Global search | Events search | Events Calendar
Home > Who we are >
Archival Unlinked Pages >
Archival Unlinked Pages >
Home > What we do >
Archival Unlinked Pages >
Archival Unlinked Pages >
Archival Unlinked Pages >
Archival Unlinked Pages >
Archival Unlinked Pages >
Emergency Medicine Cases Podcast: Emergency management of pediatric seizures - Guidance and podcast
Helman A
Helman A
With the help of two of Canada's Pediatric Emergency Medicine seizure experts handpicked by TREKK, Dr. Lawrence Richer and Dr. Angelo Mikrogianakis, we'll give you all the tools you need to approach the child who presents to the ED with a seizure with the utmost confidence.
With the help of two of Canada's Pediatric Emergency Medicine seizure experts handpicked by TREKK, Dr. Lawrence Richer and Dr. Angelo Mikrogianakis, we'll give you all the tools you need to approach the child who presents to the ED with a seizure with the utmost confidence.
Emergency Medicine Cases: Practical COVID-19 resources for front line healthcare professionals
Videos in clinical medicine. Diagnosing otitis media--otoscopy and cerumen removal
Shaikh N, Hoberman A, Kaleida PH, Ploof DL, Paradise JL
Shaikh N, Hoberman A, Kaleida PH, Ploof DL, Paradise JL
Video instructing how to diagnose otitis media with otoscopy and cerum removal.
Video instructing how to diagnose otitis media with otoscopy and cerum removal.
Bottom Line: Assessment in the emergency department for patients with head injury
National Institute for Health and Care Excellence (NICE), National Clincial Guideline Centre
National Institute for Health and Care Excellence (NICE), National Clincial G...
A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive and designed to be used online.
A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive and designed to be used online.
Acute Otitis Media- Emergency Management in Children - Flowchart
Children's Health Queensland Hospital and Health Service
Children's Health Queensland Hospital and Health Service
Flowchart of emergency management in children for acute otitis media.
Flowchart of emergency management in children for acute otitis media.
Bottom Line: Autism and the Hospital Emergency Room: A Practical Guide for Health Professionals to Meet the Needs of Individuals with Autism Spectrum Disorders
Center for Autism & Related Disabilities (CARD)
Center for Autism & Related Disabilities (CARD)
A practical guide for health professionals to meet the needs of individuals with Autism Spectrum Disorder.
A practical guide for health professionals to meet the needs of individuals with Autism Spectrum Disorder.
Bottom Line: Autism Information for Paramedics and Emergency Room Staff
Gammicchia C, Johnson C, Autism Society
Gammicchia C, Johnson C, Autism Society
Information for paramedics and emergency room staff on providing services to a person on the autism spectrum.
Information for paramedics and emergency room staff on providing services to a person on the autism spectrum.
Canadian Association of Emergency Physicians - COVID-19 Information, Resources and Advocacy Centre
Clinical Practice Guideline: Updated American College of Critical Care Medicine--pediatric advanced life support guidelines for management of pediatric and neonatal septic shock: relevance to the emergency care clinician (2010)
Kissoon NO, R. A.; Carcillo, J. A.
Kissoon NO, R. A.; Carcillo, J. A.
Objective: Shock is a major preventable cause of morbidity and mortality in children referred to emergency care. The recently updated American College of Critical Care Medicine guidelines for the management of newborns and children with septic shock emphasize the role of emergency care in improving survival and functional outcomes. Implementation of these guidelines of stepwise use of fluids, antibiotics, and, if necessary, inotropes within the first hour of admission to the emergency department can reduce mortality and neurological morbidity risks 2-fold. Published: 2010.
Objective: Shock is a major preventable cause of morbidity and mortality in children referred to emergency care. The recently updated American College of Critical Care Medicine guidelines for the management of newborns and children with septic shock emphasize the role of emergency care in improving survival and functional outcomes. Implementation of these guidelines of stepwise use of fluids, antibiotics, and, if necessary, inotropes within the first hour of admission to the emergency department can reduce mortality and neurological morbidity risks 2-fold. Published: 2010.
Guidelines: Guidelines for Managing the Client with Intellectual Disabilites in the Emergency Room
University of Toronto, Centre for Addiction and Mental Health
University of Toronto, Centre for Addiction and Mental Health
These guidelines outline ways to optimize the clinical encounter, provide a framework for understanding & assessing the complex medical and mental health issues that arise for persons with intellectual disabilities, and provide a systematic way to evaluate the best approach to treatment and triage.
These guidelines outline ways to optimize the clinical encounter, provide a framework for understanding & assessing the complex medical and mental health issues that arise for persons with intellectual disabilities, and provide a systematic way to evaluate the best approach to treatment and triage.
Clinical Practice Guideline: Acute otitis media - Emergency management in children
Children's Health Queensland Hospital and Health Service
Children's Health Queensland Hospital and Health Service
Children's Health Queensland Statewide Paediatric Guideline for emergency management of acute otitis media in children.
Children's Health Queensland Statewide Paediatric Guideline for emergency management of acute otitis media in children.
Clinical Practice Guideline: Splinting ABCs: upper and lower extremity splinting in the emergency department
Sarwark, JF, Maizels, M, Adler, MD & Nicholson, D
Sarwark, JF, Maizels, M, Adler, MD & Nicholson, D
This guideline describes preparation and application of plaster and fiberglass short arm splints and short leg splints. Materials and set up for each type of splint are discussed in detail and the advantages and disadvantages of using fiberglass splints are outlined.
This guideline describes preparation and application of plaster and fiberglass short arm splints and short leg splints. Materials and set up for each type of splint are discussed in detail and the advantages and disadvantages of using fiberglass splints are outlined.
Guidelines: Agitation Treatment for Pediatric Emergency Patients
Hilt RJ, Woodward TA, Henderson SW, Jellinek MS
Hilt RJ, Woodward TA, Henderson SW, Jellinek MS
Guideline based on a review of the existing literature & review of expert opinions for the management of agitated children in an emergency department setting.
Guideline based on a review of the existing literature & review of expert opinions for the management of agitated children in an emergency department setting.
Guidelines: Constipation
Royal Children's Hospital Melbourne
Royal Children's Hospital Melbourne
These clinical practice guidelines cover the description, etiology, diagnosis and management of constipation in children.
These clinical practice guidelines cover the description, etiology, diagnosis and management of constipation in children.
Clinical Practice Guidelines: Clinical Policy for Well-Appearing Infants and Children Younger Than 2 Years of Age Presenting to the Emergency Department With Fever
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Pediatric Fever, Mace SE, Gemme SR, Valente JH, Eskin B, Bakes...
American College of Emergency Physicians Clinical Policies Subcommittee (Writ...
This clinical policy from the American College of Emergency Physicians addresses key issues for well-appearing infants and children younger than 2 years presenting to the emergency department with fever.
This clinical policy from the American College of Emergency Physicians addresses key issues for well-appearing infants and children younger than 2 years presenting to the emergency department with fever.
Clinical Practice Guideline: Italian guidelines on the assessment and management of pediatric head injury in the emergency department.
Da Dalt L, Parri N, Amigoni A, Nocerino A, Selmin F, Manara R, et al.
Da Dalt L, Parri N, Amigoni A, Nocerino A, Selmin F, Manara R, et al.
We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury.
We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury.
Clinical Practice Guideline: A Practice Guideline for Postreduction Management of Intussusception of Children in the Emergency Department.
Kwon H, Lee JH, Jeong JH, Yang HR, Kwak YH, Kim DK, et al.
Kwon H, Lee JH, Jeong JH, Yang HR, Kwak YH, Kim DK, et al.
Objective: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence.
Objective: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence.
Emergency management of the paediatric patient with generalized convulsive status epilepticus
Friedman J.
Friedman J.
The present guideline paper addresses the emergency management of generalized convulsive status epilepticus (CSE) in children and infants older than one month of age. It replaces the previous statement from 1996, and includes a new treatment algorithm and table of recommended medications, reflecting new evidence and the evolution of clinical practice over the past 15 years. The document focuses on the acute pharmacological management of CSE, but some issues regarding supportive care, diagnostic approach and treatment of refractory CSE are discussed.
