Pediatric emergency medicine practice最新文献_第9页

Appropriateness of rabies post-exposure prophylaxis in pediatric patients visiting the emergency department due to animal bite 因动物咬伤而到急诊室就诊的儿科患者狂犬病暴露后预防的适当性

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2019.00129

J. Yoo, Jung-In Ko, W. Yeo, Taejin Park, S. K. Jung, J. Kwon

{"title":"Appropriateness of rabies post-exposure prophylaxis in pediatric patients visiting the emergency department due to animal bite","authors":"J. Yoo, Jung-In Ko, W. Yeo, Taejin Park, S. K. Jung, J. Kwon","doi":"10.22470/pemj.2019.00129","DOIUrl":"https://doi.org/10.22470/pemj.2019.00129","url":null,"abstract":"Purpose: To study the appropriateness of rabies post-exposure prophylaxis (rPEP) for children with animal bite who visited the emergency department (ED). Methods: The study enrolled children younger than 18 years with animal bite who visited the National Medical Center ED between January 2014 and October 2017. The children’s electronic medical records were retrospectively reviewed. Data for analysis included age, sex, body parts bitten by animals, species of animals, regions where animal bites occurred, history of recent antibiotics therapy and tetanus vaccination, and justification by the 2017 Guidelines for Rabies Control in Korea and implementation of rPEP. In children who underwent unjustified rPEP or did not undergo justified one, we recorded their guardians’ opinion for or against rPEP. Results: Of the 63 enrolled children, rPEP was justified for 38 children by the Korean guidelines. Of the 38 children, 35 actually underwent rPEP. Among the remaining 3 children, 2 did not undergo the prophylaxis as per the guardians’ requests. Among the 25 children whose rPEP was not justified, 8 underwent the prophylaxis. Of these 8 children, 7 did based on the guardians’ requests. Conclusion: In this study, inappropriate rPEP was usually affected by the guardians’ requests, regardless of the criteria for such prophylaxis. Thus, their requests for or against rPEP should be discussed with emergency physicians who are aware of the relevant criteria to prevent occurrence of rabies or unnecessary use of medical resources.","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"58 1","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85648502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of ingested multiple magnetic beads: the importance of suspicion based on medical history 摄入多个磁珠一例:基于病史怀疑的重要性

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2020.00080

Kwang Yeon Kim

引用次数: 0

Utilization characteristics of an advanced pediatric emergency center: a single center study over 2 years 一所高级儿科急诊中心的利用特点:一项超过2年的单中心研究

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2019.00164

S. Shin, H. Choi, Bogeum Choi

{"title":"Utilization characteristics of an advanced pediatric emergency center: a single center study over 2 years","authors":"S. Shin, H. Choi, Bogeum Choi","doi":"10.22470/pemj.2019.00164","DOIUrl":"https://doi.org/10.22470/pemj.2019.00164","url":null,"abstract":"Purpose: Advanced pediatric emergency centers play an important role in professional treatment of children. We analyzed the characteristics of children who visited an advanced pediatric emergency center. Methods: The study enrolled children younger than 15 years who had visited Keimyung University Dongsan Medical advanced pediatric emergency center between April 2016 and March 2018. We reviewed the children’s age group characteristics, time of visit, triage results by the Korean Triage and Acuity Scale (KTAS), use of the emergency medical service ambulances, emergency department length of stay, final diagnosis, and final disposition. Results: A total 41,355 children (mean age, 3.1 ± 3.0 years) were enrolled, and those aged 1-4 years accounted for 65.7%. The visit was most frequent in December, at night (40.2%), and at holiday hours (30.2%) (c.f., business hours, 11.5%). Fever (33.2%) and eyelid laceration (11.5%) were the most common final diagnoses of diseases and injuries, respectively. The children triaged as the KTAS 1-2 accounted for 5.9% of the study children (c.f., KTAS 3-4, 91.5%). According to time of visit, the proportion of hospitalization (31.4%) and transfer from other hospitals (34.7%) were most frequent at business hours than other times of visit (P < 0.001). Conclusion: The children tended to visit the center with minor diseases or injuries, especially during holidays and at night. Further research is needed for optimizing the roles of advanced pediatric emergency centers, taking into account the characteristics of patients and demand for the centers.","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"17 1","pages":"16-22"},"PeriodicalIF":0.0,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86927982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Recovery without neurological sequelae of traumatic spinal epidural hematoma masquerading as Guillain-Barré syndrome in a child 儿童外伤性脊髓硬膜外血肿伪装为格林-巴罗综合征后无神经系统后遗症的康复

