Identification of children with a nondiagnostic ultrasound at a low appendicitis risk using a pediatric Appendicitis Risk Calculator.

Objectives: Up to 50% of ultrasounds (USs) for suspected pediatric appendicitis are nondiagnostic. While the validated low-risk clinical pediatric Appendicitis Risk Calculator (pARC) score < 15% and the low-risk US with nonvisualized appendix and no periappendiceal inflammation carry relatively low appendicitis risks, the contribution of the combination of both characteristics to this risk has never been assessed. The primary objective was to determine the proportion of children with the low-risk US-low-risk pARC combination with appendicitis.

Updates on the clinical integration of point-of-care ultrasound in pediatric emergency medicine.

Purpose Of Review: There is expanding evidence for point-of-care ultrasound (POCUS) use in pediatric emergency medicine - this review highlights the benefits and challenges in the clinical integration of high-yield POCUS applications. Specifically, it will delve into POCUS applications during resuscitations, controversies of Focused Assessment with Sonography for Trauma (FAST) in pediatric trauma, POCUS-guided procedures, and examples of clinical pathways where POCUS can expedite definitive care.

Recent Findings: POCUS can enhance diagnostic accuracy and aid in management of pediatric patients in shock and help identify reversible causes during cardiac arrest.

Diagnosis of Serious Conditions Delayed in Association with Ondansetron Treatment for Vomiting in the Pediatric Emergency Department.

Objectives: We evaluated the characteristics and sought risk factors for hospitalization in children who return to the emergency department within 7 days of discharge after oral or intravenous ondansetron treatment for vomiting. The secondary aim was to determine whether the diagnosis of any serious condition had been delayed as the result of discharge after ondansetron treatment.

Methods: This retrospective analysis of the medical records of children who had been treated for vomiting with ondansetron in a tertiary care pediatric emergency department and revisited the emergency department within 7 days was performed between 2017 and 2019.

C-Reactive Protein and the Outcome of a Pediatric Emergency Department 7 Days Revisit.

Background: Pediatric emergency department (PED) return visits represent an important quality of care metric and constitute a patient-centered outcome. C-reactive protein (CRP) is an inflammatory biomarker that is commonly used as screening tool in the PED. In this study, we assessed the clinical outcomes of children whose levels of CRP are 150 mg/L or higher at the initial PED visit and if such levels could be useful in predicting outcomes at a second PED visit.

The Outcome of Cerumen Removal in the Pediatric Emergency Department.

Objective: Cerumen obstructs the visualization of the tympanic membrane (TM) in up to 40% of children, sometimes posing a challenge to rule out the diagnosis of acute otitis media (AOM) as the source of otalgia (for verbal children), irritability, fever, and febrile seizures. We aim to determine the rate at which removing the cerumen from blocking the view of the TM could change the management of these patients in the pediatric emergency department (PED).

Methods: We retrospectively investigated all medical records of patients who underwent cerumen removal in the PED at a tertiary children's hospital from 2018 to 2019.

Impact of Maternal Anxiety on Human Milk Macronutrients Content: A Prospective Observational Study.

The impact of maternal anxiety on the macronutrients content of human milk (HM) is unknown. We hypothesized that maternal stress generated by her infant's hospitalization will affect the mother's breast milk's macronutrients content. HM samples (2-3 mL) were collected from 21 mothers whose infants were hospitalized for 2-3 days between August 2016 and November 2017 due to neonatal fever.