Pediatric emergency care最新文献

{"title":"Factors Associated With Use of Procedural Sedation in Pediatric Facial Laceration Repair in the Emergency Department: A Retrospective Cross-Sectional Study.","authors":"Isabella G Steidley, David Mills, Elizabeth Waltman, Michael C Monuteaux, Todd Lyons, Andrew Miller, Chris A Rees, Assaf Landschaft, Amanda Stewart, Eric W Fleegler, Amir Kimia","doi":"10.1097/PEC.0000000000003628","DOIUrl":"10.1097/PEC.0000000000003628","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors associated with the utilization of procedural sedation during pediatric facial laceration repair.</p><p><strong>Methods: </strong>We performed a retrospective cross-sectional study at a tertiary care pediatric ED from 2016 to 2020 of patients aged 0 to 18 with facial lacerations repaired with sutures. Our primary outcome was utilization of procedural sedation (ketamine, propofol alone or plus fentanyl or ketamine, midazolam plus fentanyl), with a secondary outcome of utilization of anxiolysis (intranasal midazolam). We measured the association of covariates, including provider subspecialty and patient age, sex, race and ethnicity, insurance status, time and day, laceration characteristics, mechanism, and layers of repair in a multivariate analysis and multinomial logistic regression.</p><p><strong>Results: </strong>We identified 4943 patient visits, with 3859 (78.8%) laceration repairs performed by emergency medicine providers and 1084 (21.9%) performed by plastic surgery. Procedural sedation was used in 373 (7.6%) visits. Lacerations repaired by plastic surgery were 25 times more likely to involve procedural sedation compared with those repaired by emergency medicine providers [adjusted odds ratio (aOR): 25.0, 95% CI: 17.1-36.5]. Additional factors included: laceration length (≥5 vs. <2.5 cm, aOR: 3.87, 95% CI: 1.88, 7.94), laceration complexity (complex vs. simple aOR: 2.50, 95% CI: 1.75, 3.57), and time of presentation (overnight vs. day, aOR: 2.58, 95% CI: 1.36, 4.91).</p><p><strong>Conclusion: </strong>Provider specialty was the strongest independent predictor of procedural sedation use, even after adjustment for wound characteristics. These findings highlight substantial practice variation and suggest an opportunity to develop standardized, clinically driven approaches to sedation decision-making for pediatric facial lacerations.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"743-749"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964551","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":"Racial Disparity and Disproportionality Among Emergency Department Visits for Child Maltreatment: Evidence From the Nationwide Emergency Department Sample (NEDS): 2019 to 2020.","authors":"Corbinian Wanner, Amy A Hunter, Meghan Fish, Nina Livingston","doi":"10.1097/PEC.0000000000003630","DOIUrl":"10.1097/PEC.0000000000003630","url":null,"abstract":"<p><strong>Background: </strong>Each year in the US, approximately 600,000 (8.1 per 1000 child population) children are victims of maltreatment. In 2023, rates among Black/African American children were 47% higher than the overall national rate. It is unclear whether similar disparities exist in national emergency department (ED) data, as the Nationwide Emergency Department Sample (NEDS) just began including race and ethnicity in data in 2019.</p><p><strong>Objective: </strong>To evaluate racial disparity and disproportionality among a nationally representative sample of ED visits involving child maltreatment concerns.</p><p><strong>Methods: </strong>International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) codes were used to identify ED visits for confirmed (T74) and suspected (T76) child maltreatment concerns in patients under 18 years old from 1/1/2019 to 12/31/2020. NEDS sampling weights were applied to produce national estimates. Racial disparity and disproportionality were calculated using the Disparity Index (DI) and the Disproportionality Representation Index (DRI), respectively.</p><p><strong>Results: </strong>A total of 29,667 ED visits (130,981 weighted) involving child maltreatment concerns were identified. The DRI revealed that non-Hispanic Black children had maltreatment codes applied at a rate that was 1.8 greater times what was expected given their proportion in the general population. The DI showed that non-Hispanic Black children were twice as likely to have a maltreatment-related diagnosis code applied when compared with their non-Hispanic White counterparts.</p><p><strong>Conclusions: </strong>This research exposes racial differences in the application of diagnosis codes for child maltreatment concerns in a nationally representative ED sample. Future research should explore factors which may influence the application of maltreatment-related diagnosis codes.