The present guideline paper addresses the emergency management of generalized convulsive status epilepticus (CSE) in children and infants older than one month of age. It replaces the previous statement from 1996, and includes a new treatment algorithm and table of recommended medications, reflecting new evidence and the evolution of clinical practice over the past 15 years. The document focuses on the acute pharmacological management of CSE, but some issues regarding supportive care, diagnostic approach and treatment of refractory CSE are discussed.
Managing acute pain in children presenting to the emergency department without opioids
Corrie E Chumpitazi1,Cindy Chang2,Zaza Atanelov3,Ann M Dietrich4,Samuel Hiu-Fung Lam5,Emily Rose6,Tim Ruttan7,Sam Shahid8,Michael J Stoner9,Carmen Sulton10,M...
Corrie E Chumpitazi1,Cindy Chang2,Zaza Atanelov3,Ann M Dietrich4,Samuel Hiu-F...
Meningitis: Emergency Management in Children
Tracy A, Waterfield T.
Tracy A, Waterfield T.
Cochrane Summary: Local anaesthesia (numbing medicine) that is directly applied to the skin can provide pain control for repair of skin lacerations
Tayeb BO, Eidelman A, Eidelman CL, McNicol ED, Carr DB
Tayeb BO, Eidelman A, Eidelman CL, McNicol ED, Carr DB
To assess whether benefits of noninvasive topical anaesthetic application occur at the expense of decreased analgesic efficacy. To compare the efficacy of various singlecomponent or multicomponent topical anaesthetic agents for repair of dermal laceration
To assess whether benefits of noninvasive topical anaesthetic application occur at the expense of decreased analgesic efficacy. To compare the efficacy of various singlecomponent or multicomponent topical anaesthetic agents for repair of dermal laceration
Evidence Summary: Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: Can emergency physicians safely rule in or rule out paediatric intussusception in the emergency department using bedside ultrasound?
Raymond-Dufresne , Ghanayem H,
Raymond-Dufresne , Ghanayem H,
This summary investigates the diagnostic use of bedside ultrasound for paediatric intussusception in the emergency department.
This summary investigates the diagnostic use of bedside ultrasound for paediatric intussusception in the emergency department.
Evidence Summary: Towards evidence based medicine for paediatricians. Question 3. Does the administration of glucagon improve the rate of radiological reduction in children with acute intestinal intussusception?
Cachat F, Ramseyer P,
Cachat F, Ramseyer P,
This summary examines the relationship between glucagon and the rate of radiological reduction for acute intestinal intussusception.
This summary examines the relationship between glucagon and the rate of radiological reduction for acute intestinal intussusception.
Review: Evaluation and Management of Pediatric Febrile Seizures in the Emergency Department
Hampers LC, Spina LA
Hampers LC, Spina LA
This review describes the differences between simple and complex febrile seizures in pediatric patients. The document provides an overview of clinical assessment, laboratory testing, imaging and discharge instructions.
This review describes the differences between simple and complex febrile seizures in pediatric patients. The document provides an overview of clinical assessment, laboratory testing, imaging and discharge instructions.
Review: Febrile seizures: emergency medicine perspective
Kimia AA, Bachur RG, Torres A, Harper MB
Kimia AA, Bachur RG, Torres A, Harper MB
This review describes current evidence on the evaluation of febrile seizures in the acute setting, the need for further outpatient assessment, and predictors regarding long-term outcomes of these patients
This review describes current evidence on the evaluation of febrile seizures in the acute setting, the need for further outpatient assessment, and predictors regarding long-term outcomes of these patients
Review: Emergency Medicine Myths: Computed Tomography of the Head Prior to Lumbar Puncture in Adults with Suspected Bacterial Meningitis - Due Diligence or Antiquated Practice?
April MD, Long B, Koyfman A
April MD, Long B, Koyfman A
Objective: To review the evidence regarding the utility of obtaining head CT prior to lumbar puncture in adults with suspected bacterial meningitis.
Objective: To review the evidence regarding the utility of obtaining head CT prior to lumbar puncture in adults with suspected bacterial meningitis.
Cochrane Systematic Review: Traditional Chinese medicine for epilepsy
Li Q, Chen XY, He L, Zhou D
Li Q, Chen XY, He L, Zhou D
OBJECTIVES: To determine the effectiveness and safety of traditional Chinese medicine in people with epilepsy.
OBJECTIVES: To determine the effectiveness and safety of traditional Chinese medicine in people with epilepsy.
Cochrane Systematic Review: Chinese herbal medicine Huangqi type formulations for nephrotic syndrome
Feng M, Yuan W, Zhang R, Fu P, Wu T
Feng M, Yuan W, Zhang R, Fu P, Wu T
OBJECTIVES: To assess the benefits and harms of Huangqi and Huangqi type formulations in treating nephrotic syndrome in any age group, either as sole agents or in addition to other drug therapies.
OBJECTIVES: To assess the benefits and harms of Huangqi and Huangqi type formulations in treating nephrotic syndrome in any age group, either as sole agents or in addition to other drug therapies.
Cochrane Systematic Review: Chinese herbal medicine for atopic eczema
Zhang W, Leonard T, Bath-Hextall FJ, Chambers C, Lee C, Humphreys R, Williams HC
Zhang W, Leonard T, Bath-Hextall FJ, Chambers C, Lee C, Humphreys R, William...
OBJECTIVES: To assess the effects of Chinese herbal mixtures in the treatment of atopic eczema.
OBJECTIVES: To assess the effects of Chinese herbal mixtures in the treatment of atopic eczema.
Cochrane Systematic Review: Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department
Doan Q, Enarson P, Kissoon N, Klassen TP, Johnson DW.
Doan Q, Enarson P, Kissoon N, Klassen TP, Johnson DW.
Objectives: To determine the effect of rapid viral testing in the ED on the rate of precautionary testing, antibiotic use, and length of ED visit.
Objectives: To determine the effect of rapid viral testing in the ED on the rate of precautionary testing, antibiotic use, and length of ED visit.
Cochrane Systematic Review: Early emergency department treatment of acute asthma with systemic corticosteroids
Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW.
Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW.
Objectives: To determine the benefit of treating patients with acute asthma with systemic corticosteroids within an hour of presenting to the emergency department (ED).
Objectives: To determine the benefit of treating patients with acute asthma with systemic corticosteroids within an hour of presenting to the emergency department (ED).
Cochrane Systematic Review: Early use of inhaled corticosteroids in the emergency department treatment of acute asthma
Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH.
Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH.
Objectives: To determine the benefit of ICS for the treatment of patients with acute asthma managed in the emergency department (ED).
Objectives: To determine the benefit of ICS for the treatment of patients with acute asthma managed in the emergency department (ED).
Cochrane Systematic Review: Inhaled steroids for acute asthma following emergency department discharge
Edmonds ML, Milan SJ, Brenner BE, Camargo CA Jr, Rowe BH.
Edmonds ML, Milan SJ, Brenner BE, Camargo CA Jr, Rowe BH.
Objectives: To determine the effectiveness of ICS on outcomes in the treatment of acute asthma following discharge from the ED. To quantify the effectiveness of ICS therapy on acute asthma following ED discharge, when used in addition to, or as a substitute for, systemic corticosteroids.
Objectives: To determine the effectiveness of ICS on outcomes in the treatment of acute asthma following discharge from the ED. To quantify the effectiveness of ICS therapy on acute asthma following ED discharge, when used in addition to, or as a substitute for, systemic corticosteroids.
Cochrane Systematic Review: Interventions for educating children who are at risk of asthma-related emergency department attendance
Boyd M, Lasserson TJ, McKean MC, Gibson PG, Ducharme FM, Haby M.
Boyd M, Lasserson TJ, McKean MC, Gibson PG, Ducharme FM, Haby M.
Objectives: To conduct a systematic review of the literature and update the previous review as to whether asthma education leads to improved health outcomes in children who have attended the emergency room for asthma.
Objectives: To conduct a systematic review of the literature and update the previous review as to whether asthma education leads to improved health outcomes in children who have attended the emergency room for asthma.
Cochrane Systematic Review: Intravenous beta2-agonists for acute asthma in the emergency department
Travers A, Jones AP, Kelly K, Barker SJ, Camargo CA, Rowe BH.
