Pediatric emergency care最新文献

{"title":"Letter to the Editor Regarding Comparison of Adenosine Administration Utilizing a Single-Syringe Versus a Double-Syringe Method in a Simulated Pediatric Patient; Authors Response.","authors":"Kelly E Steidl, Brianna Schafer, Jeni L Burgess, Vincent Calleo, Patrick Rose, Mark Su, Robert Seabury","doi":"10.1097/PEC.0000000000003556","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003556","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":"42 5","pages":"e82"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding Comparison of Adenosine Administration Utilizing a Single-Syringe Versus a Double-Syringe Method in a Simulated Pediatric Patient.","authors":"Ahmet Kağan Özkaya, Elif Nur İldeş","doi":"10.1097/PEC.0000000000003527","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003527","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":"42 5","pages":"e81"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weather-Related Exposures and Emergency Department Visits for Pediatric Sickle Cell Complications.","authors":"Frank Gonzalez, Matt Hall, Rima Habre, Jay G Berry, Yan Xu, Danica B Liberman, Pradip P Chaudhari","doi":"10.1097/PEC.0000000000003561","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003561","url":null,"abstract":"<p><strong>Objective: </strong>Sickle cell disease (SCD) is an inherited disorder that leads to significant morbidity from health complications beginning in childhood. Weather-related factors may influence the frequency of SCD complications, but evidence regarding the impact of weather changes in the pediatric population remains limited. Our objective was to determine the association between weather-related exposures and odds of emergency department (ED) visits for acute complications in youth with SCD.</p><p><strong>Methods: </strong>We conducted a retrospective case-crossover study of ED encounters among patients aged 0 to 21 years at 40 US children's hospitals (2015-2020). ED visits for vaso-occlusive crisis (VOC) and/or acute chest syndrome (ACS) were included. Patients were categorized as low-risk or high risk based on the number of ED visits in the preceding year. We constructed single-variable conditional logistic regression models to identify the odds of ED visit in association with weather-related exposures of temperature, heat index (HI), and wet bulb globe temperature (WBGT).</p><p><strong>Results: </strong>Among 48,885 ED encounters for VOC and ACS in high-risk patients, increases in temperature, HI, and WBGT on lag day 3 were associated with increased odds of ED visits for VOC. Increases in these variables were associated with decreased odds of ED visits for ACS. No significant associations were found for low-risk patients.</p><p><strong>Conclusions: </strong>Increased temperature, HI, and WBGT among high-risk pediatric patients with SCD were associated with increased odds of ED visit for VOC and decreased odds for ACS. As climate change progresses, further studies are needed to identify population, neighborhood, and patient-level environmental risk factors contributing to acute complications for patients with SCD.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":"42 5","pages":"367-374"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Based Prediction Model for Air Enema Failure in Pediatric Ileocolic Intussusception: Comparison of Point-of-Care Ultrasound and Radiologist-Performed Ultrasound.","authors":"Sung-Ha Kim, Jae-Hyun Kwon, So-Hyun Paek, Soo Hyun Park, Min-Jung Kim, Young-Hoon Byun, Ho-Young Song, Jin Hee Kim","doi":"10.1097/PEC.0000000000003554","DOIUrl":"10.1097/PEC.0000000000003554","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatric ileocolic intussusception often presents without classic symptoms, making early diagnosis and management challenging. While the enema reduction is the standard treatment, failed reduction may lead to surgical intervention. This study aimed to identify predictors of reduction failure focusing on ultrasonographic features, to develop a predictive model and to assess capabilities of point-of-care ultrasound (POCUS).</p><p><strong>Methods: </strong>We conducted a retrospective study at a pediatric emergency center from January 2020 to December 2024. Children who underwent air enema reduction for ileocolic intussusception were included. Univariable and multivariable logistic regression analyses were performed to identify predictors of reduction failure. A prediction model was constructed using ultrasound features and validated using a distinct cohort. Paired comparative analysis between POCUS and radiologist-performed ultrasound was performed.</p><p><strong>Results: </strong>Among 179 children, 35 experienced failure. Most of the demographic and symptom-based variables were not significantly associated with outcomes. Radiologist-performed US revealed that lymph nodes around the lesion, greater invagination length, hypoechoic ring thickness, and suspected low vascularity were associated with failure. A multivariable logistic regression model using 6 ultrasound features demonstrated good predictive performance. External validation with 58 patients yielded good predictive performance and 100% sensitivity. Comparative analysis showed that radiologists more frequently assessed long-axis views and vascularity, identifying risk features more comprehensively than pediatric emergency physicians.</p><p><strong>Conclusions: </strong>Ultrasound-based features are possibly more reliable predictors of enema reduction failure in pediatric emergency settings. Our validated model and comparative analysis highlight the importance of standardized ultrasound assessment and support the expanded role of POCUS.