Importance: A simple, reliable tool for rapid estimation of weight in children would be useful in limited-resource settings where current weight estimation tools are not reliable, nearly all global under-five mortality occurs, severe acute malnutrition is a significant contributor in approximately one-third of under-five mortality, and a weight scale may not be immediately available to healthcare professionals including first-response providers.
Objective: To test the accuracy and precision of an existing weight estimation tool based on patient height and mid-upper arm circumference (MUAC) in children between six months and five years of age in low-to-middle income countries.
Design: Data were collected in 2,434 nutritional surveys during 1992-2017 using a modified Expanded Program of Immunization two-stage cluster design.
J Pediatr Intensive Care
March 2017
Of the estimated 6.3 million global annual deaths in children younger than the age of 5 years, nearly all (99%) occur in low- to middle-income countries (LMIC). Existing management guidelines for children with emergency conditions as taught in a variety of current pediatric life support courses are mostly applicable to high-income countries with a different disease range and full resources compared with LMIC.
View Article and Find Full Text PDFImportance: A simple, reliable anthropometric tool for rapid estimation of weight in children would be useful in limited-resource settings where current weight estimation tools are not uniformly reliable, nearly all global under-five mortality occurs, severe acute malnutrition is a significant contributor in approximately one-third of under-five mortality, and a weight scale may not be immediately available in emergencies to first-response providers.
Objective: To determine the accuracy and precision of mid-upper arm circumference (MUAC) and height as weight estimation tools in children under five years of age in low-to-middle income countries.
Design: This was a retrospective observational study.
Background: Worldwide, 6.6 million children die each year, partly due to a failure to recognize and treat acutely ill children. Programs that improve provider recognition and treatment initiation may improve child survival.
View Article and Find Full Text PDFNearly all global mortality in children younger than 5 years (99%) occurs in developing countries. The leading causes of mortality in children younger than 5 years worldwide, pneumonia and diarrhoeal illness, account for 1·396 and 0·801 million annual deaths, respectively. Although important advances in prevention are being made, advanced life support management in children in developing countries is often incomplete because of limited resources.
View Article and Find Full Text PDFThe ideal first response to a life-threatening pediatric emergency includes early recognition of the emergency, activation of the appropriate emergency response system, performance of basic life support (cardiopulmonary resuscitation/automated external defibrillator treatment), and initiation of advanced life support, but the extent of resuscitation training among health care providers likely to be first at the side of a critically ill or injured child is often deficient. In the past, resuscitation courses beyond basic life support focused on training advanced providers. The Pediatric Emergency Assessment, Recognition, and Stabilization course was developed by the American Heart Association to target a broad range of health care providers who are likely to be first at the side of a child requiring resuscitation.
View Article and Find Full Text PDFPediatric toxicologic exposures are common, and the primary care pediatric practitioner must be prepared to handle emergencies related to poisoning and overdose in children and adolescents. Fortunately, many poisonings in children are unintentional, preventable, and benign. For both simple and complex cases, help is available to medical professionals 24/7 from multiple sources, including an improved toxic exposure database, new research, the network of Certified Specialists in Poison Information at our nation's regional poison control centers, and backup medical and clinical toxicologists.
View Article and Find Full Text PDFOur study compared levalbuterol (LEV) to the combination of racemic albuterol (RAC) and ipratropium bromide (IB) in 140 patients aged 6-18 years presenting to a tertiary hospital Emergency Department with acute asthma and a peak expired flow rate (PEF)<80% predicted. Patients were randomized to: LEV (
Physiologic anterior subluxation is a phenomenon that is common to the upper pediatric cervical spine and characterized by the normal forward displacement of one cervical vertebra relative to the subjacent one. Physiologic anterior subluxation can be seen in children in the setting of trauma, when it must be distinguished from pathologic subluxation. Physiologic anterior subluxation has not been reported at lower cervical spinal levels (C 5 to C 6 or C 6 to C 7 ).
View Article and Find Full Text PDFObjective: To determine the usefulness of oblique cervical spine radiography (OCSR) in the management of children who have sustained blunt cervical spine injury, particularly if OCSR is abnormal when no acute abnormalities are shown on standard cervical spine radiography (SCSR).
Methods: We carried out a blinded radiographic review of 109 patients younger than 16 years evaluated at an academic pediatric trauma center and a community hospital between July 1990 and December 1997. All patients had SCSR (anteroposterior/lateral views) and OCSR performed for a trauma-related event within 7 days of injury.