Travers A, Jones AP, Kelly K, Barker SJ, Camargo CA, Rowe BH.
Objectives: To determine the benefit of intravenous (IV) beta2-agonists for severe acute asthma treated in the emergency department.
Objectives: To determine the benefit of intravenous (IV) beta2-agonists for severe acute asthma treated in the emergency department.
Cochrane Systematic Review: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department
Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr.
Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr.
Objectives: To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department.
Objectives: To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department.
Cochrane Systematic Review: Emergency intubation for acutely ill and injured patients
Lecky F, Bryden D, Little R, Tong N, Moulton C
Lecky F, Bryden D, Little R, Tong N, Moulton C
OBJECTIVES: To determine in acutely ill and injured patients who have real or anticipated problems in maintaining an adequate airway whether emergency endotracheal intubation, as opposed to other airway management techniques, improves the outcome in terms of survival, degree of disability at discharge or length of stay and complications occurring in hospital.
OBJECTIVES: To determine in acutely ill and injured patients who have real or anticipated problems in maintaining an adequate airway whether emergency endotracheal intubation, as opposed to other airway management techniques, improves the outcome in terms of survival, degree of disability at discharge or length of stay and complications occurring in hospital.
Cochrane Systematic Review: Tranexamic acid for reducing mortality in emergency and urgent surgery
Perel P, Ker K, Morales Uribe CH, Roberts I
Perel P, Ker K, Morales Uribe CH, Roberts I
OBJECTIVES: To assess the effects of tranexamic acid on mortality, blood transfusion and thromboembolic events in adults undergoing emergency or urgent surgery.
OBJECTIVES: To assess the effects of tranexamic acid on mortality, blood transfusion and thromboembolic events in adults undergoing emergency or urgent surgery.
Cochrane Systematic Review: Emergency interventions for hyperkalaemia
Mahoney BA, Smith WA, Lo DS, Tsoi K, Tonelli M, Clase CM
Mahoney BA, Smith WA, Lo DS, Tsoi K, Tonelli M, Clase CM
OBJECTIVES: To review randomised evidence informing the emergency (i.e. acute, rather than chronic) management of hyperkalaemia
OBJECTIVES: To review randomised evidence informing the emergency (i.e. acute, rather than chronic) management of hyperkalaemia
Systematic Review: Screening injured children for physical abuse or neglect in emergency departments: a systematic review
Woodman J, Lecky F, Hodes D, Pitt M, Taylor B, Gilbert R
Woodman J, Lecky F, Hodes D, Pitt M, Taylor B, Gilbert R
Screening markers are used in emergency departments (EDs) to identify children who should be assessed for possible physicalabuseand neglect. We conducted three systematic reviews evaluating age, repeat attendance and injury type as markers for physicalabuseor neglect in injured children attending EDs.
Screening markers are used in emergency departments (EDs) to identify children who should be assessed for possible physicalabuseand neglect. We conducted three systematic reviews evaluating age, repeat attendance and injury type as markers for physicalabuseor neglect in injured children attending EDs.
Review: Understanding and Improving Care for Individuals with Intellectual and Developmental Disabilities in the Emergency Department
Lusky Y, Lake JK, Durbin J, Perry A, Bullock H, Morris S, Lee JS
Lusky Y, Lake JK, Durbin J, Perry A, Bullock H, Morris S, Lee JS
The aim of this review was to provide an overview of existing research on patterns and predictors of emergency department use among persons with intellectual and developmental disabilities, to summarize what is known about the care received and to describe interventions to improve emergency care.
The aim of this review was to provide an overview of existing research on patterns and predictors of emergency department use among persons with intellectual and developmental disabilities, to summarize what is known about the care received and to describe interventions to improve emergency care.
Review: Management of agitation in individuals with autism spectrum disorders in the emergency department
McGonigle JJ, Venkat A, Beresford C, Campbell TP, Gabriels RL
McGonigle JJ, Venkat A, Beresford C, Campbell TP, Gabriels RL
This article describes the challenges that inidividuals with autism spectrum disorder face when receiving treatment in crisis and emergency settings.
This article describes the challenges that inidividuals with autism spectrum disorder face when receiving treatment in crisis and emergency settings.
Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma
Stengel D, Bauwens K, Rademacher G, Ekkernkamp A, Gthoff C,
Stengel D, Bauwens K, Rademacher G, Ekkernkamp A, Gthoff C,
Review to assess the effects of trauma algorithms that include ultrasound examinations in patients with suspected blunt abdominal trauma.
Review to assess the effects of trauma algorithms that include ultrasound examinations in patients with suspected blunt abdominal trauma.
Review: Pediatric orthopedic injuries: evidence-based management in the emergency department
Lien J
Lien J
This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities.
This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities.
Review: During the Emergency Department Evaluation of a Well-Appearing Neonate with Fever, Should Empiric Acyclovir Be Initiated?
Bruno E, Pillus D, Cheng D, Vilke G, Pokrajac N
Bruno E, Pillus D, Cheng D, Vilke G, Pokrajac N
This review aimed to identify when to initiate testing and treatment for herpes simplex virus infection.
This review aimed to identify when to initiate testing and treatment for herpes simplex virus infection.
Review: Emergency management of burns: part 1
Stiles K
Stiles K
Objective: The aim of this article is to give an overview of burns trauma, and to describe the initial assessment and management of patients with these injuries in emergency departments (EDs). Part 1 of 2.
Objective: The aim of this article is to give an overview of burns trauma, and to describe the initial assessment and management of patients with these injuries in emergency departments (EDs). Part 1 of 2.
Review: Emergency management of burns: part 2
Stiles K
Stiles K
Objective: The aim of the two articles is to enhance emergency clinicians knowledge and confidence in burn management, and to build awareness of the life-changing implications of the initial clinical interventions in burn care. Part 2 of 2.
Objective: The aim of the two articles is to enhance emergency clinicians knowledge and confidence in burn management, and to build awareness of the life-changing implications of the initial clinical interventions in burn care. Part 2 of 2.
Review: Emergency Care of Pediatric Burns
Strobel AM, Fey R
Strobel AM, Fey R
Objective: To review emergency care, management and prevention of pediatric burns.
Objective: To review emergency care, management and prevention of pediatric burns.
Review: Optimizing emergency management to reduce morbidity and mortality in pediatric burn patients
Haines E, Fairbrother H
Haines E, Fairbrother H
Objective: This article reviews methods for accurate classification and management of the full range of burns seen in pediatric patients.
Objective: This article reviews methods for accurate classification and management of the full range of burns seen in pediatric patients.
Review: Lyme Disease: Emergency Department Considerations
Applegren ND, Kraus CK
Applegren ND, Kraus CK
Objective: We sought to review the etiology of LD, describe its clinical presentations and sequela, and provide a practical classification and approach to ED management of patients with LD-related presentations.
Objective: We sought to review the etiology of LD, describe its clinical presentations and sequela, and provide a practical classification and approach to ED management of patients with LD-related presentations.
Review: Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department
Dorsett M, Liang SY
Dorsett M, Liang SY
Objective: This review discusses the clinical signs and symptoms that should lead emergency physicians to consider CNS infection, paying particular attention to the sensitivity and specificity of different clinical findings at the bedside. Subsequently, the diagnostic workup and management of patients for whom there is high clinical suspicion for CNS infection is discussed.
Objective: This review discusses the clinical signs and symptoms that should lead emergency physicians to consider CNS infection, paying particular attention to the sensitivity and specificity of different clinical findings at the bedside. Subsequently, the diagnostic workup and management of patients for whom there is high clinical suspicion for CNS infection is discussed.
Review: Emergency department management of meningitis and encephalitis
Fitch MT, Abrahamian FM, Moran GJ, Talan DA
Fitch MT, Abrahamian FM, Moran GJ, Talan DA
Objective: This article addresses considerations in clinical evaluation, need for CNS imaging before LP, interpretation of cerebrospinal fluid results, standards for and effects of timely antibiotic administration, and recommendations for specific antimicrobial therapy and corticosteroids.
Objective: This article addresses considerations in clinical evaluation, need for CNS imaging before LP, interpretation of cerebrospinal fluid results, standards for and effects of timely antibiotic administration, and recommendations for specific antimicrobial therapy and corticosteroids.
