Optimizing Care for Autistic Patients in Health Care Settings: A Scoping Review and Call to Action.

Objective: We conducted a scoping review of interventions designed to improve the health care experiences of autistic individuals and assessed the methodology and outcomes used to evaluate them.

Methods: Literature from January 2005 to October 2020 was searched using PubMed, Excerpta Medica dataBASE (EMBASE), Cumulated Index to Nursing and Allied Health Literature (CINAHL), PsycINFO as well as hand searching. Studies included described an intervention for autistic individuals in inpatient or outpatient settings and evaluated the intervention using standardized methodology.

A Qualitative Study of Resident Experiences With Clinical Event Debriefing.

Objectives: The facilitated discussion of events through clinical event debriefing (CED) can promote learning and wellbeing, but resident involvement is often limited. Although the graduate medical education field supports CED, interventions to promote resident involvement are limited by poor insight into how residents experience CED. The objective of this study was to characterize pediatric resident experiences with CED, with a specific focus on practice barriers and facilitators.

Management of Bleeding Pyogenic Granulomas in Acute Care Settings.

Background: Pyogenic granulomas are acquired, benign growths of capillary blood vessels that are commonly seen in the pediatric population. Patients with these lesions often present to emergency departments and urgent care centers with persistent bleeding after minor trauma. Much of the published literature describing the management of pyogenic granulomas, however, is focused on outpatient or definitive therapies, and there is limited information on the management of acute bleeding.

From the Frontlines: A Qualitative Study of Staff Experiences With Clinical Event Debriefing.

Objectives: Clinical event debriefing (CED) can improve patient care and outcomes, but little is known about CED across inpatient settings, and participant experiences have not been well described. In this qualitative study, we sought to characterize and compare staff experiences with CED in 2 hospital units, with a goal of generating recommendations for a hospital-wide debriefing program.

Methods: We conducted 32 semistructured interviews with clinical staff who attended a CED in the previous week.

Arterial Fat Embolism in a Pediatric Patient with Femur Fracture: A Case Report.

Case: Here, we present the case of a pediatric polytrauma patient found to have lower extremity intra-arterial fat embolism causing ischemic necrosis and ultimately necessitating below-the-knee amputation.

Conclusion: Fat embolism, a common complication of long bone fractures in adults, can be associated with significant morbidity. Although rare, it should be considered among the possible etiologies for a pulseless limb after trauma.

Healthcare utilization among children with early autism diagnoses, children with other developmental delays and a comparison group.

To describe healthcare utilization patterns among children with autism (n = 1821), and compare these patterns to children with other developmental delays (DD; n = 12,336) and a population comparison (PC; n = 18,210) cohort. Retrospective study of administrative billing data. Children with autism had roughly six-times more annual outpatient visits as PC children and twice as many as children with DD.

Symptomatic Persistent Fetal Ovarian Cysts.

Vomiting in young infants is a common presentation to the pediatric emergency department with a broad differential diagnosis. We present 2 cases seen in our emergency department of infant females with symptomatic complex ovarian cysts who presented with vomiting. The first case study describes a patient with a prenatally diagnosed ovarian cyst that was being followed with serial ultrasounds by general surgery.

Disparities in Care: Do Children with Autism Spectrum Disorder Experience Differential Medication Receipt In The Emergency Department?

Objective: The primary objective of this study was to describe analgesia administration between neurotypical (NT) individuals and those with autism spectrum disorder (ASD) diagnosed with appendicitis or long bone fractures in the emergency department (ED). A secondary objective was to compare the rates of complicated appendicitis as a proxy for delayed diagnosis between the groups.

Methods: This is a retrospective cohort study using the Pediatric Health Information System database.

The Implications of Brain MRI in Autism Spectrum Disorder.

Our objective was to describe the types of providers who refer children with autism spectrum disorder (ASD) for brain magnetic resonance imaging (MRI), the referral reason, and MRI results. The most common referral reasons were autism spectrum disorder with seizures (33.7%), autism spectrum disorder alone (26.

Pain Assessment of Children with Autism Spectrum Disorders.

Objective: Pain assessment of individuals with autism spectrum disorder (ASD) is largely unexplored. The core deficits of ASD may interfere with this population's ability to effectively use traditional pain assessment tools. Accurate pain assessment is essential to providing quality care.

Cervical lung herniation complicating a case of acute asphyxial asthma in a child.

The abrupt onset of respiratory failure secondary to asthma, known as acute asphyxial asthma (AAA) in adults, is uncommonly reported in children. Here, we report a case of a child with the acute onset of respiratory failure consistent with AAA complicated by the finding of a neck mass during resuscitation. This 11-year-old boy with a history of asthma initially presented in respiratory failure with altered mental status after the complaint of difficulty in breathing minutes before collapsing at home.

Parent and provider perspectives on procedural care for children with autism spectrum disorders.

Objective: Children with autism spectrum disorders (CWASDs) have more difficulty tolerating hospital procedures than many other children. The aim of this study was to identify parent and provider perspectives on barriers and facilitators to procedural care for CWASDs.

Methods: Semistructured interviews were conducted with medical staff and parents of CWASDs.

Group B streptococcal cellulitis in infancy.

Cellulitis in an infant younger than 3 months is most commonly caused by group B streptococci (GBS). A baby with cellulitis in this age group should have a full septic workup including blood and cerebrospinal fluid cultures, as GBS cellulitis may be associated with bacteremia. We discuss a 6-week-old baby with cellulitis and meningitis to illustrate the potential complexity of this infectious disease process.

Patterns of health care use that may identify young children who are at risk for maltreatment.

Objectives: Early identification of children who are at risk for maltreatment continues to pose a challenge to the medical community. The objective of this study was to determine whether children who are at risk for maltreatment have characteristic patterns of health care use before their diagnosis of abuse or neglect that distinguish them from other children.

Methods: We performed a case-control study among Medicaid-enrolled children to compare patterns of health service among maltreated children in the year before a first report for abuse or neglect that led to an immediate placement into foster care, with patterns of health service use among matched control subjects.

Traumatic diaphragmatic rupture in a pediatric patient: a case report.

Diaphragmatic rupture following blunt abdominal trauma is an uncommon life-threatening injury in children. In addition to its high mortality rate, there is a significant amount of morbidity associated with this injury. Emergency medicine physicians must maintain a high index of suspicion for diaphragmatic rupture and its associated complications when evaluating victims of blunt abdominal trauma.