Lung ultrasound in the neonatal intensive care unit: Review of the literature and future perspectives.

Lung ultrasound (LU) has been increasingly used as a point-of-care method in recent years. LU has numerous advantages compared to traditional imaging tools such as chest X-ray (radiography) (CXR): it is faster and portable, does not use ionizing radiation, is performed by the same physician who cares for the patient, and can be repeated to follow the progress of the disease and the response to treatment. There is a large body of evidence that LU has an excellent diagnostic effectiveness compared to CXR, not only in adults and children, but also in neonates.

Accuracy of presepsin in neonatal sepsis: systematic review and meta-analysis.

Neonatal sepsis represents a major cause of morbidity and mortality in neonates. No diagnostic test has been demonstrated to be sufficiently accurate to confirm or exclude neonatal sepsis. This study aimed to evaluate the diagnostic accuracy of presepsin (P-SEP) for neonatal sepsis.

Sudden Diplopia at a Pediatric Emergency Department: A Case of Gradenigo Syndrome in a Child.

Objective: Otitis media, facial pain in trigeminal region, and ipsilateral abducens nerve palsy clinically define Gradenigo syndrome, a rare but serious complication of suppurative middle ear infection. Radiological investigation is required to confirm petrous apex involvement and to exclude further consequences as sinus thrombosis, meningitis, and intracranial abscess.

Methods/results: We report the case of an 8-year-old child referred to our emergency department for recurrent headache and sudden strabismus.

Lung ultrasound findings in congenital diaphragmatic hernia.

Congenital diaphragmatic hernia (CDH) occurs in approximately 1 in 2500 to 5000 infants. The use of lung ultrasound (LUS) for its diagnosis has been reported in only two case reports. The aim of this study was to report the LUS pattern of CDH in a case series of infants with respiratory distress.

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates.

Background: Respiratory distress (RD) is the most common neonatal illness. Lung ultrasound (LUS) is a technique previously tested in neonatal studies on RD, but literature regarding its routine clinical applicability is still lacking.

Objective: To assess the concordance between LUS performed by neonatologists with different training levels and chest X-ray (CXR) for the diagnosis of RD in newborns during the first 24 h of life.

Point-of-Care Ultrasound Diagnosis of Retinoblastoma in the Emergency Department.

An 18-month-old girl presented to the emergency department with the chief complaint of squinting. The right eye demonstrated esotropia, heterochromia, and anisocoria. Ocular point-of-care ultrasound facilitated the rapid diagnosis of retinoblastoma, which was confirmed by computed tomography scan and orbital magnetic resonance imaging.

Patients at High Risk of Intervention for Pediatric Traumatic Liver Injury.

Objectives: Nonoperative management of hemodynamically stable liver lacerations in pediatric trauma patients is a safe and effective management strategy for pediatric patients; approximately 90% will be successfully managed nonoperatively. No study has specifically identified risk criteria for the need for intervention versus observation alone. Our objective for this study was to determine risk factors from the physical examination, computed tomography scan, and laboratory results associated with intervention for liver laceration.

Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries.

: Provision of psychosocial care, in particular trauma-informed care, in the immediate aftermath of paediatric injury is a recommended strategy to minimize the risk of paediatric medical traumatic stress. : To examine the knowledge of paediatric medical traumatic stress and perspectives on providing trauma-informed care among emergency staff working in low- and middle-income countries (LMICs). : Training status, knowledge of paediatric medical traumatic stress, attitudes towards incorporating psychosocial care and barriers experienced were assessed using an online self-report questionnaire.

Prescription Drug Shortages: Implications for Ambulatory Pediatrics.

Objective: To describe contemporary drug shortages affecting general ambulatory pediatrics.

Study Design: Data from January 2001 to December 2015 were obtained from the University of Utah Drug Information Service. Two pediatricians reviewed drug shortages and identified agents used in ambulatory pediatrics.

Point-of-Care Ultrasound for the Diagnosis of Skull Fractures in Children Younger Than Two Years of Age.

Objectives: To determine the accuracy of skull point-of-care ultrasound (POCUS) for identifying fractures in children younger than 2 years of age with signs of head trauma, and the ability of POCUS to identify the type and depth of fracture depression.

Study Design: This was a multicenter, prospective, observational study of children younger than 2 years of age with nontrivial mechanisms of injury and signs of scalp/skull trauma. Patients were enrolled if they underwent computed tomography (CT).

Italian guidelines on the assessment and management of pediatric head injury in the emergency department.