Systematic Review: Suicide Evaluation in the Pediatric Emergency Setting
Ambrose AJH, Prager LM
Ambrose AJH, Prager LM
Objective: to review current peds education screening tools
Objective: to review current peds education screening tools
Systematic Review: A Systematic Review of Instruments to Identify Mental Health and Substance Use Problems Among Children in the Emergency Department
Newton AS, Soleimani A, Kirkland SW, Gokiert RJ.
Newton AS, Soleimani A, Kirkland SW, Gokiert RJ.
Objective: to investigate the psychometric properties, accuracy, and performance metrics of instruments used in the ED to identify pediatric mental health and substance use problems.
Objective: to investigate the psychometric properties, accuracy, and performance metrics of instruments used in the ED to identify pediatric mental health and substance use problems.
Systematic Review: Literature-based Recommendations for Suicide Assessment in the Emergency Department: A Review
Ronquillo L, Minassian A, Vilke GM, Wilson MP
Ronquillo L, Minassian A, Vilke GM, Wilson MP
Objective: Given the emphasis on screening for suicidal ideation in the general hospital and ED, it is important for Emergency Physicians to be able to understand and perform suicide risk assessment.
Objective: Given the emphasis on screening for suicidal ideation in the general hospital and ED, it is important for Emergency Physicians to be able to understand and perform suicide risk assessment.
Systematic Review: Screening for Suicide Risk in the Pediatric Emergency and Acute Care Setting
Wintersteen MB, Diamond GS, Fein JA
Wintersteen MB, Diamond GS, Fein JA
Objective: reviews epidemiology, psychiatric comorbidities, risk factors, warning signs, screening measures, and issues related to screening for suicide risk in the pediatric emergency department and acute care settings.
Objective: reviews epidemiology, psychiatric comorbidities, risk factors, warning signs, screening measures, and issues related to screening for suicide risk in the pediatric emergency department and acute care settings.
Systematic review: Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician's point of view.
Junior H, Sakano TMS, Rodrigues RM, et al.
Junior H, Sakano TMS, Rodrigues RM, et al.
Objective: Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease (COVID-19) is a rare and challenging diagnosis requiring early treatment. The diagnostic criteria involve clinical, laboratory, and complementary tests. This review aims to draw pediatrician attention to this diagnosis, suggesting early treatment strategies, and proposing a pediatric emergency care flowchart.
Objective: Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease (COVID-19) is a rare and challenging diagnosis requiring early treatment. The diagnostic criteria involve clinical, laboratory, and complementary tests. This review aims to draw pediatrician attention to this diagnosis, suggesting early treatment strategies, and proposing a pediatric emergency care flowchart.
Rational use of high-flow therapy in infants with bronchiolitis. What do the latest trials tell us?' A Paediatric Research in Emergency Departments International Collaborative perspective.
O'Brien S, Craig S, Babl FE, Borland ML, Oakley E, Dalziel SR; Paediatric Research in Emergency Departments International Collaborative (PREDICT)
O'Brien S, Craig S, Babl FE, Borland ML, Oakley E, Dalziel SR; Paediatric Res...
Over the past decade, the use of high-flow nasal cannulae (HFNC) therapy has increased markedly and it is now utilised not only in the intensive care unit setting but in general paediatric wards and emergency departments. The aim of this systematic review was to summarise and critique the current evidence-base for the use of HFNC in infants with bronchiolitis.
Over the past decade, the use of high-flow nasal cannulae (HFNC) therapy has increased markedly and it is now utilised not only in the intensive care unit setting but in general paediatric wards and emergency departments. The aim of this systematic review was to summarise and critique the current evidence-base for the use of HFNC in infants with bronchiolitis.
Review: Approach to Pediatric Traumatic Brain Injury in the Emergency Department.
Belisle S, Lim R, Hochstadter E, Sangha G.
Belisle S, Lim R, Hochstadter E, Sangha G.
We discuss the initial management of traumatic brain injury based on mild, moderate and severe presentations. Management strategies to address Intracranial Pressure and Cerebral perfusion pressure, the use of oxygenation and ventilation strategies, temperature, correction of metabolic abnormalities and seizure care are discussed.
We discuss the initial management of traumatic brain injury based on mild, moderate and severe presentations. Management strategies to address Intracranial Pressure and Cerebral perfusion pressure, the use of oxygenation and ventilation strategies, temperature, correction of metabolic abnormalities and seizure care are discussed.
Review: Emergency Department Implementation of the Brain Trauma Foundation's Pediatric Severe Brain Injury Guideline Recommendations.
Lumba-Brown A, Totten A, Kochanek PM.
Lumba-Brown A, Totten A, Kochanek PM.
Provides new and updated recommendations applicable to the emergency department management of children with severe traumatic brain injury. Practice-changing takeaways include specific recommendations for administration of 3% hypertonic saline, administration of seizure prophylaxis, and avoiding hyperventilation.
Provides new and updated recommendations applicable to the emergency department management of children with severe traumatic brain injury. Practice-changing takeaways include specific recommendations for administration of 3% hypertonic saline, administration of seizure prophylaxis, and avoiding hyperventilation.
Systematic Review: Diagnostic Accuracy of Point-of-Care Ultrasound for Intussusception in Children Presenting to the Emergency Department: A Systematic Review and Meta-analysis
Lin-Martore M, Kornblith AE, Kohn MA, Gottlieb M.
Lin-Martore M, Kornblith AE, Kohn MA, Gottlieb M.
Objective: The purpose of this systematic review and meta-analysis was to determine the diagnostic accuracy of POCUS for children with suspected ileocolic intussusception by emergency physicians (EP).
Objective: The purpose of this systematic review and meta-analysis was to determine the diagnostic accuracy of POCUS for children with suspected ileocolic intussusception by emergency physicians (EP).
Systematic Review: Inpatient Admission versus Emergency Department Management of Intussusception in Children: A Systemic Review and Meta-Analysis of Outcomes.
Amuddhu SK, Chen Y, Nah SA.
Amuddhu SK, Chen Y, Nah SA.
We performed a systematic review and meta-analysis to compare recurrence rates and length of hospital stay between the groups.
We performed a systematic review and meta-analysis to compare recurrence rates and length of hospital stay between the groups.
Review: Youth With Autism Spectrum Disorder in the Emergency Department
Lytle S, Hunt A, Moratschek S, Hall-Mennes M, Sajatovic M.
Lytle S, Hunt A, Moratschek S, Hall-Mennes M, Sajatovic M.
Youth (aged 0-17 years) with ASD were up to 30 times more likely to present to the ED than youth without ASD. Individuals with ASD who visited the ED were older, more likely to have public insurance, and more likely to have nonurgent ED visits. For youth with ASD, up to 13% of visits were for behavioral or psychiatric problems, whereas for youth without ASD less than 2% were for psychiatric problems. ASD youth were more likely to present for externalizing problems or psychotic symptoms. Youth with ASD were also likely to have repeat visits to the ED and more likely to be admitted to a psychiatric unit or medical floor than youth without ASD.
Youth (aged 0-17 years) with ASD were up to 30 times more likely to present to the ED than youth without ASD. Individuals with ASD who visited the ED were older, more likely to have public insurance, and more likely to have nonurgent ED visits. For youth with ASD, up to 13% of visits were for behavioral or psychiatric problems, whereas for youth without ASD less than 2% were for psychiatric problems. ASD youth were more likely to present for externalizing problems or psychotic symptoms. Youth with ASD were also likely to have repeat visits to the ED and more likely to be admitted to a psychiatric unit or medical floor than youth without ASD.
Review: See-Hear-Feel-Speak: A Protocol for Improving Outcomes in Emergency Department Interactions With Patients With Autism Spectrum Disorder
Samet D, Luterman S.
Samet D, Luterman S.
