Pediatric emergency care最新文献

{"title":"Reply: Short-term outpatient parenteral antimicrobial therapy administration in the pediatric emergency department.","authors":"Syed Amir Ahmad","doi":"10.1097/PEC.0000000000003374","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003374","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692858","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: \"Short - term Outpatient Parenteral Antimicrobial Therapy Administration in the Pediatric Emergency Department\".","authors":"David Troxler","doi":"10.1097/PEC.0000000000003367","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003367","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692572","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 Dog Bite Injury Trends During the COVID-19 Pandemic.","authors":"Paul T Menk, E Melinda Mahabee-Gittens, Stephanie Ruest, Holly R Hanson, Margaret Formica, Maneesha Agarwal, Mark R Zonfrillo, Elizabeth Curtis, Wendy J Pomerantz","doi":"10.1097/PEC.0000000000003378","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003378","url":null,"abstract":"<p><strong>Objective: </strong>To examine differences between dog bite injuries among below 18-year-old patients seen in pediatric emergency departments (PEDs) during the COVID-19 pandemic to those seen before the pandemic.</p><p><strong>Methods: </strong>This is a subanalysis of a cross-sectional study of injured children below 18 years old seen in 40 PEDs, from January 1, 2019, through December 31, 2020. Patients studied had an ICD-10 code for dog bite (W54.0XXA). Cases before the pandemic (March 17, 2019, to December 31, 2019) were compared with cases during the pandemic (March 15, 2020, to December 31, 2020).</p><p><strong>Results: </strong>In total, 3891 dog bites occurred during the pandemic, and 3696 occurred before the pandemic. The proportion of dog bites to all injuries was greater during the pandemic than before (1.6% vs. 1.1%, P< 0.001). Children aged 5 to 9 years represented a higher proportion of cases during the pandemic than before (36.3% vs. 33.0%, P<0.05). More dog bites occurred during daytime hours (8:00 am to 4 pm) during the pandemic (26.1% vs. 24.3%, P<0.05). During the pandemic, the admission rate for dog bites was higher (12.9% vs. 11.4%, P<0.05). More injuries to the head, face, or neck occurred during the pandemic than before (62.8% vs. 58.3%, P< 0.01).</p><p><strong>Conclusions: </strong>Pediatric dog bites accounted for a significantly higher number and proportion of injuries seen during the COVID-19 pandemic. Stay-at-home orders may have had some influence on pediatric dog bite demographics, as evidenced by more bites occurring from 8 am to 4 pm and more school-aged children 5 to 9 years old sustaining dog bites. Location of body parts injured and increased admissions suggest more severe injuries occurred during the pandemic.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670574","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":"Response to Rohl S, Meredith M, Anderson T, et al. Comparing the Use of Crotaline-Polyvalent Immune Fab (Ovine) Versus Observation in Children. Pediatr Emerg Care. 2024;40(11):e270-e276.","authors":"Caitlin Bonney, Spencer Greene","doi":"10.1097/PEC.0000000000003373","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003373","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663769","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 the Coronavirus Disease 2019 Pandemic on Clinical Trends in Pediatric Intentional Self-Poisonings.","authors":"Hannah Wilkins, Jennifer Perry, Chary Akmyradov, Erica Liebelt","doi":"10.1097/PEC.0000000000003376","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003376","url":null,"abstract":"<p><strong>Objectives: </strong>During the coronavirus disease 2019 pandemic, there was a significant increase in pediatric emergency department visits and hospital admissions for suicidality and self-harm, including deliberate self-poisoning. This study compares demographics, clinical characteristics, management, and outcome data of pediatric patients with intentional self-poisonings before and during the pandemic. A secondary aim is to identify predictors of severe outcomes.</p><p><strong>Methods: </strong>De-identified data were retrieved from the Toxicology Investigators Consortium registry of patients ages 6 to 18 years presenting with intentional self-poisoning. χ2 analyses and Fisher exact test were performed to determine associations among variables between the \"pre-pandemic\" (April 2017 to February 2020) and \"pandemic\" (March 2020 to October 2022) periods, with P value <0.05 considered statistically significant. Multivariable logistic regression analysis was conducted to explore correlates of severe outcomes.</p><p><strong>Results: </strong>There were 7034 cases identified, 3480 pre-pandemic and 3604 pandemic. The pandemic group was associated with a higher percentage of patients aged 7 to 12 years, patients identifying as transgender or gender non-conforming, and the use of non-opioid analgesics as a primary agent. The pre-pandemic group had more frequent polysubstance ingestions and severe outcomes. Subgroup analysis of severe outcomes showed few differences between pre-pandemic and pandemic groups. No demographic characteristics were strongly associated with severe outcomes.</p><p><strong>Conclusions: </strong>The demographic differences between time periods suggest the pandemic may have had a disparate impact on these vulnerable populations. Identifying trends in pediatric self-poisonings may help guide public health strategies and resources for prevention and harm reduction.