Factors Associated with Pediatric Drowning-Associated Lung Injury.

Objective: To identify risk factors for clinically-important drowning-associated lung injury (ciDALI) in children.

Study Design: This was a cross-sectional study of children (0 through 18 years) who presented to 32 pediatric emergency departments (EDs) from 2010 through 2017. We reviewed demographics, comorbidities, prehospital data, chest radiographs reports, and ED course from emergency medical services, medical, and fatality records.

Primary series COVID-19 vaccine effectiveness among health care workers in the country of Georgia, March-December 2021.

Background: Healthcare workers (HCWs) have suffered considerable morbidity and mortality during the COVID-19 pandemic. Few data on COVID-19 vaccine effectiveness (VE) are available from middle-income countries in the WHO European Region. We evaluated primary series COVID-19 VE against laboratory-confirmed COVID-19 among HCWs in Georgia.

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Background: Cervical spine injuries in children are uncommon but potentially devastating; however, indiscriminate neck imaging after trauma unnecessarily exposes children to ionising radiation. The aim of this study was to derive and validate a paediatric clinical prediction rule that can be incorporated into an algorithm to guide radiographic screening for cervical spine injury among children in the emergency department.

Methods: In this prospective observational cohort study, we screened children aged 0-17 years presenting with known or suspected blunt trauma at 18 specialised children's emergency departments in hospitals in the USA affiliated with the Pediatric Emergency Care Applied Research Network (PECARN).

Public support for and concerns regarding pediatric dose optimization for seizures in emergency medical services: An exception from informed consent (EFIC) trial.

Background: Federal regulations allow exception from informed consent (EFIC) to study emergent conditions when obtaining prospective consent is not feasible. Little is known about public views on including children in EFIC studies. The Pediatric Dose Optimization for Seizures in EMS (PediDOSE) trial implements age-based, standardized midazolam dosing for pediatric seizures.

Prevalence of Low-Acuity Pediatric Emergency Medical Services Transports to a Pediatric Emergency Department in an Urban Area.

Objectives: Many patients transported by Emergency Medical Services (EMS) do not have emergent resource needs. Estimates for the proportion of pediatric EMS calls for low-acuity complaints, and thus potential candidates for alternative dispositions, vary widely and are often based on physician judgment. A more accurate reference standard should include patient assessments, interventions, and dispositions.

Pediatric Primary Care Provider Perspectives on Including Children in Alternative Emergency Medical Services Disposition Programs.

Introduction: Many emergency medical services (EMS) agencies have implemented alternative disposition programs for low-acuity complaints, including transportation to clinics. Our objectives were to describe pediatric primary care providers' views on alternative EMS disposition programs.

Method: We conducted virtual focus groups with pediatric primary care providers.

Prehospital Recognition and Management of Pediatric Sepsis: A Qualitative Assessment.

Background And Purpose: Sepsis is a life-threatening disease in children and is a leading cause of morbidity and mortality. Early prehospital recognition and management of children with sepsis may have significant effects on the timely resuscitation of this high-risk clinical condition. However, the care of acutely ill and injured children in the prehospital setting can be challenging.

Caregiver Perspectives on Including Children in Alternative Emergency Medical Services Disposition Programs: A Qualitative Study.

Objectives: Almost half of pediatric EMS calls may be for low-acuity problems. Many EMS agencies have implemented alternative disposition programs for low-acuity patients, including transportation to clinics, substituting taxis for ambulances, and treatment in place without transport to an emergency department. Including children in such programs poses specific challenges, with one concern being potential caregiver opposition.

Clinician and Caregiver Determinations of Acuity for Children Transported by Emergency Medical Services: A Prospective Observational Study.

Study Objective: Many Emergency Medical Services (EMS) agencies have developed alternative disposition processes for patients with nonemergency problems, but there is a lack of evidence demonstrating EMS clinicians can accurately determine acuity in pediatric patients. Our study objective was to determine EMS and other stakeholders' ability to identify low acuity pediatric EMS patients.