The presentation of children and adolescents with autism in the emergency department (ED) poses a unique set of challenges to clinicians and their teams, which have not yet been met. Children and adolescents with autism spectrum disorder (ASD) are more likely than their age and ethnically matched counterparts to visit both pediatric and general EDs and are more likely to use it for primary care complaints and dental care and to present for psychiatric concerns including suicidality. Despite the higher relative frequency, individuals with ASD demonstrate lower patient satisfaction, lower healthcare self-efficacy, and higher odds of unmet healthcare needs related to physical health, mental health, health maintenance, and vaccination. This can be ameliorated by simple strategies regarding communication, sensory and environmental modification, and distraction. After performing a literature review of existing evidence-based recommendations via PubMed as well as resources from autism advocacy and self-advocacy groups, we compiled a 4-step system: "See-Hear-Feel-Speak" an approach conducive to learning with the goal of enabling clinicians and their teams to facilitate patient-centered encounters with pediatric patients with ASD. The protocol meets the practicality requirements defined by published research.
The presentation of children and adolescents with autism in the emergency department (ED) poses a unique set of challenges to clinicians and their teams, which have not yet been met. Children and adolescents with autism spectrum disorder (ASD) are more likely than their age and ethnically matched counterparts to visit both pediatric and general EDs and are more likely to use it for primary care complaints and dental care and to present for psychiatric concerns including suicidality. Despite the higher relative frequency, individuals with ASD demonstrate lower patient satisfaction, lower healthcare self-efficacy, and higher odds of unmet healthcare needs related to physical health, mental health, health maintenance, and vaccination. This can be ameliorated by simple strategies regarding communication, sensory and environmental modification, and distraction. After performing a literature review of existing evidence-based recommendations via PubMed as well as resources from autism advocacy and self-advocacy groups, we compiled a 4-step system: "See-Hear-Feel-Speak" an approach conducive to learning with the goal of enabling clinicians and their teams to facilitate patient-centered encounters with pediatric patients with ASD. The protocol meets the practicality requirements defined by published research.
Fluid treatment for children with diabetic ketoacidosis: How do the results of the pediatric emergency care applied research network Fluid Therapies Under Investigation in Diabetic Ketoacidosis (FLUID) Trial change our perspective?
Glaser N, Kuppermann N.
Glaser N, Kuppermann N.
The optimal fluid treatment protocol for children with diabetic ketoacidosis (DKA) has long been a subject of controversy. Until recently, there was no high-quality evidence from randomized clinical trials to support an optimal guideline, and recommendations were mainly based on theoretical considerations. As a consequence, fluid treatment protocols for children with DKA vary between institutions (and countries). In June 2018, the results from the Fluid Therapies Under Investigation in DKA Trial conducted in the Pediatric Emergency Care Applied Research Network were published. This large, factorial-designed randomized controlled trial assessed neurological outcomes of 1387 children with DKA who were treated with one of four fluid protocols that varied in infusion rate and sodium content. In this commentary, we review and discuss the results of this new study and the implications for clinical care of DKA in children.
The optimal fluid treatment protocol for children with diabetic ketoacidosis (DKA) has long been a subject of controversy. Until recently, there was no high-quality evidence from randomized clinical trials to support an optimal guideline, and recommendations were mainly based on theoretical considerations. As a consequence, fluid treatment protocols for children with DKA vary between institutions (and countries). In June 2018, the results from the Fluid Therapies Under Investigation in DKA Trial conducted in the Pediatric Emergency Care Applied Research Network were published. This large, factorial-designed randomized controlled trial assessed neurological outcomes of 1387 children with DKA who were treated with one of four fluid protocols that varied in infusion rate and sodium content. In this commentary, we review and discuss the results of this new study and the implications for clinical care of DKA in children.
Systematic review and validation of prediction rules for identifying children with serious infections in emergency departments and urgent-access primary care.
Thompson M, Van den Bruel A, Verbakel J, Lakhanpaul M, Haj-Hassan T, Stevens R, et al
Thompson M, Van den Bruel A, Verbakel J, Lakhanpaul M, Haj-Hassan T, Stevens ...
We systematically identified clinical features and laboratory tests which identify serious infection in children attending the ED and primary care. We also identified clinical prediction rules and validated those using existing data sets.
We systematically identified clinical features and laboratory tests which identify serious infection in children attending the ED and primary care. We also identified clinical prediction rules and validated those using existing data sets.
Management protocols for status epilepticus in the pediatric emergency room: systematic review article
Au CC, Branco RG, Tasker RC.
Au CC, Branco RG, Tasker RC.
This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department treatment of status epilepticus.
This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department treatment of status epilepticus.
Review: Relief of pain and anxiety in pediatric patients in emergency medical systems
Fein JA, Zempsky WT, Cravero JP, Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine
Fein JA, Zempsky WT, Cravero JP, Committee on Pediatric Emergency Medicine an...
Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child's and family's reaction to current and futu
Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child's and family's reaction to current and futu
Intranasal drugs for analgesia and sedation in children admitted to pediatric emergency department: a narrative review
Pansini V, Curatola A, Gatto A, Lazzareschi I, Ruggiero A, Chiaretti A.
Pansini V, Curatola A, Gatto A, Lazzareschi I, Ruggiero A, Chiaretti A.
Acute pain is one of the most common symptoms in children admitted to the Pediatric Emergency Department (PED) and its management represents a real clinical challenge for pediatricians.
Acute pain is one of the most common symptoms in children admitted to the Pediatric Emergency Department (PED) and its management represents a real clinical challenge for pediatricians.
A Retrospective Review of Antipsychotic Medications Administered to Psychiatric Patients in a Tertiary Care Pediatric Emergency Department
Rudolf, F., K. Hollenbach, K. L. Carstairs and S. D. Carstairs
Rudolf, F., K. Hollenbach, K. L. Carstairs and S. D. Carstairs
Key Study: Outcome of Pediatric Forearm Fracture Reductions Performed by Pediatric Emergency Medicine Providers Compared With Reductions Performed by Orthopedic Surgeons: A Retrospective Cohort Study
Milner, D, Krause, E, Hamre, K and Flood, A
Milner, D, Krause, E, Hamre, K and Flood, A
The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions.
The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions.
Key Study: Diagnostic Accuracy of Point-Of-Care Ultrasound for Intussusception Performed by Pediatric Emergency Medicine Physicians.
Arroyo AC, Zerzan J, Vazquez H, Dickman E, Likourezos A, Hossain R, et al
Arroyo AC, Zerzan J, Vazquez H, Dickman E, Likourezos A, Hossain R, et al
Objective: Our objective was to determine the diagnostic accuracy of POCUS by novice sonographer pediatric emergency medicine physicians (PEM-Ps) who received focused US training for diagnosing INT.
Objective: Our objective was to determine the diagnostic accuracy of POCUS by novice sonographer pediatric emergency medicine physicians (PEM-Ps) who received focused US training for diagnosing INT.
Key Study: Pediatric Emergency Medicine Point-of-Care Ultrasound for the Diagnosis of Intussusception.
Trigylidas TE, Hegenbarth MA, Patel L, Kennedy C, O'Rourke K, Kelly JC.
Trigylidas TE, Hegenbarth MA, Patel L, Kennedy C, O'Rourke K, Kelly JC.
Objectives: The primary objective was to evaluate the accuracy of PEM POCUS in identifying ileocolic intussusception. The secondary objective was to identify factors associated with air enema failure.
Objectives: The primary objective was to evaluate the accuracy of PEM POCUS in identifying ileocolic intussusception. The secondary objective was to identify factors associated with air enema failure.
Key Study: Rapid fluid resuscitation in pediatrics: testing the American College of Critical Care Medicine guideline (2007)
Stoner MJG, D. G.; Cohen, D. M.; Fernandez, S. A.; Hall, M. W.
Stoner MJG, D. G.; Cohen, D. M.; Fernandez, S. A.; Hall, M. W.
Objective: The 2002 American College of Critical Care Medicine (ACCM) guidelines for the resuscitation of pediatric septic shock suggest that 20 mL/kg of bolus intravenous fluid be given within 5 minutes. Of 3 commonly used, inexpensive methods of fluid delivery, we hypothesized that only use of a manual push-pull system will permit guideline adherence. Published: 2007.
Objective: The 2002 American College of Critical Care Medicine (ACCM) guidelines for the resuscitation of pediatric septic shock suggest that 20 mL/kg of bolus intravenous fluid be given within 5 minutes. Of 3 commonly used, inexpensive methods of fluid delivery, we hypothesized that only use of a manual push-pull system will permit guideline adherence. Published: 2007.
