Objective: To identify risk factors for clinically-important drowning-associated lung injury (ciDALI) in children.
Study Design: This was a cross-sectional study of children (0 through 18 years) who presented to 32 pediatric emergency departments (EDs) from 2010 through 2017. We reviewed demographics, comorbidities, prehospital data, chest radiographs reports, and ED course from emergency medical services, medical, and fatality records.
Objective: Pediatric injuries associated with participation in sports are common. Understanding the epidemiology and trends of sports-related injuries is an important component of injury prevention efforts and is the objective of this study.
Methods: A retrospective review of sports injuries presenting during the course of 1 year (2019) to the emergency department (ED) of Benjamin Russell Hospital for Children, a large academic children's hospital, was performed.
Background: To assist clinicians with identifying children at risk of severe outcomes, we assessed the association between laboratory findings and severe outcomes among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children and determined if SARS-CoV-2 test result status modified the associations.
Methods: We conducted a cross-sectional analysis of participants tested for SARS-CoV-2 infection in 41 pediatric emergency departments in 10 countries. Participants were hospitalized, had laboratory testing performed, and completed 14-day follow-up.
Background: The COVID-19 pandemic resulted in drastic decreases in volume for most pediatric emergency departments (ED). Injuries have persisted and there is concern that injuries may have increased during the pandemic. This study evaluates the impact of the COVID-19 pandemic on ED patient trends at a freestanding children's hospital.
View Article and Find Full Text PDFObjective: The aim of the study was to evaluate the ability of a combinatorial pharmacogenomic test to predict medication blood levels and relative clinical improvements in a selected pediatric population.
Methods: This study enrolled patients between ages 3 to 18 years who presented to a pediatric emergency department with acute psychiatric, behavioral, or mental health crisis and/or concerns, and had previously been prescribed psychotropic medications. Patients received combinatorial pharmacogenomic testing with medications categorized according to gene-drug interactions (GDIs); medications with a GDI were considered "incongruent," and medications without a GDI were considered "congruent.
Examining a child's tympanic membrane (TM) is challenging, but crucial for proper management of acute otitis media (AOM). CellScope Oto (CSO) is an attachment that turns a smartphone into an otoscope. We aimed to assess pediatric resident comfort level with ear exams using CSO to see whether comfort level and accuracy of diagnosis of AOM improved.
View Article and Find Full Text PDFObjective: Describe the clinical presentation, prevalence of concurrent serious bacterial infection (SBI), and outcomes among infants with omphalitis.
Methods: Within the Pediatric Emergency Medicine Collaborative Research Committee, 28 sites reviewed records of infants ≤90 days of age with omphalitis seen in the emergency department from January 1, 2008, to December 31, 2017. Demographic, clinical, laboratory, treatment, and outcome data were summarized.
Importance: Severe outcomes among youths with SARS-CoV-2 infections are poorly characterized.
Objective: To estimate the proportion of children with severe outcomes within 14 days of testing positive for SARS-CoV-2 in an emergency department (ED).
Design, Setting, And Participants: This prospective cohort study with 14-day follow-up enrolled participants between March 2020 and June 2021.
Objectives: Describe the clinical presentation, prevalence, and outcomes of concurrent serious bacterial infection (SBI) among infants with mastitis.
Methods: Within the Pediatric Emergency Medicine Collaborative Research Committee, 28 sites reviewed records of infants aged ≤90 days with mastitis who were seen in the emergency department between January 1, 2008, and December 31, 2017. Demographic, clinical, laboratory, treatment, and outcome data were summarized.
Objectives: Drowning is the leading cause of death for children ages 1 to 4, and it is among the leading causes of death for children of all ages. National data show disparities in drowning risk for certain racial groups. This study aimed to describe characteristics of patients presenting after a drowning event to guide focused drowning prevention outreach efforts.
View Article and Find Full Text PDFBackground: Belimumab, the first biologic approved for the treatment of systemic lupus erythematosus (SLE), has been shown to reduce autoantibody levels in people with SLE and help control disease activity.
Objectives: To assess the benefits and harms of belimumab (alone or in combination) in systematic lupus erythematosus.
Search Methods: An Information Specialist carried out the searches of CENTRAL, MEDLINE, Embase, CINAHL, Web of Science, the World Health Organization (WHO) International Clinical Trials Registry Platform, and clinicaltrials.