Methods: We conducted a prospective, observational study of children transported to a pediatric emergency department (ED) by EMS.

Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis.

Introduction: Emergency medical services (EMS) systems have developed alternative disposition processes for patients (including leaving the patient at the scene, using taxis, and transporting to clinics) vs taking patients directly to an emergency department (ED). Studies show that patients favorably support these alternative options but have not included the perspectives of caregivers of children. Our objective was to describe caregivers' views about these alternative disposition processes and analyze whether caregiver support is associated with sociodemographic factors.

Emergency Medical Services Clinicians' Perspectives on Pediatric Non-Transport.

Objectives: Emergency medical services clinicians do not transport one-third of all children assessed, even without official pediatric non-transport protocols. Little is known about how EMS clinicians and caregivers decide not to transport a child. Our objectives were to describe how EMS clinicians currently decide whether or not to transport a child and identify barriers to and enablers of successfully implementing an EMS clinician-initiated pediatric non-transport protocol.

The Effect of Documenting Patient Weight in Kilograms on Pediatric Medication Dosing Errors in Emergency Medical Services.

Up to 40% of children who receive a medication from emergency medical services (EMS) are subject to a dosing error. One of the reasons for this is difficulties adjusting dosages for weight. Converting weights from pounds to kilograms complicates this further.

National Characteristics of Non-Transported Children by Emergency Medical Services in the United States.

Most 911 calls result in ambulance transport to an emergency department. In some cases, transport is refused or deemed unnecessary. The frequency of pediatric non-transport is unknown.

R.E.S.P.e.c.T and intimate partner violence: a cross-sectional study using DHS data in Kenya.

Background: Thirty per cent of all women experience intimate partner violence (IPV) in their lifetime. The aim of this study was to examine the association between the WHO's novel R.E.

Availability and Prices of WHO Essential Diagnostics in Laboratories in West Africa: A Landscape Survey of Diagnostic Testing in Northern Ghana.

Background: We determined the availability and pricing of laboratory testing in the Northern Region of Ghana to identify current gaps with respect to the WHO's Essential Diagnostics List (EDL).

Methods: A representative sample of facilities offering diagnostic testing within the Northern Region was geographically mapped and evaluated, with random sampling stratified by population density. Data were collected on testing menus, volumes, turn-around times, and out-of-pocket test prices.

Evaluation of a Selective Prehospital Pediatric Spinal Protection Protocol.

Recent studies demonstrate an association between spinal immobilization and neck pain, increased use of radiographs, and increased admission rates for pediatric trauma patients. There is an increasing trend toward spinal protection protocols that limit the use of backboards in trauma patients. However, many of these protocols do not address the youngest patients.

Chikungunya in Children: A Clinical Review.

Chikungunya (CHIKV) is an emerging arboviral infection with recent spikes in transmission in the Americas. Chikungunya is most commonly transmitted by mosquitos, specifically Aedes aegypti and Aedes albopictus. These mosquitoes are found throughout many parts of the United States.

Premature adrenarche.

Premature adrenarche refers to the presence of secondary sexual hair in girls younger than 8 years old and boys younger than 9 years old. It is a relatively common presentation to paediatricians and is more frequent in girls than boys. It is a benign diagnosis, but other causes of androgen excess such as congenital adrenal hyperplasia or adrenal tumours should be excluded first.

The epidemiology of psychosis in Luton.

Background: There is a dearth of epidemiological research on psychosis. Little is known about how psychosis rates vary within contrasting urban areas. Variation in rates would have implications for the aetiology of psychosis.

Caval interruption: methods and indications.

Venous thromboembolism is a significant cause of morbidity and mortality worldwide. Anticoagulation is the preferred treatment, but is not feasible in some patients. Caval interruption is the treatment of choice for prevention of recurrent pulmonary embolism.