Key study: Identifying persistent postconcussion symptom risk in a pediatric sports medicine clinic
Howell DR, Zemek R, Brilliant AN, Mannix RC, Master CL, Meehan WP.
Howell DR, Zemek R, Brilliant AN, Mannix RC, Master CL, Meehan WP.
To determine if the Predicting Persistent Post-concussive Problems in Pediatrics (5P) clinical risk score, an emergency department (ED)derived and validated tool, is associated with developing PPCS when obtained in a primary care sports concussion setting.
To determine if the Predicting Persistent Post-concussive Problems in Pediatrics (5P) clinical risk score, an emergency department (ED)derived and validated tool, is associated with developing PPCS when obtained in a primary care sports concussion setting.
Summary: Emergency preparedness and response: multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19).
Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
Objective: Providing 1) background information on several cases of a recently reported multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19); and 2) a case definition for this syndrome.
Objective: Providing 1) background information on several cases of a recently reported multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19); and 2) a case definition for this syndrome.
Key Study: Evaluation of bedside sonography performed by emergency physicians to detect intussusception in children in the emergency department.
Tonson la Tour A, Desjardins MP, Gravel J.
Tonson la Tour A, Desjardins MP, Gravel J.
Objective: The aim of our study was to evaluate the test characteristics of point-of-care ultrasound (POCUS) performed by emergency physicians with varying levels of experience among children having undergone diagnostic radiology ultrasound for intussusception in a pediatric emergency department (PED).
Objective: The aim of our study was to evaluate the test characteristics of point-of-care ultrasound (POCUS) performed by emergency physicians with varying levels of experience among children having undergone diagnostic radiology ultrasound for intussusception in a pediatric emergency department (PED).
Key Study: Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: diagnostic study (2013)
Nijman RGV, Y.; Thompson, M.; Van Veen, M.; Van Meurs, A. H.; Van Der Lei, J.; Steyerberg, E. W.; Moll, H. A.; Oostenbrink, R.
Nijman RGV, Y.; Thompson, M.; Van Veen, M.; Van Meurs, A. H.; Van Der Lei, J....
Objective: To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Published: 2013.
Objective: To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Published: 2013.
Key Study: Serum lactate as a screening tool and predictor of outcome in pediatric patients presenting to the emergency department with suspected infection (2013)
Reed LC, J.; Cummings, A.; Markwell, S.; Wall, J.; Duong, M.
Reed LC, J.; Cummings, A.; Markwell, S.; Wall, J.; Duong, M.
Objective: No single reliable sepsis biomarker exists for risk stratification and prognostication in pediatric patients presenting to the emergency department (ED). Serum lactate (LA) predicts mortality in septic adults. We sought to determine if serum LA correlated with the diagnosis of sepsis, admission rates, and outcomes in pediatric patients presenting to the ED with suspected infection. Published: 2013.
Objective: No single reliable sepsis biomarker exists for risk stratification and prognostication in pediatric patients presenting to the emergency department (ED). Serum lactate (LA) predicts mortality in septic adults. We sought to determine if serum LA correlated with the diagnosis of sepsis, admission rates, and outcomes in pediatric patients presenting to the ED with suspected infection. Published: 2013.
Key Study: Implementation of goal-directed therapy for children with suspected sepsis in the emergency department (2011)
Cruz ATP, A. M.; Williams, E. A.; Graf, J. M.; Wuestner, E. R.; Patel, B.
Cruz ATP, A. M.; Williams, E. A.; Graf, J. M.; Wuestner, E. R.; Patel, B.
Background: Suboptimal care for children with septic shock includes delayed recognition and inadequate fluid resuscitation. OBJECTIVE: To describe the implementation of an emergency department (ED) protocol for the recognition of septic shock and facilitate adherence to national treatment guidelines. Published: 2011.
Background: Suboptimal care for children with septic shock includes delayed recognition and inadequate fluid resuscitation. OBJECTIVE: To describe the implementation of an emergency department (ED) protocol for the recognition of septic shock and facilitate adherence to national treatment guidelines. Published: 2011.
Key Study: An emergency department septic shock protocol and care guideline for children initiated at triage (2011)
Larsen GYM, N.; Greenberg, R.
Larsen GYM, N.; Greenberg, R.
Background: Unrecognized and undertreated septic shock increases morbidity and mortality. Septic shock in children is defined as sepsis and cardiovascular organ dysfunction, not necessarily with hypotension. OBJECTIVE: Cases of unrecognized and undertreated septic shock in our emergency department (ED) were reviewed with a focus on (1) increased recognition at triage and (2) more aggressive treatment once recognized. We hypothesized that septic shock protocol and care guideline would expedite identification of septic shock, increase compliance with recommended therapy, and improve outcomes.
Background: Unrecognized and undertreated septic shock increases morbidity and mortality. Septic shock in children is defined as sepsis and cardiovascular organ dysfunction, not necessarily with hypotension. OBJECTIVE: Cases of unrecognized and undertreated septic shock in our emergency department (ED) were reviewed with a focus on (1) increased recognition at triage and (2) more aggressive treatment once recognized. We hypothesized that septic shock protocol and care guideline would expedite identification of septic shock, increase compliance with recommended therapy, and improve outcomes.
Key Study: How well do vital signs identify children with serious infections in paediatric emergency care? (2009)
Thompson MC, N.; Harnden, A.; Mayon-White, R.; Perera, R.; Mant, D.
Thompson MC, N.; Harnden, A.; Mayon-White, R.; Perera, R.; Mant, D.
Objective: To determine whether vital signs identify children with serious infections, and to compare their diagnostic value with that of the Manchester triage score (MTS) and National Institute for Health and Clinical Excellence (NICE) traffic light system of clinical risk factors. Published: 2009.
Objective: To determine whether vital signs identify children with serious infections, and to compare their diagnostic value with that of the Manchester triage score (MTS) and National Institute for Health and Clinical Excellence (NICE) traffic light system of clinical risk factors. Published: 2009.
Key Study: Emergency management of children with severe sepsis in the United Kingdom: the results of the Paediatric Intensive Care Society sepsis audit (2009)
Inwald DPT, R. C.; Peters, M. J.; Nadel, S.
Inwald DPT, R. C.; Peters, M. J.; Nadel, S.
Objective: To audit current UK practice of the management of severe sepsis in children against the 2002 American College of Critical Care Medicine/Pediatric Advanced Life Support (ACCM-PALS) guideline. Published: 2009.
Objective: To audit current UK practice of the management of severe sepsis in children against the 2002 American College of Critical Care Medicine/Pediatric Advanced Life Support (ACCM-PALS) guideline. Published: 2009.
Key Study: Emergency ultrasound in the detection of pediatric long-bone fractures
Barata, I, Spencer, R, Suppiah, A, Raio, C, Ward, MF, & Sama, A
Barata, I, Spencer, R, Suppiah, A, Raio, C, Ward, MF, & Sama, A
Objective: The goal of this study was to assess the agreement between emergency physicians' and radiologists' final assessments of suspected long-bone fractures using emergency ultrasound and radiography, respectively, in the pediatric population.
Objective: The goal of this study was to assess the agreement between emergency physicians' and radiologists' final assessments of suspected long-bone fractures using emergency ultrasound and radiography, respectively, in the pediatric population.
Key Study: Extremity fracture pain after emergency department reduction and casting: predictors of pain after discharge
Thompson, RW, Krauss, B, Kim, YJ, Monuteaux, MC, Zerriny, S, & Lee, LK
Thompson, RW, Krauss, B, Kim, YJ, Monuteaux, MC, Zerriny, S, & Lee, LK
Objectives: To determine the prevalence of pediatric extremity fracture pain after emergency department (ED) discharge, compare pain severity between fractures requiring simple casting versus sedated reduction and casting, and explore predictors of postdischarge pain.
Objectives: To determine the prevalence of pediatric extremity fracture pain after emergency department (ED) discharge, compare pain severity between fractures requiring simple casting versus sedated reduction and casting, and explore predictors of postdischarge pain.
Key Study: Diagnostic accuracy of bedside emergency ultrasound screening for fractures in pediatric trauma patients
Sinha, TP, Bhoi, S, Kumar, S, Ramchandani, R, Goswami, A, Kurrey, L, & Galwankar, S
Sinha, TP, Bhoi, S, Kumar, S, Ramchandani, R, Goswami, A, Kurrey, L, & Ga...
