Factors Associated With Low Procedural Pain Scores Among 1- to 5-Year-Old Patients Undergoing Facial Laceration Repair.

Objectives: Our objectives were to quantify pain experienced by young children undergoing facial laceration repair and identify factors associated with low procedural pain scores.

Methods: We conducted a prospective cohort study of children's distress among a convenience sample of children aged 1 to 5 years undergoing facial or scalp laceration repair in 2 pediatric emergency departments. We reviewed video recordings and documented pain scores at 15-second intervals using the Face, Leg, Activity, Cry, Consolability-Revised (FLACC-r) scale.

Streptococcal Pharyngitis: Compliance With National Testing Guidelines in a Pediatric Emergency Department.

Objectives: The Infectious Diseases Society of America (IDSA) guidelines regarding group A streptococcal (GAS) pharyngitis advise against routine testing for patients younger than 3 years, patients without pharyngitis, and patients with symptoms suggesting a viral infection. Group A streptococcal testing may be overused in some clinical settings; thus, we conducted this study to evaluate compliance with the IDSA guidelines in a pediatric emergency department (ED) setting.

Methods: This retrospective cohort study describes patients younger than 18 years presenting to 2 urban pediatric EDs in 2016 who underwent rapid antigen detection testing for GAS pharyngitis.

Utilization of the electrocardiogram in the pediatric emergency department.

Objective: Review pediatric electrocardiogram (ECG) result severity classification and describe the utilization of ECG testing, and rate of clinically significant results, in the pediatric emergency department (PED).

Methods: This was a review of patients ≤18 years who had an ECG performed in a tertiary children's hospital PED 2005-2017. Using established guidelines and expert consultation, ECG results were categorized: Class 0 = normal, Class I = mild abnormality (no cardiology follow-up), Class II = moderate abnormality (cardiology follow-up), Class III = severe abnormality (immediate intervention).

Outcome of Pediatric Forearm Fracture Reductions Performed by Pediatric Emergency Medicine Providers Compared With Reductions Performed by Orthopedic Surgeons: A Retrospective Cohort Study.

Objective: The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions.

Methods: We performed an analysis of patients between 1 and 14 years of age who presented to the emergency department (ED) with a forearm fracture requiring reduction. Data collected included reducing provider (PEM or orthopedist) and prereduction, postreduction, and follow-up fracture angles and displacements of both radius and ulna.

Implementation of Electronic Clinical Decision Support for Pediatric Appendicitis.

Background And Objective: Computed tomography (CT) and ultrasound (US) are commonly used in patients with acute abdominal pain. We sought to standardize care and reduce CT use while maintaining patient safety through implementation of a multicomponent electronic clinical decision support tool for pediatric patients with possible appendicitis.

Methods: We conducted a quasi-experimental study of children 3 to 18 years old who presented with possible appendicitis to the pediatric emergency department (ED) between January 2011 and December 2013.

Analysis of radiation dose to pediatric patients during computed tomography examinations.

Background: Computed tomography (CT) utilization has increased rapidly over the past 15 years. CT is the most common source for radiation exposure.

Objectives: The objective was to measure the effective dose of radiation delivered during routine head and abdominal CT examinations at a children's hospital.

Pediatric lateral patellar dislocation: is there a role for plain radiography in the emergency department?

Background: Osteochondral fractures are reported to complicate patellar dislocations in 5-95% of patients. For this reason, post-reduction radiographs are recommended for the routine evaluation of patellar dislocations in all patients. To date, no data have been reported regarding the impact plain radiography has on the Emergency Department (ED) management of pediatric patients with lateral patellar dislocations.

Traumatic deaths in children: is there a difference between urban and rural populations?

Objective: Trauma is a leading cause of death among children. Detailed knowledge of the epidemiology of traumatic childhood deaths is necessary for allocating available treatment resources and for preventing injuries at both community and regional levels. To our knowledge, there has been no report comparing urban to rural pediatric deaths of this nature.