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"750-755"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942361","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":"Intestinal Ultrasound for Inflammatory Bowel Disease: Expanding the Role of Point-of-Care Ultrasound in the Emergency Department.","authors":"Cindy C Y Law, Sigmund J Kharasch","doi":"10.1097/PEC.0000000000003681","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003681","url":null,"abstract":"<p><p>Patients with inflammatory bowel disease (IBD) frequently utilize emergency department (ED) care. Intestinal ultrasound (IUS) is a noninvasive, point-of-care, radiation-free imaging modality increasingly used in outpatient IBD management. The purpose of this article is to introduce the use of IUS for the evaluation of IBD to emergency medicine physicians who utilize ultrasound as part of their clinical practice. Studies demonstrate that IUS is highly sensitive and specific for detecting active bowel inflammation. Key sonographic findings include increased bowel wall thickness and bowel wall hyperemia. IUS can also identify important IBD-related complications such as strictures and abscesses. IUS represents a promising addition to ED assessment of IBD and may serve as a valuable complementary tool for the initial evaluation of suspected IBD flare or disease-related complications. Its rapid bedside application, lack of required bowel preparation, and absence of radiation exposure make it particularly attractive in emergency and pediatric settings. Emerging evidence supports the feasibility of IUS using cart-based ultrasound systems and handheld ultrasound devices. With appropriate training, this may allow broad implementation in the ED. Further studies are needed to define optimal implementation strategies and evaluate its impact on clinical efficiency, reduction in radiation exposure, cost-effectiveness, and patient outcomes.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":"42 10","pages":"801-808"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081744","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":"Factors Associated With Reports to Child Protective Services Following Unintentional Ingestions in Children Younger Than Age 6.","authors":"Nicole Irgens-Moller, Carly Shea, Sundes Kazmir, James Dodington, Julie R Gaither, Gunjan Tiyyagura","doi":"10.1097/PEC.0000000000003631","DOIUrl":"10.1097/PEC.0000000000003631","url":null,"abstract":"<p><strong>Objective: </strong>Unintentional ingestions in children are a common presenting chief complaint in the emergency department (ED). The decision to consult social work or report to Child Protective Services (CPS) relies on the provider's discretion. We sought to investigate the association between race or insurance status and providers' decisions.</p><p><strong>Methods: </strong>A retrospective cross-sectional study of children younger than 6 years of age presenting to 1 of 6 hospitals within the Yale New Haven Health system in 2013 to 2021 with an ICD-9/10 code of poisoning or accidental ingestion. Multivariable logistic regression was used to assess factors associated with social work and CPS consults.</p><p><strong>Results: </strong>Among 759 children with unintentional ingestions, there were 467 (48.4%) ingestions of over-the-counter substances, 359 (47.3%) ingestions of prescription medications and 24 (3.2%) ingestions of illicit substances. Medication error by caregiver accounted for 46 cases (6.1%). Social work was consulted in 23% of cases. Factors associated with social work consults were changes in baseline mental status and vital signs (adjusted odds ratio [aOR]=3.35 [95% CI: 1.62-6.92]), requiring inpatient care (aOR=14.3 [8.04-25.6]), PICU admission (aOR=24.5 [5.57-107.9]), and having toxicology tests ordered (aOR=3.2 [1.85-5.51]). Presentation to a general ED decreased the odds of a social work consult (aOR=0.14 [0.08-0.24]). CPS reports were filed in 6.7% of cases. Factors associated with CPS reports were ingestion type (prescription aOR=2.73 [95%CI 1.19-6.27]; substances illegal for a minor [eg, alcohol, nicotine, THC-containing products] aOR=21.8 [6.76-70.4]), change in mental status or vital signs from baseline (aOR=3.18 [1.39-7.26]), requiring inpatient care (aOR=4.17 [1.95-8.91]) PICU (aOR=6.23 [95%CI 1.67-23.3]) and having toxicology tests ordered (aOR=3.6 [1.71-7.57]).</p><p><strong>Conclusions: </strong>In children presenting after unintentional ingestion, involvement of social work or CPS was associated with clinical severity and substance type but not with race or insurance status.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"756-763"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144259","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":"Inferior Vena Cava to Aorta Ratio in Children With Non-Hemorrhagic Shock After Fluid Bolus Using Point of Care Ultrasound.","authors":"Vengatabaskarane Hamsika, Prerna Batra, Vikram Bhaskar, Sumaira Khalil","doi":"10.1097/PEC.0000000000003626","DOIUrl":"10.1097/PEC.0000000000003626","url":null,"abstract":"<p><strong>Objective: </strong>To compare IVC/Ao ratio, IVC collapsibility/distensibility indices before and after the administration of fluid bolus therapy in children with non-hemorrhagic shock using point of care ultrasound, and to correlate the changes in IVC/Ao ratio after fluid bolus therapy with changes in heart rate, shock index, and blood pressure.</p><p><strong>Methods: </strong>Cross-sectional observational study was conducted in children aged 1 to 12 years with non-hemorrhagic shock requiring fluid bolus therapy. Vital parameters were recorded and IVC diameter, IVC collapsibility/distensibility, IVC/Aorta ratio were measured using point of care ultrasound before and after administration of fluid bolus.