Objective: To assess the diagnostic accuracy of bedside ultrasound for fractures in pediatric trauma patients.
Objective: To assess the diagnostic accuracy of bedside ultrasound for fractures in pediatric trauma patients.
Key Study: Emergency room visits by pediatric fracture patients treated with cast immobilization
Sawyer, JR, Ivie, CB, Huff, AL, Wheeler, C, Kelly, DM, Beaty, JH, & Canale, ST
Sawyer, JR, Ivie, CB, Huff, AL, Wheeler, C, Kelly, DM, Beaty, JH, & Canal...
Objectives: To determine when and why pediatric patients with cast complaints return to the emergency room (ER). If this could be determined, educational and treatment strategies may help decrease the number of these visits and the cost of care.
Objectives: To determine when and why pediatric patients with cast complaints return to the emergency room (ER). If this could be determined, educational and treatment strategies may help decrease the number of these visits and the cost of care.
Key Study: Ability of emergency ultrasonography to detect pediatric skull fractures: a prospective, observational study
Parri N, Crosby BJ, Glass C, Mannelli F, Sforzi I, Schiavone R, Ban KM
Parri N, Crosby BJ, Glass C, Mannelli F, Sforzi I, Schiavone R, Ban KM
Our objective was to determine if bedside ED ultrasound is an accurate diagnostic tool for identifying skull fractures when compared toheadCT.
Our objective was to determine if bedside ED ultrasound is an accurate diagnostic tool for identifying skull fractures when compared toheadCT.
Key Study: Cost Consequence Analysis of Implementing the Low Risk Ankle Rule in Emergency Departments
Boutis, K, von Keyserlingk, C, Willan, A, Narayanan, UG, Brison, R, Grootendorst, P, Plint AC, Parker, M & Goeree, R
Boutis, K, von Keyserlingk, C, Willan, A, Narayanan, UG, Brison, R, Grootendo...
Objective: To examine the costs and consequences of implementing the Low Risk Ankle Rule.
Objective: To examine the costs and consequences of implementing the Low Risk Ankle Rule.
Key Study: Epidemiology of pediatric fractures presenting to emergency departments in the United States
Naranje, SM, Erali, RA, Warner, WC Jr, Sawyer, JR, & Kelly, DM
Naranje, SM, Erali, RA, Warner, WC Jr, Sawyer, JR, & Kelly, DM
Objective: To identify the most frequent pediatric fractures per 1000 population at risk in the United States using the 2010 National Electronic Injury Surveillance System database and 2010 Census information.
Objective: To identify the most frequent pediatric fractures per 1000 population at risk in the United States using the 2010 National Electronic Injury Surveillance System database and 2010 Census information.
Key Study: Management of toddler's fractures in the pediatric emergency department
Schuh, AM, Whitlock, KB, & Klein, EJ
Schuh, AM, Whitlock, KB, & Klein, EJ
Objectives: To evaluate current practice in treatment of toddler's fractures, as well as subsequent healthcare utilization and complications.
Objectives: To evaluate current practice in treatment of toddler's fractures, as well as subsequent healthcare utilization and complications.
Key Study: Evidence into practice: emergency physician management of common pediatric fractures
Boutis, K, Howard, A, Constantine, E, Cuomo, A, & Narayanan, U
Boutis, K, Howard, A, Constantine, E, Cuomo, A, & Narayanan, U
Objectives: To determine the proportion of emergency physicians who prescribe removable devices for distal radius buckle fractures and/or nondisplaced distal fibular Salter-Harris I fractures. The investigators also examined follow-up referral patterns for these injuries.
Objectives: To determine the proportion of emergency physicians who prescribe removable devices for distal radius buckle fractures and/or nondisplaced distal fibular Salter-Harris I fractures. The investigators also examined follow-up referral patterns for these injuries.
Overview of studies: Emergency presentation of congenital heart disease in children
EB Medicine
EB Medicine
Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.
Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.
Key Study: The Prevalence of Bruising Among Infants in Pediatric Emergency Departments
Pierce MC, Magana JN, Kaczor K, Lorenz DJ, Meyers G, Bennett BL, Kanegaye JT
Pierce MC, Magana JN, Kaczor K, Lorenz DJ, Meyers G, Bennett BL, Kanegaye JT
Bruising can indicate abuse for infants. Bruise prevalence among infants in the pediatric emergency department (ED) setting is unknown. Our objective is to determine prevalence of bruising, associated chief complaints, and frequency of abuse evaluations in previously healthy infants presenting to pediatric EDs.
Bruising can indicate abuse for infants. Bruise prevalence among infants in the pediatric emergency department (ED) setting is unknown. Our objective is to determine prevalence of bruising, associated chief complaints, and frequency of abuse evaluations in previously healthy infants presenting to pediatric EDs.
Key Study: Accuracy of a screening instrument to identify potential child abuse in emergency departments
Louwers EC, Korfage IJ, Affourtit MJ, Ruige M, van den Elzen AP, de Koning HJ, Moll HA
Louwers EC, Korfage IJ, Affourtit MJ, Ruige M, van den Elzen AP, de Koning HJ...
This study was designed to measure the accuracy of a screening instrument for detection of potential child abuse used in EDs.
This study was designed to measure the accuracy of a screening instrument for detection of potential child abuse used in EDs.
Key Study: Emergency department evaluation of child abuse
Leetch AN, Woolridge D
Leetch AN, Woolridge D
This review outlines emergency department evaluation of child abuse.
This review outlines emergency department evaluation of child abuse.
Key Study: Emergency Management of febrile status epilepticus: results of the FEBSTAT study
Seinfeld S, Shinnar S, Sun S, Hesdorffer DC, Deng X, Shinnar RC, O'Hara K, Nordli DR Jr, Frank LM, Gallentine W, Mosh SL, Pellock JM
Seinfeld S, Shinnar S, Sun S, Hesdorffer DC, Deng X, Shinnar RC, O'Hara K, No...
The FEBSTAT study is a prospective study of the consequences of febrile status epilepticus. Acute management, and the relationship between treatment delay, total seizure duration and associated morbidity are analyzed.
The FEBSTAT study is a prospective study of the consequences of febrile status epilepticus. Acute management, and the relationship between treatment delay, total seizure duration and associated morbidity are analyzed.
Key Study: Risk of intracranial pathologic conditions requiring emergency intervention after a first complex febrile seizure episode among children
Teng D, Dayan P, Tyler S, Hauser WA, Chan S, Leary L, Hesdorffer D
Teng D, Dayan P, Tyler S, Hauser WA, Chan S, Leary L, Hesdorffer D
Objective: To determine the likelihood of intracranial pathologic conditions requiring emergency neurosurgical or medical intervention among children without meningitis who presented to the pediatric emergency department after a first complex febrile seizure.
Objective: To determine the likelihood of intracranial pathologic conditions requiring emergency neurosurgical or medical intervention among children without meningitis who presented to the pediatric emergency department after a first complex febrile seizure.
Overview of studies: Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department
Judge P, Meckler G
Judge P, Meckler G
Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.
Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.
Key Study: Epidemiology of Injury-Related Emergency Department Visits in the US Among Youth with Autism Spectrum Disorder
Kalb LG, Vasa RA, Ballard ED, Woods S, Goldstein M, Wilcox HC
Kalb LG, Vasa RA, Ballard ED, Woods S, Goldstein M, Wilcox HC
This study aims to use nationally-representative emergency department data to characterize injury-related ED visits among youth with autism spectrum disorder.
This study aims to use nationally-representative emergency department data to characterize injury-related ED visits among youth with autism spectrum disorder.
Key Study: Parent and health care provider perspectives related to disclosure of autism spectrum disorder in pediatric emergency departments
Muskat B, Greenblatt A, Nicholas DB, Ratnapalan S, Cohen-Silver J, Newton AS, Craig WR, Kilmer C, Zwaigenbaum L
Muskat B, Greenblatt A, Nicholas DB, Ratnapalan S, Cohen-Silver J, Newton AS,...