Objective: We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury.

Methods: These guidelines were commissioned by the Italian Society of Pediatric Emergency Medicine and include a systematic review and analysis of the literature published since 2005. Physicians with expertise and experience in the fields of pediatrics, pediatric emergency medicine, pediatric intensive care, neurosurgery and neuroradiology, as well as an experienced pediatric nurse and a parent representative were the components of the guidelines working group.

Perspectives of hospital emergency department staff on trauma-informed care for injured children: An Australian and New Zealand analysis.

Aim: To examine Australian and New Zealand emergency department (ED) staff's training, knowledge and confidence regarding trauma-informed care for children after trauma, and barriers to implementation.

Methods: ED staff's perspectives on trauma-informed care were assessed using a web-based self-report questionnaire. Participants included 468 ED staff (375 nursing and 111 medical staff) from hospitals in Australia and New Zealand.

Traumatic diaphragmatic rupture in pediatric age: review of the literature.

Purpose: Traumatic diaphragm rupture (TDR) is a rare complication of trauma in pediatric age and may be easily missed by the severity of associated injuries so that delayed emergent presentation can occur with increased rate of morbidity and mortality. No review has been available to guide clinicians through the pitfalls and the initial diagnostic approach to pediatric TDR.

Methods: A Medline thorough search on TDR was conducted using different queries.

Psychosocial Care for Injured Children: Worldwide Survey among Hospital Emergency Department Staff.

Objective: To examine emergency department (ED) staff's knowledge of traumatic stress in children, attitudes toward providing psychosocial care, and confidence in doing so, and also to examine differences in these outcomes according to demographic, professional, and organizational characteristics, and training preferences.

Study Design: We conducted an online survey among staff in ED and equivalent hospital departments, based on the Psychological First Aid and Distress-Emotional Support-Family protocols. Main analyses involved descriptive statistics and multiple regressions.

Cephalic Tetanus in an Immunized Teenager: An Unusual Case Report.

Tetanus is a rare disease in developed countries but is prevalent worldwide. It has significant morbidity and mortality. The causative agent Clostridium tetani is ubiquitous in nature.

Mobile and web-based education: delivering emergency department discharge and aftercare instructions.

Prior research has identified deficiencies in the standard process of providing instructions for care at discharge from the emergency department (ED). Patients typically receive a brief verbal instruction, along with preformatted written discharge documents. Studies have found that understanding and retention of such information by families are very poor, leading to nonadherence in follow-up care, unnecessary return visit to the ED, and poor health outcomes.

Intravenous magnesium for pediatric sickle cell vaso-occlusive crisis: methodological issues of a randomized controlled trial.

Multiple recent Sickle Cell Disease studies have been terminated due to poor enrollment. We developed methods to overcome past barriers and utilized these to study the efficacy and safety of intravenous magnesium for vaso-occlusive crisis (VOC). We describe the methods of the Intravenous Magnesium in Sickle Vaso-occlusive Crisis (MAGiC) trial and discuss methods used to overcome past barriers.

Chest compression quality over time in pediatric resuscitations.

Background: Chest compression (CC) quality deteriorates with time in adults, possibly because of rescuer fatigue. Little data exist on compression quality in children or on work done to perform compressions in general. We hypothesized that compression quality, work, and rescuer fatigue would differ in child versus adult manikin models.

Flexibility in faculty work-life policies at medical schools in the Big Ten conference.

Purpose: Women lag behind men in several key academic indicators, such as advancement, retention, and securing leadership positions. Although reasons for these disparities are multifactorial, policies that do not support work-life integration contribute to the problem. The objective of this descriptive study was to compare the faculty work-life policies among medical schools in the Big Ten conference.

Family presence during trauma activations and medical resuscitations in a pediatric emergency department: an evidence-based practice project.

Introduction: The existing family presence literature indicates that implementation of a family presence policy can result in positive outcomes. The purpose of our evidence-based practice project was to evaluate a family presence intervention using the 6 A's of the evidence cycle (ask, acquire, appraise, apply, analyze, and adopt/adapt). For step 1 (ask), we propose the following question: Is it feasible to implement a family presence intervention during trauma team activations and medical resuscitations in a pediatric emergency department using national guidelines to ensure appropriate family member behavior and uninterrupted patient care?

Methods: Regarding steps 2 through 4 (acquire, appraise, and apply), our demonstration project was conducted in a pediatric emergency department during the implementation of a new family presence policy.