{"title":"A case of hydrogen peroxide-induced proctocolitis in a child","authors":"S. Choi","doi":"10.22470/pemj.2019.00157","DOIUrl":"https://doi.org/10.22470/pemj.2019.00157","url":null,"abstract":"Hydrogen peroxide has antibacterial effects, and is frequently used to disinfect wounds and devices. However, when the colon is exposed to this chemical, reaction with catalase can cause acute colitis due to the release of oxygen. Symptoms include abdominal pain, hematochezia, diarrhea, and tenesmus. Colonoscopy findings of this condition, including white plaques, erythema of the surrounding mucosa, and multiple ulcers, are similar to those of other causes of colitis, such as ischemic colitis. Therefore, the differentiation is essential. Although several cases of hydrogen peroxide-induced colitis have been reported, there is a lack of relevant reports in children. We present here a pediatric case of hydrogen peroxide-induced proctocolitis with a literature review. This study was approved by the Institutional Review Board (IRB No. 2019-11042).","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"1 1","pages":"53-56"},"PeriodicalIF":0.0,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90552158","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}
{"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}
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}
{"title":"Ultrasound-guided central venous catheter insertion in pediatric patients","authors":"I. Chang, J. Park, J. Jung","doi":"10.22470/pemj.2019.00171","DOIUrl":"https://doi.org/10.22470/pemj.2019.00171","url":null,"abstract":"소아환자(환자)에서 중심정맥카테터 삽입은 수액, 약, 고농도 전해질, 혈압상승제 또는 수축촉진약 투여, 수혈, 정맥영양, 투석 등에 필요하다. 그러나, 삽입 빈도가 성인 보다 낮고, 작은 혈관 크기, 술기에 협조가 어려운 점 등 소아의 특성 때문에 시술이 어렵다. 소아환자에서 초음 파 유도 중심정맥카테터 삽입은 1980년대에 보고된 이후, 그 유용성이 다양하게 연구됐다. 1990년대 초부터 초음파 유도 삽입이 기존 해부학적 기준점(anatomical landmark, 기준점) 이용 삽입의 단점을 보완하는 방법으로 권 장되고 있다. 최근 연구에서 초음파 유도 삽입이 성공률은 높이고 시술 관련 합병증은 줄일 수 있다고 알려졌다. 본 저자는 소아환자에서 중심정맥카테터 삽입 시 기준 점 및 초음파를 이용한 방법을 각각 살펴보고, 관련 연구 를 통해 각 방법에 따른 성공률 및 주요 합병증 발생률을 알아보고자 한다.","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"1 1","pages":"10-15"},"PeriodicalIF":0.0,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90286680","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}
{"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}
{"title":"COVID-19: the effects on the practice of pediatric emergency medicine.","authors":"David M Walker, Victorio R Tolentino","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An informal survey of 65 pediatric emergency department leaders in North America-from 30 U.S. states and 4 Canadian provinces-revealed changes in operations, infrastructure, staffing, and clinical care that were undertaken as a result of the COVID-19 pandemic. The changes identified by the survey respondents were driven by reductions in pediatric patient volumes, a surge of adult patients, clinical considerations related to containment of infection, and financial factors. Survey respondents also reported effects of the pandemic on academic training programs and provider wellness. This report uses the survey responses to provide a snapshot of the adaptability of pediatric emergency medicine departments and clinicians during a public health emergency.</p>","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"17 Suppl 6-3","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2020-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38058994","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}
{"title":"Optimizing emergency management to reduce morbidity and mortality in pediatric burn patients.","authors":"Hilary Fairbrother, Megan Long, Elizabeth Haines","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Burns are a significant cause of injury-induced morbidity and mortality in pediatric patients. The spectrum of management for pediatric burn victims is vast and relies heavily on both the classification of the burn and the body systems involved. The immediate focus of management includes resuscitation and stabilization, fluid management, and pain control. Additional focus includes decreasing the risk of infection as well as improving healing and cosmetic outcomes. Discharge care and appropriate follow-up instructions need to be communicated carefully in order to avoid long-standing complications. This supplement reviews methods for accurate classification and management of the full range of burns seen in pediatric patients.</p>","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"17 Suppl 6-2","pages":"1-51"},"PeriodicalIF":0.0,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38042095","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}
{"title":"COVID-19: The impact on pediatric emergency care","authors":"David M Walker, Victorio R Tolentino","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although there is still much that is not understood, experience with previous coronavirus outbreaks and available data on COVID-19 indicate a reduced propensity to affect children. Nonetheless, serious complications—although rare—are being seen in pediatric patients. This review, written with the emergency medicine clinician in mind, describes the epidemiology, clinical features, and management implications for COVID-19 in pediatric patients. It includes a discussion of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, as well as other aspects of the COVID-19 pandemic that are affecting children and families, such as poisonings, childhood immunizations, mental health, nonaccidental trauma, and neglect.</p>","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"17 Suppl 6-1","pages":"1-27"},"PeriodicalIF":0.0,"publicationDate":"2020-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38008744","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}
{"title":"Points & Pearls: Seizures in neonates: diagnosis and management in the emergency department.","authors":"Cassandra Koid Jia Shin, Jeranil Nunez","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"17 6","pages":"e1-e2"},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38020364","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}
{"title":"Seizures in neonates: diagnosis and management in the emergency department.","authors":"Melissa L Langhan, Brielle Stanton","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neonatal seizures are associated with high morbidity and mortality, but they can be difficult to diagnose because they often present with subtle signs and symptoms. Initial management goals in the emergency department include patient stabilization, seizure cessation, and determination of the etiology; identification of life-threatening treatable causes of the seizures should be prioritized. Further management depends on the history and physical examination findings, laboratory testing results, and imaging studies. This issue reviews common presentations and causes of neonatal seizures, considerations for emergency department management, and the evidence regarding antiepileptic medications for neonates.</p>","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"17 6","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37989147","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}