</p><p><strong>Results: </strong>IVC/Aorta ratio showed a significant increase [0.79 (0.06) vs. 0.91 (0.07); P <0.001] after fluid bolus. Also, a significant decrease was observed in IVC collapsibility /distensibility indices from 58.29 (8.28) and 49.26 (15.50) to 37.39 (8.03) and 29.51 (10.55), respectively. Change in IVC/Aorta ratio showed a weak positive correlation with change in heart rate ( r =0.28), and shock index ( r =0.26).</p><p><strong>Conclusions: </strong>Although IVC/Aorta ratio and IVC indices reflect physiological response to fluid therapy in children with non-hemorrhagic shock, its weak correlation with other clinical parameters limits its clinical utility. Further studies with larger sample sizes are needed to validate these findings.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"738-742"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869329","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":"Accidental Ingestion of Highly Toxic Drugs in Young Children: A Multicenter Study From Spanish Pediatric Emergency Departments.","authors":"Johanna Ramírez-Romero, Santiago Mintegi, Beatriz Azkunaga Santibañez","doi":"10.1097/PEC.0000000000003634","DOIUrl":"10.1097/PEC.0000000000003634","url":null,"abstract":"<p><strong>Objectives: </strong>Highly toxic medications are thought to lead to fatal overdose even after single-dose ingestions. Recent evidence has questioned some of the assumptions underlying this concept. In this context, this study aimed to evaluate the incidence, management, and outcomes of accidental ingestions involving highly toxic drugs in young children presenting to pediatric emergency departments (EDs).</p><p><strong>Methods: </strong>We performed a descriptive and analytical study using a prospective, nationwide, multicenter pediatric poisoning registry including 58 Spanish EDs from 2008 to 2024. We analyzed accidental ingestions of therapeutic drugs in children under 8 years of age with a predefined subgroup of infants under 1 year. Highly toxic drugs were defined according to established pediatric toxicology criteria. Clinical presentation, ED management, hospital disposition, and outcomes were compared with other therapeutic drug ingestions.</p><p><strong>Results: </strong>Among 3577 poisoning episodes, 1189 (33.2%) involved accidental ingestion of therapeutic drugs in children under 8 years; 61 cases (5.1%) involved highly toxic drugs. Median age was 3 years (interquartile range 1 to 6), and 26 children (46.6%) were under 1 year. Cardiovascular drugs (37.7%) and opioids (24.5%) were the most frequent agents. Only 4 patients (6.8%) were symptomatic at presentation. No child required advanced airway or circulatory support, and no fatalities occurred. Hospital admission was more frequent after ingestion of highly toxic drugs.</p><p><strong>Conclusions: </strong>Accidental ingestion of highly toxic medications represents a small proportion of pediatric poisonings in EDs and is generally associated with favorable short-term outcomes. This supports a more evidence-based approach to risk stratification in the management of exploratory ingestions.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"764-769"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150787","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 Care Coordinator-Facilitated Education Curriculum in Community Emergency Departments: A Multisite Evaluation.","authors":"Snimarjot Kaur, Carlee Lenehan, Erin Montgomery, Kamal Abulebda, Theresa Walls, Robert A Dudas, Jason Crellin, Arushi Manga, Lynda Knight, Daniel Scherzer, Elizabeth Sanseau, Sofia G Athanasopoulou, Marc Auerbach","doi":"10.1097/PEC.0000000000003638","DOIUrl":"10.1097/PEC.0000000000003638","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate a Pediatric Emergency Care Coordinator (PECC)-facilitated curriculum in Community Emergency Departments (CEDs). The objectives were to (1) increase CED staff engagement with pediatric education, (2) improve learners' pediatric knowledge and self-efficacy, and (3) explore PECCs' perceptions of the curriculum.</p><p><strong>Methods: </strong>A prospective study evaluated a 12-week curriculum focused on the topics of pediatric status epilepticus and newborn resuscitation. The curriculum consisted of 10 weeks of brief asynchronous online weekly assignments (articles, videos, and podcasts), with in situ simulations in the first and last weeks. Engagement was measured by tracking learners' access to the content. Simulation performance was measured via case-specific checklists. Online surveys measured learners' pediatric knowledge and self-efficacy, and learners'/PECCs' satisfaction and perceptions.</p><p><strong>Results: </strong>Twenty-one CED sites started the project, with 14 (67%) completing the curriculum. One hundred seventeen learners (53% nurse, 28% physician, 19% other staff) participated in the initial simulation, while 71 (61%) learners completed the follow-up simulation. Learners reported improvements in case-based pediatric knowledge and self-efficacy ( P <0.001). No change was noted in simulation performance scores. The Net Promoter Score, indicating overall satisfaction with the curriculum, was high at 82%.