Background: During the past decade, all-terrain vehicle (ATV)-related injuries treated in US emergency departments decreased by 33%, down to approximately 100,000 injuries in 2016. In comparison, the number of children evaluated for ATV injuries in the Children's of Alabama emergency department more than doubled between 2006 and 2016, counter to the national trend. The American Academy of Pediatrics guidelines state that ATV operators should be at least 16 years old; however, children younger than 16 continue to represent almost one-third of all ATV-related injuries nationwide, and nearly all of the injuries to children in Alabama.
View Article and Find Full Text PDFObjective: Voting is one of our civic duties, yet many Americans do not vote, and physician voter participation is even lower than that of the general public. We aimed to explore pediatric residents' attitudes and behaviors in regard to voting and assess the impact of interventions aimed at increasing resident participation.
Methods: Pediatric residents were given preelection surveys regarding interest in voting, plans to vote in the November 2016 national election, and barriers to participation.
Objective: There is increasing evidence for the use of point-of-care ultrasound (POCUS) in pediatric patients with skin and soft tissue infections (SSTI), but there is a lack of sufficient data on its impact on SSTI outcomes. The objective of this study was to determine whether POCUS use is associated with fewer complications after discharge from the pediatric emergency department.
Methods: This was a prospective cohort study in patients presenting to the emergency department with SSTI between the ages of 2 months and 19 years old.
Context: Gummy formulations are widely available with estimated 65% marketed for children. Currently, there are few studies describing children ingesting gummy formulated medications. The aim of this study was to quantify and identify the type of ingestions due to gummy formulated medications, evaluate their clinical significance as defined by adverse outcomes: associated symptoms, emergency department (ED) visits, and hospitalizations.
View Article and Find Full Text PDFObjective: To evaluate the knowledge of obtaining travel histories in medical students and interns.
Methods: Medical students and interns participated in a high-fidelity pediatric simulation with two cases (malaria or typhoid fever) that hinged on travel history. After the simulation, appropriate methods of obtaining travel histories were discussed.
Background: The leading cause of death in children less than 19 years old is motor vehicle crashes (MVC). Non-use or improper use of motor vehicle car seats significantly adds to the morbidity and mortality. Emergency department (ED) encounters provide an opportunity for caregiver education.
View Article and Find Full Text PDFBackground: Safe medication storage is a proven barrier to ingestions in the pediatric population, but caregivers are often unaware of the importance of safe storage practices or do not have a safe place to store medications. Caregivers may also not be fully aware that the patterns of opioid use and misuse have recently reached crisis levels. The objectives of this study were to define medication storage practices and knowledge of the opioid crisis of participants and to assess the effectiveness of an emergency department intervention on safe medication storage.
View Article and Find Full Text PDFObjectives: With soaring US health care costs, identifying areas for reducing cost is prudent. Our objective was to identify the burden of potentially unnecessary pediatric emergency department (ED) transfers and factors associated with these transfers.
Methods: We performed a retrospective analysis of Pediatric Hospital Information Systems data.
Objectives: Interfacing with patients with sensory processing difficulties is challenging to healthcare providers and even more problematic for emergency medical services (EMS) personnel in the acute care setting. Sensory training may be an effective nonpharmacologic method to deal with these patient populations. The purpose of this study was to evaluate whether an educational session and placement sensory tools would improve the comfort of EMS providers in the prehospital setting.
View Article and Find Full Text PDFObjectives: Multiple case reports of lead toxicity related to retained bullet fragments in pediatric patients sustaining gunshot wound have been published. The purpose of the present study was to determine whether the demographic and clinical characteristics of gunshot wounds (GSWs) could be classified high/low risk and whether routine blood lead monitoring is necessary in these patients.
Methods: A single-center prospective case series of pediatric GSW patients presenting to the emergency department (ED).
Pediatr Emerg Care
December 2021
Objective: Accurate and consistent assessment of pain is essential in the pediatric emergency setting. Despite recommendations for formal assessment protocols, current data are lacking on pain assessment in pediatric emergency departments (EDs) and, specifically, whether appropriate tools are being used for different age groups. Our aim was to determine the status of pain assessment in US pediatric EDs.
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