Childhood Respiratory Illnesses Before and After COVID-19 Pandemic Restrictions.

Introduction With the COVID-19 pandemic, multiple studies described a significant drop in common respiratory viruses in children with the lockdown and restrictions. With the lifting of pandemic precautions, we had the ability to observe new patterns of respiratory illnesses in children and emergency department visits. Materials and methods We studied all respiratory nucleic acid amplification test results in emergency patients from a large metropolitan children's hospital from the years 2018 to 2023.

Outcomes of Patients With Negative Cervical Imaging but Persistent Neck Tenderness Discharged With a Rigid Collar After Trauma.

Introduction It is not uncommon for patients with persistent neck pain after trauma despite negative cervical imaging to be discharged with a rigid collar. Protocols for these patients vary widely. Few studies have evaluated clinical outcomes after discharge.

COVID-19 Restrictions Are Associated With a Significant Decrease of All Common Respiratory Viral Illnesses in Children.

To combat the spread of coronavirus disease 2019 (COVID-19), significant measures were enacted including school and business closures, social distancing, and facial coverings. We hypothesized that this would have an impact on all respiratory infections in children. Using nasopharyngeal panel test results of children in the emergency department, we evaluated cross-sectional data from February to May in both 2019 and 2020.

Recreational Drone-Related Injuries in Children: A Review of National Electronic Injury Surveillance System (NEISS) Data.

Introduction Drones are unmanned aerial vehicles controlled by a person on the ground, used for recreational purposes. The purpose of the study is to describe characteristics and patterns of injuries reported in children from recreational drones. Methods We extracted data from the National Electronic Injury Surveillance System involving (NEISS) over a period of 10 years from 2010 to 2019 regarding injuries to children for ages zero up to 18 years.

A Comparison of Diagnostic Accuracy of a Rapid Antigen Detection Test in Screening for Group A Streptococcal Throat Infection Between 3- to 10-Year-Old (Children and Preadolescents) and 11- to 21-Year-Old (Adolescents).

Introduction Pharyngitis is one of the most common childhood diseases worldwide. We intended to compare the performance of one such rapid antigen detection test (RADT) using lateral flow immunoassay technique, between 3- to 10-year-old (children and preadolescent) and 11- to 21-year-old (adolescents). Methods Children and adolescents attending the pediatric ED with complaints of throat pain and signs of pharyngeal and tonsillar inflammation were tested by both the RADT and throat culture (TC) directed towards group A streptococcal (GAS) between April and June of 2016.

Young children with psychiatric complaints in the pediatric emergency department.

Introduction: Children are increasingly diagnosed with mental illnesses and self-harm behaviors. They present frequently to the emergency department (ED) for evaluation. The aim of this study is to describe the youngest children in the ED with psychiatric issues.

Nonaxial Traction Mechanisms of Nursemaid's Elbow.

Objective: This study aims to better describe those patients who present with nonaxial traction mechanisms for nursemaid's elbow.

Methods: A retrospective review on patients with the International Statistical Classification of Diseases, Ninth/Tenth Revision, code for nursemaid's elbow was performed. Patients with the classic axial traction mechanism and unknown mechanism were excluded.

Pancreatitis in pre-adolescent children: a 10 year experience in the pediatric emergency department.

Background: The diagnosis of pediatric pancreatitis has been increasing over the last 15 years but the etiology of this is uncertain. The population of pre-adolescent patients with pancreatitis in the emergency department has not been specifically described. Our objective was to determine the characteristics of these patients to illuminate this population and disease in order to better identify them and avoid a delay in diagnosis and treatment.

Replacement of Dislodged Gastrostomy Tubes After Stoma Dilation in the Pediatric Emergency Department.

Introduction: A dislodged gastrostomy tube (GT) is a common complaint that requires evaluation in the pediatric emergency department (ED) and, on occasion, will require stoma dilation to successfully replace the GT. The objective of this study was to describe the frequency that stoma dilation is required, the success rate of replacement, complications encountered, and the techniques used to confirm placement of the GT after dilation.

Methods: We conducted a retrospective medical record review of children 0-18 years who presented to the pediatric ED from February 2013 through February 2015 with a dislodged GT that required stoma dilation by pediatric emergency physicians with serially increasing Foley catheter sizes prior to successful placement of the GT.

Effect of Educational Debt on Emergency Medicine Residents: A Qualitative Study Using Individual Interviews.

Study Objective: In 2001, less than 20% of emergency medicine residents had more than $150,000 of educational debt. Our emergency medicine residents anecdotally reported much larger debt loads. Surveys have reported that debt affects career and life choices.

Pediatric acute osteomyelitis in the postvaccine, methicillin-resistant Staphylococcus aureus era.

Objective: We sought to describe the causative organisms, bones involved, and complications in cases of pediatric osteomyelitis in the postvaccine age and in the era of increasing infection with community-associated methicillin-resistant Staphylococcus aureus (MRSA).

Methods: We reviewed the medical records of children 12 years and younger presenting to our pediatric emergency department between January 1, 2003, and December 31, 2012, with the diagnosis of osteomyelitis. We reviewed operative cultures, blood cultures, and imaging studies.

Comparison of the finger counting method, the Broselow tape and common weight estimation formulae in Filipino children after Typhoon Haiyan.

