Point of Care Ultrasound Identification of Multiple Rib Fractures in a Pediatric Patient with Osteogenesis Imperfecta Type 3.

Patients with osteogenesis imperfecta (OI) are at an increased risk of pathological rib fractures even if there is no history of trauma. Early and accurate identification of such fractures are crucial for appropriate management. We present a case of a child with OI type 3 with multiple rib fractures who presented with transient cyanosis and increased work of breathing without a history of significant trauma.

Neonatal presentations to the paediatric emergency department in Singapore.

Introduction: This study aimed to characterise neonatal paediatric emergency department (PED) visits, analyse the main paediatric illnesses and establish associations of these demographics with the readmission rates and severity of their presentation.

Methods: A retrospective analysis of neonates (aged <28 days) presenting to the PEDs of our hospital over seven months was performed. Associations between the clinical and demographic data of admissions to the PED and inpatient admissions were analysed.

Point-of-Care Ultrasound Identification of Portal Vein Thrombosis in a Pediatric Patient.

Abdominal pain is one of the most common presenting complaints encountered in the pediatric emergency department. The use of point-of-care ultrasonography by emergency physicians has been shown to expedite the diagnosis of a large variety of conditions and can be used to accurately identify intra-abdominal pathology in children. We describe the case of a pediatric patient who presented to the pediatric emergency department with acute abdominal pain, in whom point-of-care ultrasonography helped expedite the diagnosis of acute portal vein thrombosis and liver abscess.

Associations of initial haemodynamic profiles and neurological outcomes in children with traumatic brain injury: a secondary analysis.

Introduction: Initial low systolic blood pressure (SBP) in paediatric traumatic brain injury (TBI) is associated with mortality. There is limited literature on how other haemodynamic parameters including heart rate (HR); diastolic blood pressure (DBP); mean arterial pressure (MAP); and shock index, paediatric age-adjusted (SIPA) affect not only mortality but also long-term neurological outcomes in paediatric TBI. We aimed to analyse the associations of these haemodynamic variables (HR, SBP, MAP, DBP and SIPA) with mortality and long-term neurological outcomes in isolated moderate-to-severe paediatric TBI.

Pediatric Abdominal Tuberculosis With Calcified Intra-abdominal Lymph Nodes Identified by Point-of-Care Ultrasound.

Background: Tuberculosis of the abdomen is one of the most common extrapulmonary manifestations of tuberculosis. Even in areas where tuberculosis is endemic, intra-abdominal tuberculous can pose a diagnostic and management challenge because of the lack of presence of overt clinical signs and availability of expertise for point of care diagnostics. Point-of-care ultrasound (POCUS) of the abdomen performed by emergency physicians is increasingly being used for a variety of clinical presentations to facilitate accurate diagnoses in the emergency department.

Point-of-care ultrasound for evaluating intra-abdominal calcification in the pediatric emergency department: case series and review of literature.

Background: The presence of intra-abdominal calcification in the pediatric population can be due to a wide range of conditions. Calcification in the abdomen can be seen in normal or abnormal anatomical structures. In some patients, abnormal calcification points towards the pathology; whereas in others, calcification itself is the pathology.

Point-of-Care Ultrasound for Evaluating Lymphadenopathy in the Pediatric Emergency Department: Case Series and Review of Literature.

Background: Children present to the pediatric emergency department (ED) with enlarged lymph nodes due to a broad spectrum of conditions ranging from benign causes like reactive lymph nodes to adverse conditions like malignancy. Identifying sonographic features typical of infection, inflammation, and neoplasms will help assist clinicians in deciding the disposition of the patients from the ED. Point-of-care ultrasound has become an essential adjunct for diagnostic assessment in pediatric emergency medicine.

Early coagulopathy in children with isolated blunt head injury is associated with mortality and poor neurological outcomes.

Objective: Traumatic brain injury (TBI) is the leading cause of long-term disability and death in children and adolescents globally. Long-term adverse outcomes, including physical, cognitive, and behavioral sequelae, have been reported after TBI in a significant number of pediatric patients. In this study the authors sought to investigate the epidemiology of TBI-associated coagulopathy and its association with mortality and poor neurological outcome in a pediatric population with isolated moderate to severe blunt head injury treated at the authors' institution.

Lateral Condyle Fracture of the Humerus Among Children Attending a Pediatric Emergency Department: A 10-Year Single-Center Experience.

Background: The lateral humeral condyle fractures in children accounts for one fifth of all elbow fractures. These fractures have a propensity to displace because of the pull of the extensor muscles on the condyle.

Objectives: The aim of this study was to examine the epidemiology, injury patterns, complications, and predictors for conservative/surgical management in patients with lateral condyle humeral fractures between 0 and 18 years of age.

A retrospective review of trampoline-related injuries presenting to a paediatric emergency department in Singapore.

Introduction: Trampolining is a popular activity. However, to our knowledge, no studies on paediatric trampoline-related injuries (TRIs) have been conducted in Asia. We aimed to provide an Asian perspective on paediatric TRIs and evaluate current safety measures.

Bicycle injuries among the paediatric population at an emergency department in Singapore.

Introduction: Bicycles injuries are the leading cause of emergency department visits among all recreational activities and have been established as a significant worldwide public health burden. The purpose of this retrospective study was to describe the epidemiology and patterns of paediatric bicycle-related injuries in Singapore.

Methods: This was a single-centre retrospective study based on data collected from a trauma registry between 2011 and 2016.

A Homemade, High-fidelity Ultrasound Model for Simulating Pneumonia with Parapneumonic Effusion and Empyema.

Background: Point-of-care ultrasonography (POCUS) is increasingly used for both diagnostic and guided procedures. Increasingly, POCUS has been used for identification of pneumonia and to assist in the differentiation of pleural effusions, as well as to guide thoracentesis. As such, there is a need for training with ideally high-fidelity lung ultrasound phantoms to ensure ultrasound proficiency and procedural competency.

Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children.

Coins are the most common ingested metallic foreign bodies among children. The goal of this protocol is to assess the accuracy and feasibility of using a handheld metal detector to detect ingested metallic foreign bodies in children. We propose that by introducing handheld metal detector screening early in the triage process of children with high suspicion of metallic foreign body ingestion, the number of radiographs being ordered to localize the metallic foreign body can be reduced in this radio-sensitive population.

Elevated Optic Disc Height and Increased Optic Nerve Sheath Diameter on Bedside Ultrasound in a Pediatric Patient With Orbital Cellulitis: More Than Meets the Eye.

Background: Orbital cellulitis is an uncommon ophthalmological emergency in children, but rapid emergency department (ED) diagnosis is essential.

Case Report: A 13-year-old boy presented to our pediatric ED with left orbital cellulitis secondary to pansinusitis. Emergency bedside ocular ultrasonography was used to evaluate and expedite his management.

Urachal Cyst Diagnosed by Point-of-care Ultrasound.

Irreducible umbilical swelling in infants is considered a surgical emergency because a delay in surgical intervention for an incarcerated umbilical hernia can lead to bowel ischemia and necrosis. We report two patients who presented to a pediatric emergency department with history and symptoms of irreducible umbilical mass suggestive of umbilical hernia. Point-of-care ultrasound was used at the bedside to demonstrate the presence of urachal cyst remnants and accurately guided the care of these children.