</p><p><strong>Conclusions: </strong>A PECC-facilitated curriculum in CEDs was associated with an increase in pediatric educational activities as well as improved pediatric knowledge and self-efficacy, but not simulation performance. Learners and PECCs expressed a high level of satisfaction.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"e141-e148"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252775","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 Mortality Rate of Eczema Herpeticum Is Lower Than What Is Commonly Cited.","authors":"Loren G Yamamoto, Bao Xin Liang, Kevin Liu","doi":"10.1097/PEC.0000000000003593","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003593","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":"42 10","pages":"e138-e139"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081827","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":"Establishing Age-Specific and Sex-Specific Norms for Mitral Valve E-Point Septal Separation (EPSS) Measurements in Pediatric Patients.","authors":"Jaya C Ruffin, Christopher T Stem, Scott Pletzer, Mathew J Gregoski, Asha Kumar-Veeraswamy, Matthew M Moake","doi":"10.1097/PEC.0000000000003625","DOIUrl":"10.1097/PEC.0000000000003625","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric heart failure is a rare condition with significant morbidity that requires timely diagnosis and treatment. Mitral valve E-point septal separation (EPSS) may be used as an estimate of systolic function in this evaluation. Although well studied in adults, there is limited literature looking at pediatric EPSS values. The goal of this study was to establish normal pediatric EPSS values that can serve as a reference in this evaluation.</p><p><strong>Methods: </strong>This was a single-center retrospective study of 455 pediatric patients aged 17 years or younger, who had an outpatient transthoracic echocardiogram performed from January 1, 2020, until June 26, 2023. Those with reduced ejection fraction and cardiac abnormalities were excluded. EPSS measurements were taken from parasternal long-axis B-mode views. Relationships between EPSS and patient biometric and echo measurements were evaluated. Consistency of EPSS measurement between independent reviewers was also evaluated.</p><p><strong>Results: </strong>Across all patients, the median EPSS for all measurements was 2.25 mm (IQR 2.06 mm). When looking specifically at the lowest 3 EPSS measurements for each patient, the median EPSS was 1.33 mm (IQR 2.56 mm). EPSS demonstrated statistically significant ( P <0.05) but low magnitude ( R <0.3) correlations with several patient biometric and echo measurements, including a negative correlation with ejection fraction and a positive correlation with age, height, weight, and body surface area. There was no significant correlation with sex. Interclass correlation by Cronbach Alpha was 0.951.</p><p><strong>Conclusions: </strong>EPSS measurements observed in this large pediatric patient sample are lower than those reported in both adults and children. Differences in imaging and measurement technique may explain these observed differences. Future prospective studies are needed to explore these differences and better define reference EPSS values and their clinical implications.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"729-737"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964609","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":"Multicenter Insights into Pediatric Extreme Leukocytosis: A 5-Year Retrospective Study.","authors":"Noa Guzner, Saar Hashavya, Yuval Barak-Corren, Eyal Heiman, Zimmerman Deena, Oren Gordon, Giora Wieser, Roni Sedakah, Itai Gross","doi":"10.1097/PEC.0000000000003636","DOIUrl":"10.1097/PEC.0000000000003636","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the clinical outcomes of pediatric emergency department (PED) patients with extreme leukocytosis (EL; WBC >25,000/µL) to those with moderate leukocytosis (ML; WBC 15,000 to 25,000/µL).</p><p><strong>Methods: </strong>We conducted a retrospective analysis using the MALRADI database, which includes pediatric visits to Jerusalem's 3 major hospitals, the largest urgent care network, TEREM. Demographics, clinical data, lab results, and outcomes were analyzed for culture positivity and WBC trends over time.</p><p><strong>Results: </strong>Among 125,471 pediatric records, 19,955 (15.9%) had EL and 105,516 (84.1%) had ML. EL patients were younger (mean age 3.4 vs. 4.2 y, P <0.00001), had higher inflammatory markers (CRP 12.1 vs. 7.8 mg/L; ESR 46.6 vs. 34.6 mm/h; P <0.0001), and more frequently positive cultures (3% vs. 1.5%; P <0.0001). A rapid decline in WBC count within 24 hours was observed in EL patients, compared with a slight increase in the ML group. Malignancy was rare (0.06%) in EL cases, indicating that EL is generally infection-related in this population.</p><p><strong>Conclusion: </strong>Extreme leukocytosis in pediatric patients is more frequently associated with infections requiring targeted monitoring but rarely indicates malignancy. These findings highlight the clinical importance of extreme leukocytosis and support the need for careful evaluation and monitoring in affected patients.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"776-780"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219108","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}