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2019.00143

J. Lee, Dong Hyun Kim, Y. Kwon

引用次数: 0

Two cases of splenic infarction due to torsion of wandering spleen requiring laparoscopic splenectomy in adolescent girls 少女游离脾扭转致脾梗死需腹腔镜脾切除术2例

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2019.00136

Soo-Hong Kim, Y. Cho, Hae-Young Kim

引用次数: 0

A case of hydrogen peroxide-induced proctocolitis in a child 儿童过氧化氢诱发直肠炎1例

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2019.00157

S. Choi

引用次数: 0

A review of the designated health care institution for child abuse in Korea and the compatible systems in other countries 对韩国指定的虐待儿童保健机构和其他国家的配套制度的审查

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2020.00024

Myung Hun Kim, Y. Kwak

{"title":"A review of the designated health care institution for child abuse in Korea and the compatible systems in other countries","authors":"Myung Hun Kim, Y. Kwak","doi":"10.22470/pemj.2020.00024","DOIUrl":"https://doi.org/10.22470/pemj.2020.00024","url":null,"abstract":"한국 정부와 사회의 예방 노력에도 불구하고 아동학대 가 꾸준히 증가하고, 이로 인한 사망 사건이 종종 발생하 고 있어 사회적 충격을 주고 있다. 아동학대 예방부터 종 합적 피해자에 지원까지 학대에 대한 국가의 책임을 강화 하는 취지로 보건복지부에선 2019년 1월 전담 부서로 아 동학대대응과를 설치했다. 더불어, 같은 해 5월 학대 대응 체제를 포함한 아동보호체계를 개편하여 보호 필요 아동 에 대한 국가의 책임을 강화하는 취지의 포용국가 아동정 책을 발표했다. 같은 해 7월, 아동권리보장원이 출범하여 아동보호 및 권리 보장을 위한 정책과 서비스를 통합적으 로 지원하는 체제를 정비했다. 중앙아동보호전문기관은 아동권리보장원의 아동학대예방본부로 편입되어, 학대 예 방, 대응 체계 개선, 학대 후 가족관계 회복을 위한 서비스 개선 등 보다 포괄적인 활동을 운영하게 된다. 대한의사협회에서 2002년“아동학대예방전문위원회” 를 설치하여 학대 문제에 적극적으로 참여하기 시작했다. 종합병원 내 학대아동보호팀 구성을 촉진하고, 학대에 이 해를 갖춘 인력을 양성하여 고통받는 어린이를 눈 크게 뜨 고 구하자는 취지의“왕눈이 운동”을 시작했다. 2003년 한국을포함한각국의아동학대전담의료기관유사사례고찰","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"13 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87769948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Clinical features of children with carbon monoxide intoxication: a single center study 儿童一氧化碳中毒的临床特征:一项单中心研究

