, anxiety, or a host of other mental health outcomes.
CT scans are typically not recommended in pediatric patients, but can be useful in adults with concern for tracheal stenosis or recurrent tracheitis, however airway stabilization takes precedence. [2][3] 2][3][9] Glucocorticoid were not shown to alter clinical course or patient outcomes. [2][3] Hospital Pediatrics.
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