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"353-359"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Emergency Department Research Participation: The Influence of Study Design Across Race and Ethnicity.","authors":"Hayder Jaafar, Perry A Catlin, Adrienne P Davis, Adrianna Doucas, Alexis Visotcky, Holly Erpenbach, Danny Thomas","doi":"10.1097/PEC.0000000000003566","DOIUrl":"10.1097/PEC.0000000000003566","url":null,"abstract":"<p><strong>Objectives: </strong>The underrepresentation of racial and ethnic minorities in clinical research limits the generalizability of findings. This study examined how specific study design elements, such as follow-up requirements, stipends, and research procedures, were associated with participation refusal rates across racial and ethnic groups in a pediatric emergency department setting.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed recruitment outcomes from prospective studies conducted between 2012 and 2022 in a pediatric emergency department with approximately 70,000 annual visits. Studies requiring informed consent were included, excluding those targeting specific racial or ethnic groups. Demographic data were abstracted from the electronic health record using standard categories obtained by self-report during ED registration. Logistic regression assessed associations between study design elements and consent likelihood across racial and ethnic subgroups.</p><p><strong>Results: </strong>Among 14,500 encounters, the median age was 12 years; 14.0% identified as Hispanic, 41.6% as Black, 55.7% as White, and 2.0% as Asian. Recruitment was successful in 71.5% of cases, with a 25.4% refusal rate. Moderate enrollment procedure time (6 to 15 min) were associated with higher consent odds for all groups, while very short (<6 min) or prolonged durations (>30 min) were linked to lower consent odds. High stipends (>$135) were associated with reduced likelihood of consent across all groups. Requirements for biobanking and lab work were more likely to be linked with refusal among Black and Asian participants. Hispanic participants were more likely to consent to medication trials (OR: 1.74, P =0.003). Follow-up requirements were associated with lower consent odds among Hispanic and White participants, with a stronger association for Hispanic participants (OR: 0.39, P =0.002).</p><p><strong>Conclusions: </strong>Study design elements were significantly associated with recruitment outcomes, with notable variation across racial and ethnic groups. Transparent communication, culturally responsive engagement, and logistical flexibility may help reduce participation barriers and promote equity in pediatric clinical research.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"380-384"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Virtual Reality Technology on Pediatric Patients During Venous Access in the Emergency Department: A Meta-Analysis.","authors":"Ling Lin, Cui Zhu, Lili Liu","doi":"10.1097/PEC.0000000000003578","DOIUrl":"10.1097/PEC.0000000000003578","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the impact of virtual reality (VR) technology on pediatric patients during venous access in the emergency departments (EDs).</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) investigating the effects of VR technology on pediatric patients during venous access in the EDs were retrieved from databases including CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science, with the search period spanning from inception to July 2025. Data analysis was performed using RevMan 5.2 software.</p><p><strong>Results: </strong>A total of 8 RCTs involving 629 pediatric patients in the EDs were included. The analysis revealed that the VR technology group showed significantly better outcomes in pain scores compared with the control group (SMD=-0.73, 95% CI=-1.42 to -0.04, P =0.04). However, no significant differences were observed between the 2 groups in fear scores ( SMD =-0.94, 95% CI=-2.13 to 0.26, P =0.12) or first-attempt success rate (OR=1.01, 95% CI=0.60-1.72, P =0.96).</p><p><strong>Conclusion: </strong>VR technology may help alleviate pain in pediatric patients during venous access in the EDs, but no significant improvements were found in reducing fear or increasing the first-attempt success rate.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"400-406"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scene Time and Outcome in Pediatric Out-of-Hospital Cardiac Arrest: Findings From NEMSIS Data.","authors":"SunHee Chung, Ashley Blair, Steven Mcgaughey, Matt Hansen, Joshua Lupton, Amber L Lin","doi":"10.1097/PEC.0000000000003553","DOIUrl":"10.1097/PEC.0000000000003553","url":null,"abstract":"<p><strong>Background: </strong>Pediatric out-of-hospital cardiac arrest (P-OHCA) has a low incidence rate with a survival rate ranging from 2% to 11%. While national guidelines exist for P-OHCA management, they do not clearly address how long EMS providers should treat on-scene and when to initiate transportation.</p><p><strong>Objective: </strong>This study aims to explore the factors influencing scene time and its correlation with the return of spontaneous circulation (ROSC) in pediatric cases using the National Emergency Medical Services Information System (NEMSIS).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed NEMSIS data from 2019 to 2020. P-OHCA cases who received EMS treatment and were transported to the ED were included. We examined demographic and scene-related factors influencing EMS scene time and categorized interventions by scene time groups (<10, 10 to 30, >30 min). Using multivariable logistic regression, the study explored the relationship between scene time and ROSC, adjusting for various clinical and demographic predictors, and validated the model with calibration plots and sensitivity analyses.</p><p><strong>Results: </strong>A total of 8467 cardiac arrest cases met the inclusion criteria for analysis. The most common EMS scene time was 10 to 30 minutes, and longer scene times were significantly associated with ROSC. ROSC was more likely with older age, public or health care arrest locations, and defibrillation use, while airway interventions and medications were associated with lower odds of ROSC.</p><p><strong>Conclusion: </strong>We found that younger children had shorter EMS scene times, while those who achieved ROSC had longer scene times. Further investigation is needed to clarify the underlying factors and their impact on survival and neurological outcomes.