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2020.00010

Habeck Jo, H. W. Yoo, Seong Heon Kim, Young Mi Kim, H. Kim

{"title":"Clinical features of children with carbon monoxide intoxication: a single center study","authors":"Habeck Jo, H. W. Yoo, Seong Heon Kim, Young Mi Kim, H. Kim","doi":"10.22470/pemj.2020.00010","DOIUrl":"https://doi.org/10.22470/pemj.2020.00010","url":null,"abstract":"Purpose: To investigate the effect of lifestyle changes on patterns of carbon monoxide (CO) exposure and the association between neurologic symptoms and outcomes in Korean children with CO intoxication. Methods: We reviewed the medical records of patients (< 18 years) with CO intoxication who visited the emergency department of Pusan National University Hospital between February 2012 and January 2020. We collected clinical findings, including age and sex, transfer from other hospitals, source, time and duration of exposure, manifestations with neurologic symptoms (syncope, seizure, and altered mental status), intensive care unit hospitalization, hospital length of stay, implementation of hyperbaric oxygen therapy, and findings of neuroimaging. These variables were compared between children with and without neurologic symptoms. In addition, levels of carboxyhemoglobin and lactate were compared between patients with and without specific manifestations. Results: The enrolled 47 patients’ median age was 10 years (interquartile range, 4.5-14.0). The most common source of exposure was fire (46.8%), followed by camping (23.4%). The most common times of exposure were night (44.7%) and winter (44.7%). The patients with neurologic symptoms (14 [29.8%]) showed longer duration of exposure and hospital length of stay (P < 0.001 and P = 0.007, respectively). Of the 14 patients, 2 were hospitalized to the intensive care unit without an in-hospital mortality. A significant association was found between dyspnea and lactate level (P = 0.049), also between syncope or presyncope and carboxy hemoglobin level (P = 0.017). Conclusion: CO intoxication in Korean children is most often caused by fire and camping, and at night and in winter. There is a correlation between neurologic symptoms and duration of exposure to CO.","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"26 1","pages":"35-40"},"PeriodicalIF":0.0,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89759825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ultrasound-guided central venous catheter insertion in pediatric patients 超声引导下小儿中心静脉置管的应用

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2019.00171

I. Chang, J. Park, J. Jung

引用次数: 0

Performances of serum creatinine, C-reactive protein and white blood cell to predict urinary tract infection in febrile children younger than 24 months of age 血清肌酐、c反应蛋白和白细胞对24月龄以下发热儿童尿路感染的预测价值

Pediatric emergency medicine practice Pub Date : 2020-06-30 DOI: 10.22470/pemj.2020.00038

H. Lee, Y. Kwak, J. Park, Do Kyun Kim, Se Uk Lee

{"title":"Performances of serum creatinine, C-reactive protein and white blood cell to predict urinary tract infection in febrile children younger than 24 months of age","authors":"H. Lee, Y. Kwak, J. Park, Do Kyun Kim, Se Uk Lee","doi":"10.22470/pemj.2020.00038","DOIUrl":"https://doi.org/10.22470/pemj.2020.00038","url":null,"abstract":"Purpose: Differentiation of urinary tract infection (UTI) from viral infection is a critical challenge in febrile children in emergency departments (EDs). This study aimed to assess the predicting performances of creatinine, C-reactive protein (CRP), and white blood cell (WBC) for predicting UTI in the children. Methods: This study was a retrospective analysis of a prospectively enrolled cohort of febrile children who presented to our children’s hospital ED from August 2016 through February 2018. We included previously healthy, febrile (≥ 38。C) children younger than 24 months whose urine cultures were obtained. Accuracy of creatinine, CRP, and WBC were assessed by optimal cutoffs, which were calculated using receiver operating characteristic curves. Results: Among the total 33,013 children to the ED, 7,847 (23.8%) febrile children were registered to the fever registry. Finally, 506 children were included, and UTI was diagnosed in 127 (25.1%). The areas under the curve of creatinine, CRP, and WBC to predict UTI were 0.41 (95% confidence interval [CI], 0.35-0.46), 0.71 (95% CI, 0.66-0.77), and 0.66 (95% CI, 0.60-0.72), respectively. The cutoffs were 0.26 mg/dL for creatinine, 2.3 mg/dL for CRP, and 14.4 × 10 cells/μL for WBC. Creatinine showed worse performance than the other variables. The application of creatinine added to the other variables led to an increase only in the sensitivity, but at the expense of a lower specificity, positive predictive value, and negative predictive value. Conclusion: Serum creatinine showed a poor performance in predicting UTI in the febrile young children. Since a single biomarker can neither rule in nor rule out UTI in the children, the prediction of UTI can be achieved by the interpretation of both clinical and laboratory findings.","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"43 1","pages":"28-34"},"PeriodicalIF":0.0,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82669705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0