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664284","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":"Reply: Antivenom Administration Strategies in Pediatric Snake Envenomation.","authors":"Stephen Rohl, Mark Meredith, Tucker Anderson, Mark Snider, Saralyn Williams, Elizabeth Tolley, Donna Seger","doi":"10.1097/PEC.0000000000003379","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003379","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662731","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":"Reply: Comparing the Use of Crotaline-Polyvalent Immune Fab (Ovine) Versus Observation in Children.","authors":"Stephen Rohl, Mark Meredith, Tucker Anderson, Mark Snider, Saralyn Williams, Elizabeth Tolley, Donna Seger","doi":"10.1097/PEC.0000000000003380","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003380","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663484","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":"Predicting Future Acute Care Visit Risk in Kids With Asthma (PARKA): A Nested Cohort Study.","authors":"Dhenuka Radhakrishnan, Patricia Li, Meltem Tuna, Madhura Thipse, Nick Barrowman, Vid Bijelic, Naveen Poonai, Dominic Chalut, Roger Zemek, Eric I Benchimol, Francine M Ducharme","doi":"10.1097/PEC.0000000000003336","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003336","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to develop a clinical risk score to predict future asthma acute care visits [emergency department (ED) visits or hospitalizations] within 1 year following a discharge from 1 of 2 tertiary care pediatric EDs in Ontario, Canada.</p><p><strong>Methods: </strong>We assembled a nested Ontario cohort from the multicenter prospective DOORWAY cohort study and included children 1 to 17 years of age, with an ED visit for a moderate/severe asthma exacerbation. We linked this with provincial health administrative data. We used multivariable regression to derive and internally validate a practical clinical risk score to predict future asthma acute care visits.</p><p><strong>Results: </strong>A total of 257 children [32% female, median age 3.0 years (IQR 1 to 7 y)] were included, and 58 experienced an asthma visit within the following year. These were best predicted by 4 factors: food allergy (OR 4.2, 95% CI: 1.2-14.9), family history of asthma (OR 0.5, 95% CI: 0.3-0.9), prior acute asthma medical visits (OR 2.8, 95% CI: 0.9-8.6), and prior emergency room visits for any respiratory diagnosis (OR 3.0, 95% CI: 1.4-6.4). A score of 0, 1, or 2 points was applied to each factor for up to a maximum of 6 points; the PARKA score has very good overall performance with a scaled Brier score of 0.11 on internal validation and good discrimination with an AUC of 0.72 (95% CI: 0.64-0.78).</p><p><strong>Conclusions: </strong>The PARKA score predicts the risk of a future asthma acute care visit in a cohort of Ontario children with a moderate/severe asthma ED visit. Following external validation, this tool may aid ED clinicians in accurately targeting resource-intensive preventative interventions for at-risk children.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664288","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":"These Hips Don't Lie: Deep Vein Thrombosis in an Adolescent With an Inferior Vena Cava Anomaly.","authors":"Brandon Ho, Dewesh Agrawal","doi":"10.1097/PEC.0000000000003375","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003375","url":null,"abstract":"<p><p>Congenital anomalies of the inferior vena cava can predispose adolescents to deep vein thrombosis. A 13-year-old male with left hip pain after a sports injury was found to have extensive deep vein thromobis due to an interrupted inferior vena cava. The diagnosis led to catheter-directed thrombolysis and anticoagulation, resolving symptoms.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625506","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":"Ophthalmology Examinations in Children With Skull Fractures and Underlying Focal Hemorrhage.","authors":"Karli Breeden, Cindy W Christian, Joanne N Wood, Gil Binenbaum, Daniel M Lindberg, Angela Bachim, Colleen J Bressler, Lori Frasier, Terra Frazier, Nicole R Johnson, Natalie Laub, Megan M Letson, Tagrid Ruiz-Maldonado, Matthew Valente, Jenna Kiely, Jan Leonard, M Katherine Henry","doi":"10.1097/PEC.0000000000003334","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003334","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the frequency and yield of retinal examination in children below 2 years old undergoing abuse evaluations in the setting of skull fracture(s) and small underlying intracranial hemorrhage.</p><p><strong>Methods: </strong>This cross-sectional study used CAPNET, a multicenter child physical abuse network, to identify children below 2 years with a skull fracture(s) and intracranial injury limited to an underlying small focal intracranial hemorrhage undergoing subspeciality child abuse evaluations. Our outcomes of interest were (1) the performance of a retinal examination, (2) the identification of retinal hemorrhages, and (3) associations of clinical factors and CAPNET site with the performance of retinal examinations. We hypothesized that retinal hemorrhages would be identified in <5% of patients.</p><p><strong>Results: </strong>Of 242 children who met inclusion criteria, the majority (189, 78.1%) presented with a reported history of accidental trauma, and most (211, 87.2%) lacked additional injuries. Only 9 (3.7%) had loss of consciousness and/or seizures/seizure-like activity. The majority (201, 83.1%) had low concern for abuse. Overall, 104 (43.0%) children underwent retinal examinations, of which 0 had retinal hemorrhages (one-sided 95% CI: 0-2.8%). Children without a reported accidental mechanism of injury (P=0.004), those with intermediate/high concern for abuse (P<0.001), and children with occipital fractures (P=0.008) were more likely than their counterparts to undergo retinal examination. The proportion of children undergoing retinal examination varied by CAPNET site (P<0.001).</p><p><strong>Conclusions: </strong>Our findings suggest that it may be reasonable to forgo retinal examinations in children below 2 years of age with skull fracture(s) and intracranial injury limited to an underlying small focal hemorrhage who are overall neurologically well-appearing.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606006","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}