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"360-366"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening Pediatric Trauma Patients for Blunt Cerebrovascular Injury Using the McGovern Score: A Retrospective Cohort Study.","authors":"Reyna G Osorio, Adam B Johnson, Lucas P Neff, Katherine M Riera, John K Petty, Daniel E Couture, Charlene L Kramer, Sidish S Venkataraman, Amit K Saha, Michael C McCrory","doi":"10.1097/PEC.0000000000003552","DOIUrl":"10.1097/PEC.0000000000003552","url":null,"abstract":"<p><strong>Background: </strong>Blunt cerebrovascular injury (BCVI), defined as an injury occurring to the carotid and/or vertebral arteries, occurs in ~1% of pediatric blunt trauma patients and is associated with morbidity and mortality. Our objective was to evaluate the sensitivity and specificity of the McGovern score, a pediatric-specific screening tool for BCVI, and describe the effect of its implementation on the use of additional imaging for BCVI and the detection of BCVI.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients below 16 years old presenting with blunt trauma to the Pediatric Emergency Department of a tertiary care level 1 pediatric trauma center pre- (July 1, 2020, to November 30, 2021) and post- (December 1, 2021, to December 31, 2022) implementation of McGovern scoring into the clinical decision algorithm for blunt trauma. Patient characteristics, diagnostic studies used [including computed tomography angiography (CTA) or magnetic resonance angiography (MRA) of the neck vessels], and outcomes (BCVI, stroke, mortality), were obtained from the medical record and compared pre-McGovern versus post-McGovern score implementation.</p><p><strong>Results: </strong>A total of 1189 patients were included in the study; 664 p reimplementation of the McGovern scoring and 525 postimplementation. Median age was 6 years (IQR 2 to 11), and 668 (56%) were trauma activations (leveled traumas), with no significant differences in patient characteristics between the 2 cohorts. Imaging for BCVI was performed in 13 (2.0%) patients in the preimplementation group and 27 (5.0%) patients in the postimplementation group ( P =0.003). BCVI was detected in 12/1189 patients overall (1.0%); 2 in the preimplementation group (0.3%), and 10 (1.9%) in the postimplementation group ( P =0.007). In the postimplementation group, the sensitivity of the McGovern score was 90% while the specificity was 96.7%.</p><p><strong>Conclusions: </strong>The implementation of the McGovern score into the pediatric trauma decision algorithm was associated with the detection of an increased number of BCVIs compared to the preimplementation group, with good sensitivity and specificity, but a significant increase in the use of imaging.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"346-352"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Years or Three? Rethinking the Ideal PEM Training Timeline.","authors":"Priya G Jain, Paria M Wilson, Aline A Baghdassarian, Jessica A Bailey, Derya Caglar, Joshua Nagler, Thuy L Ngo, Cindy Ganis Roskind, Melissa L Langhan","doi":"10.1097/PEC.0000000000003585","DOIUrl":"10.1097/PEC.0000000000003585","url":null,"abstract":"<p><p>Concerns about the pediatric subspecialty workforce and financial impacts of subspecialty training have prompted national conversations regarding the optimal duration of pediatric subspecialty training. It is unknown whether accrediting bodies will change duration of training, and if so, which data/influences/drivers will inform those decisions. This special feature, assembled by a national group of pediatric emergency medicine educational leaders, compares the current 3-year training model with a shortened 2-year training duration for pediatric emergency medicine fellows. We discuss the rationale and potential impacts of each of these models in regard to recruitment, clinical competency, scholarly activity, and career preparation for fellows in this subspecialty. A balanced look at aspects of each model can help guide the national conversation and serve as a starting point to explore experiences and perceptions of key stakeholders-trainees and program leadership-in an effort to better inform future decisions about subspecialty training.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"407-411"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Point-of-Care Lung Ultrasound in the Diagnosis of Pneumonia in Pediatric Patients.","authors":"Noah Marzook","doi":"10.1097/PEC.0000000000003533","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003533","url":null,"abstract":"<p><p>Traditional methods to evaluate for pediatric pneumonia include clinical examination and chest radiography (CXR). Point-of-care lung ultrasound (LUS) has emerged as a promising, noninvasive alternative for diagnosing pediatric pneumonia. This review highlights the diagnostic accuracy, benefits, and limitations of LUS compared with clinical assessment and CXR in pediatric patients with suspected pneumonia. Multiple meta-analyses demonstrate that LUS offers high sensitivity (up to 94%) and specificity (up to 96%) in diagnosing pediatric pneumonia, comparable to or exceeding CXR performance. LUS provides significant advantages, including no radiation, bedside applicability, and lower costs. However, challenges remain in standardizing LUS interpretation, particularly distinguishing bacterial pneumonia from viral illness and asthma, where overlapping ultrasound findings are common and require careful clinical correlation. Standardized protocols, clinician training, and diagnostic algorithms are essential to optimize LUS utility in pediatric respiratory care. Further research is warranted to refine differentiation between bacterial and viral etiologies and effectively integrate LUS into routine clinical pathways.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":"42 5","pages":"391-399"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}