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March 29, 2016

TREKK E-update: March 29th, 2016

Spring has sprung! See what's new throughout the TREKK network in this latest e-update.

In This Issue...

Predicting the duration of post-concussion symptoms

What works and what's safe in pediatric emergency procedural sedation: an overview of reviews

Couching health evidence in a story

Profiling pediatric pain expert: Dr. Samina Ali

APA Pediatric Emergency and Injury Control Special Interest Groups Meeting

Webinar: Mobilizing knowledge to improve pediatric health care

Predicting the duration of post-concussion symptoms

A new study led by a Children's Hospital of Eastern Ontario researcher and TREKK content advisor Dr. Roger Zemek will help health providers and researchers predict the duration of pediatric concussion symptoms. Published in the Journal of the American Medical Association (JAMA), the Predicting and Preventing Post-concussive Problems in Pediatrics (5P) study collected data from more than 3,000 children from nine pediatric emergency departments across Canada at three time points - 7, 14 and 28 days after their head injury.

The data allowed researchers to derive a 12-point score, in which patients with a score of 3 or lower at first visit were deemed low-risk while those with 9 to 12 were classified as likely to suffer from persistent post-concussive symptoms. The score incorporates nine variables found to be most predictive of risk, including age, biological gender, medical history and cognitive complaints.

The persistent postconcussion symptoms (PPCS) risk score, when applied within the first 48-hours of a head injury, was found to be better at predicting future concussion problems than the currently utilized method and though boys sustained more concussions, girls were found to be at higher risk of suffering lasting concussion symptoms. 

The hope is that this scoring system will help health providers determine who is at highest risk for persistent symptoms and help drive research in this field forward.

Article: Zemek R, Barrowman N, Freedman SBGravel JGagnon IMcGahern C, Aglipay M, Sangha GBoutis KBeer DCraig WBurns E,Farion KMikrogianakis A, Barlow K, Dubrovsky AS, Meeuwisse W, Gioia G, Meehan WP, Beauchamp M, Kamil Y, Grool AM, Hoshizaki B, Anderson P, Brooks BL, Yeates KO, Vassilyadi M, Klassen T, Keightley M, Richer L, DeMatteo C, Osmond MH, for the PERC Concussion Team. Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED. JAMA 2016;315(10):1014-1025. http://jama.jamanetwork.com/article.aspx?articleid=2499274&resultClick=3

The Globe and Mail: http://www.theglobeandmail.com/news/national/girls-at-higher-risk-of-suffering-lasting-concussion-symptoms-study/article29073321/

CBC News: http://www.cbc.ca/news/canada/ottawa/concussion-study-kids-length-prediction-1.3479587?cmp=rss

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What works and what's safe in pediatric emergency procedural sedation: an overview of reviews

This overview of systematic reviews examines the safety and efficacy of sedative agents commonly used for procedural sedation in children in the ED or similar settings, finding consistent safety and efficacy for nitrous oxide and ketamine, with very rare significant adverse events for propofol. Considerable heterogeneity in outcomes and reporting across studies and previous reviews indicates a need for standardized outcome sets and reporting to facilitate evidence-based recommendations for care. 

Hartling LMilne AFoisy MLang ESinclair DKlassen TPEvered L. What works and what's safe in pediatric emergency procedural sedation: an overview of reviews. Acad Emerg Med. 2016 Feb 9. doi: 10.1111/acem.12938. [Epub ahead of print]

Read the abstract here.

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Couching health evidence in a story

In the first monthly installment of the new video series, “Cochrane - Making a Difference,” Denise Thomson and Lisa Hartling from Cochrane’s Child Health Field share how they've developed croup books as an evidence-based patient intervention. Incorporating systematic review evidence into story, they've developed an evoking way to bring health evidence to parents, families and emergency medicine practitioners. 

Watch the video here: http://www.cochrane.org/news/making-difference-managing-croup

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Profiling pediatric pain expert: Dr. Samina Ali

TREKK content advisor for pediatric pain, Dr. Samina Ali, shares her journey to her current program of research - studying the best ways to treat children’s pain in the emergency department.  Along with her research team, Dr. Ali is involved in national and international collaborations for trials, systematic review, knowledge translation, and quality improvement projects for acute pain in children and has established meaningful relationships and collaborations with TREKKPediatric Emergency Research Canada (PERC), and the Canadian Association of Pediatric Health Centres (CAPHC).

Read the full story here.

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APA Pediatric Emergency and Injury Control Special Interest Groups Meeting

Monday May 2nd, 08:30-11:30

Boundaries of the Pediatric Emergency Medicine Mission: What Constitutes an “Emergency”?

This year, the Emergency Medicine and Injury Control Special Interests Groups will have a special, combined meeting on May 2nd at the Pediatric Academic Societies Annual Meeting, held in Baltimore from April 30 - May 3rd. The emergency department, in its role as interface between the hospital and a relatively vulnerable patient population, has always had a multi-faceted mission that is often outside the care of the acutely ill and injured.  The fluid nature of the boundary around our mission requires us to regularly re-examine what is included.  For example, is Injury Prevention part of our job?  Chronic asthma care?  Sexual Health?  Warm meals? 


For pediatric emergency departments, this is all the more true given the vulnerability of children. However, an unfocussed ever-expanding mission that varies from pediatric emergency department to pediatric emergency department is a threat to the cohesion of the field. We propose to use this combined Special Interest Group to look at this dilemma more closely, in a forum encouraging active discussion. 

Speakers and Topics

  • Dr. Mark Zonfrillo: Role of the Emergency Department in Injury Prevention
  • Dr. Roger Zemek and Dr. William Meehan: Concussion and the Extension of the Emergency Department Mission
  • Dr. Yaron Finkelstein:  Poisoning and Efforts beyond Acute Treatment 
  • Dr. Joseph Zorc: Asthma and the Limits of Follow-up
  • Dr. Cynthia Mollen: Role of the Emergency Department for Patients with Sexual Health Issues
  • Dr. Eliot Nelson, Dr. Karen Sheehan, Dr. Stephen Teach and Dr. Cynthia Mollen: Panel Discussion

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Webinar: Mobilizing knowledge to improve pediatric health care

April 13, 2016 3:00 - 4:00 PM (MDT)

Presenters: 
Lisa Hartling, BScPT, MSc, PhD
Shannon Scott, RN, BN, MN, PhD    

Objectives:

  • to provide an overview of the goals and purpose of TREKK
  • to discuss the results of a national needs assessment conducted to identify information needs and priorities
  • to present strategies developed to mobilize knowledge to healthcare providers and parents, including use of knowledge pyramids, social media, and electronic tools.
  • to reflect on our experience to date including factors that have helped us achieve our goals.

 Click here to register!    

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Contact Us

Any questions, comments, feedback?  We'd love to hear from you.

Contact the Central Admin Team at trekk@chrim.ca or  call (204) 975 7744.  Or send your comments via the feedback tab on our website.

Stay in touch!

TREKK.ca
512E-715 McDermot Avenue
University of Manitoba
Winnipeg, Manitoba R3E 3P4 Canada
Phone: (204) 975-7744