Objectives: We sought to evaluate commonly used paediatric weight estimation techniques in a sample of children in the Philippines.

Methods: We prospectively collected age, height and weight data for a sample of 207 children aged 1-9 years seen during a medical aid trip. Weights were estimated using the finger counting method, the Broselow method and four formulae.

Pediatric procedural sedation with propofol using a higher initial bolus dose.

Objectives: We sought to describe the doses of propofol used for sedation in our pediatric emergency department, along with the range of procedures performed under propofol sedation. We also planned to describe clinically important physiologic changes seen and physician satisfaction with propofol at the doses observed.

Methods: This was a prospective observational case series.

Finger counting: an alternative method for estimating pediatric weights.

Objectives: We compared the accuracy of a conceptually simple pediatric weight estimation technique, the finger counting method, with other commonly used methods.

Methods: We prospectively collected cross-sectional data on a convenience sample of 207 children aged 1 to 9 presenting to our pediatric emergency department. Bland-Altman plots were constructed to compare the finger counting method to the Broselow tape method, parental estimate, the Luscombe formula, and the advanced pediatric life support (APLS) formula.

Changes in community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections presenting to the pediatric emergency department: comparing 2003 to 2008.

Objectives: This study aimed to compare the differences in the type and location of skin infections, organisms cultured, and antibiotic resistance patterns presenting to the same pediatric emergency department from 2003 to 2008 with specific focus on community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections.

Methods: We performed a retrospective chart review of children younger than 18 years who presented to the pediatric emergency department with a skin or soft tissue infection from January 1 to December 31, 2008, and compared these data to a similar data set collected at the same institution from January 1 to December 31, 2003.

Results: From 2003 to 2008, the proportion of abscesses among all skin or soft tissue infections increased from 14% (95% confidence interval [CI], 8.

Bilious vomiting does not rule out infantile hypertrophic pyloric stenosis.

Objective: To describe the incidence of bilious vomiting in infants with infantile hypertrophic pyloric stenosis that presented to a pediatric emergency department.

Methods: A retrospective medical record review included all infants who presented to our level 1 pediatric emergency department from January 1, 2005, through December 31, 2009, who were diagnosed intraoperatively with infantile hypertrophic pyloric stenosis. Emesis was determined to be bilious if the vomit was described as "green," "containing bile," or "bilious.

Test characteristics of urinalysis to predict urologic injury in children.

Objective: To use receiver operator characteristic curve methodology to determine the test characteristics of microscopic hematuria for identifying urologic injuries in children who underwent computed tomography (CT) of the abdomen and pelvis as part of a trauma evaluation.

Methods: We performed a retrospective medical record review of all children from 0 to 12 years of age who presented to our pediatric emergency department within a Level 1 trauma center, had an abdominal and pelvic CT and a microscopic urinalysis as part of an initial evaluation for trauma. Urologic injury was defined as any injury to the kidneys, ureters or bladder.

Esophageal coin removal by emergency physicians: a continuous quality improvement project incorporating rapid sequence intubation.

Objective: The objective of this study was to describe our experience removing esophageal coins from children in a tertiary care pediatric emergency department over a 4-year period.

Methods: We retrospectively reviewed a continuous quality improvement data set spanning October 1, 2004, through September 30, 2008.

Results: In 96 of 101 cases (95%), emergency physicians successfully retrieved the coin.

Etiology of septic arthritis in children: an update for the new millennium.

Objective: We sought to describe the causative organisms and joints involved in cases of pediatric septic arthritis in the post-Haemophilus influenzae type B and post-pneumococcal vaccine age and in the age of increasing infection with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).

Methods: This was a retrospective chart review of all children younger than 13 years presenting to our tertiary care pediatric emergency department between January 1, 2003, and December 31, 2007, with the diagnosis of septic arthritis. We reviewed the results of synovial fluid Gram stain and synovial fluid and blood culture.

Predictors of emesis and recovery agitation with emergency department ketamine sedation: an individual-patient data meta-analysis of 8,282 children.

Study Objective: Ketamine is widely used in emergency departments (EDs) to facilitate painful procedures; however, existing descriptors of predictors of emesis and recovery agitation are derived from relatively small studies.

Methods: We pooled individual-patient data from 32 ED studies and performed multiple logistic regression to determine which clinical variables would predict emesis and recovery agitation. The first phase of this study similarly identified predictors of airway and respiratory adverse events.

Predictors of airway and respiratory adverse events with ketamine sedation in the emergency department: an individual-patient data meta-analysis of 8,282 children.

Study Objective: Although ketamine is one of the most commonly used sedatives to facilitate painful procedures for children in the emergency department (ED), existing studies have not been large enough to identify clinical factors that are predictive of uncommon airway and respiratory adverse events.

Methods: We pooled individual-patient data from 32 ED studies and performed multiple logistic regressions to determine which clinical variables would predict airway and respiratory adverse events.

Results: In 8,282 pediatric ketamine sedations, the overall incidence of airway and respiratory adverse events was 3.

Ketamine-associated vomiting: is it dose-related?

Objective: Vomiting is a common adverse event after emergency department ketamine sedation in children. We sought to determine if the rate of vomiting is dose related to intravenous ketamine.

Methods: Treating physicians administered intravenous ketamine to children requiring sedation for a procedure in a pediatric emergency department using doses of their discretion in this prospective observational study.