This qualitative study utilized a grounded theory approach and analyzed data from parents and health care providers related to autism spectrum disorder disclosure within two Canadian pediatric emergency departments.
This qualitative study utilized a grounded theory approach and analyzed data from parents and health care providers related to autism spectrum disorder disclosure within two Canadian pediatric emergency departments.
Key Study: Toward Practice Advancement in Emergency Care for Children With Autism Spectrum Disorder
Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Cohen-Silver J, Sharon RF, Greenblatt A, Kilmer C
Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Cohen-Silver J, Sh...
The objective of this study was to identify stakeholder perspectives in determining clinical priorities and recommendations to guide emergency department service delivery for children with autism spectrum disorder.
The objective of this study was to identify stakeholder perspectives in determining clinical priorities and recommendations to guide emergency department service delivery for children with autism spectrum disorder.
Key Study: Experiences of emergency department care from the perspective of families in which a child has autism spectrum disorder
Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Kilmer C, Greenblatt A, Roberts W, Cohen-Silver J
Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Kilmer C, Greenbla...
In this study, parents and their children with autism spectrum disorder shared their perspectives on emergency department care.
In this study, parents and their children with autism spectrum disorder shared their perspectives on emergency department care.
Key Study: Perspectives of Health Care Providers Regarding Emergency Department Care of Children and Youth with Autism Spectrum Disorder
Zwaigenbaum L, Nicholas DB, Muskat B, Kilmer C, Newton AS, Craig WR,Ratnapalan S, Cohen-Silver J, Greenblatt A, Roberts W, Sharon R
Zwaigenbaum L, Nicholas DB, Muskat B, Kilmer C, Newton AS, Craig WR,Ratnapala...
This study aimed to characterize the perspectives of health professionals who care for children with autism spectrum disorder in the emergency department, and to determine what strategies could optimize care.
This study aimed to characterize the perspectives of health professionals who care for children with autism spectrum disorder in the emergency department, and to determine what strategies could optimize care.
Key Study: Development and evaluation of educational materials for pre-hospital and emergency department personnel on the care of patients with autism spectrum disorder
McGonigle JJ, Migyanka JM, Glor-Scheib SJ, Cramer R, Fratangeli JJ, Hegde GG, Shang J, Venkat A
McGonigle JJ, Migyanka JM, Glor-Scheib SJ, Cramer R, Fratangeli JJ, Hegde GG,...
This study describes the development of education materials on ASD and the results of training of emergency medical services and emergency department personnel.
This study describes the development of education materials on ASD and the results of training of emergency medical services and emergency department personnel.
Key Study: Psychiatric-related emergency department visits among children with an autism spectrum disorder
Kalb LG, Stuart EA, Freedman B, Zablotsky B, Vasa R
Kalb LG, Stuart EA, Freedman B, Zablotsky B, Vasa R
This study aimed to examine the prevalence and characteristics of psychiatry-related emergency department visits among children with autism spectrum disorder, including the specific reason for visit, as well as the influence of insurance type.
This study aimed to examine the prevalence and characteristics of psychiatry-related emergency department visits among children with autism spectrum disorder, including the specific reason for visit, as well as the influence of insurance type.
Key Study: Safety and efficacy of milk and molasses enemas in the emergency department
Vilke GM, DeMers G, Patel N, Castillo EM
Vilke GM, DeMers G, Patel N, Castillo EM
The objective of this study was to evaluate the success and complication rates of administering milk and molasses enemas in the ED.
The objective of this study was to evaluate the success and complication rates of administering milk and molasses enemas in the ED.
Key Study: Pediatric constipation in the emergency department: evaluation, treatment, and outcomes
Freedman SB, Thull-Freedman J, Rumantir M, Eltorki M, Schuh S
Freedman SB, Thull-Freedman J, Rumantir M, Eltorki M, Schuh S
The primary objective of this study was to determine whether enema administration is associated with 7-day emergency department (ED) revisits for persistent symptoms of pediatric constipation. Secondary objectives focused on assessing other predictors of ED revisits.
The primary objective of this study was to determine whether enema administration is associated with 7-day emergency department (ED) revisits for persistent symptoms of pediatric constipation. Secondary objectives focused on assessing other predictors of ED revisits.
Key Study: A randomized trial of enemaversus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department
Miller MK, Dowd MD, Friesen CA, Walsh-Kelly CM
Miller MK, Dowd MD, Friesen CA, Walsh-Kelly CM
This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment.
This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment.
Key Study: Safety and efficacy of milk and molasses enemas compared with sodium phosphate enemas for the treatment of constipation in a pediatric emergency department
Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J
Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J
The purpose of this study was to determine the safety and efficacy of routine milk and molasses enemas (MME) compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department (ED). A secondary objective included the identification of factors associated with enema selection in the pediatric ED.
The purpose of this study was to determine the safety and efficacy of routine milk and molasses enemas (MME) compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department (ED). A secondary objective included the identification of factors associated with enema selection in the pediatric ED.
Key Study: Emergency department management and short-term outcome of children with constipation
Miller MK, Dowd MD, Fraker M
Miller MK, Dowd MD, Fraker M
The objective of this study was to describe variation in emergency department evaluation and treatment of children with constipation and characteristics and treatments associated with improvement.
The objective of this study was to describe variation in emergency department evaluation and treatment of children with constipation and characteristics and treatments associated with improvement.
Key Study: Predictive factors for short-term symptom persistence in children after emergency department evaluation for constipation
Patel H, Law A, Gouin S
Patel H, Law A, Gouin S
The objectives of this study were to describe the clinical characteristics of children presenting to the ED with constipation and the ED interventions; to measure short-term symptom resolution at 48 hours and 7 days after the ED visit; and to identify predictive factors associated with poor symptom resolution at 48 hours and 7 days after the ED visit.
The objectives of this study were to describe the clinical characteristics of children presenting to the ED with constipation and the ED interventions; to measure short-term symptom resolution at 48 hours and 7 days after the ED visit; and to identify predictive factors associated with poor symptom resolution at 48 hours and 7 days after the ED visit.
Key Study: Intravenous regional anaesthesia (Bier's block) for pediatric forearm fractures in a pediatric emergency department-Experience from 2003 to 2014
Chua ISY, Chong SL, Ong GYK
Chua ISY, Chong SL, Ong GYK
The objective of the study was to evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures.
The objective of the study was to evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures.
Key Study: The utility of clinical ultrasonography in identifying distal forearm fractures inthe pediatric emergency department
Galletebeitia Laka I, Samson F, Gorostiza I, Gonzalez A, Gonzalez C
Galletebeitia Laka I, Samson F, Gorostiza I, Gonzalez A, Gonzalez C
The aim of this study is to evaluate the utility of point-of-care ultrasound for diagnosing distal forearm fractures in pediatric emergency departments.
The aim of this study is to evaluate the utility of point-of-care ultrasound for diagnosing distal forearm fractures in pediatric emergency departments.
Key Study: Reduced Length of Stay and Adverse Events Using Bier Block for Forearm Fracture Reduction in the Pediatric Emergency Department
Fauteux-Lamarre E, Burstein B, Cheng A, Bretholz A
Fauteux-Lamarre E, Burstein B, Cheng A, Bretholz A
This study sought to compare Bier block and procedural sedation for forearm fracture reduction.
This study sought to compare Bier block and procedural sedation for forearm fracture reduction.
Key Study: Manipulation and reduction of paediatric fractures of the distal radius and forearm using intranasal diamorphine and 50% oxygen and nitrous oxide in the emergency department: a 2.5-year study
Kurien T, Price KR, Pearson RG, Dieppe C, Hunter JB
Kurien T, Price KR, Pearson RG, Dieppe C, Hunter JB
This study presents the results of managing children's fracture of the distal forearm in the ED using intranasal diamorphine and Entonox to allow manipulation and discharge on the same day.
This study presents the results of managing children's fracture of the distal forearm in the ED using intranasal diamorphine and Entonox to allow manipulation and discharge on the same day.
Key Study: Effect of a Computerized Reminder on Splinting of Pediatric Upper Limb Fractures in the Emergency Department
Mills E, Craig S, Oakley E
Mills E, Craig S, Oakley E
The primary objective was to assess if a computerized pop-up reminder increased splint application before X-ray in pediatric emergency department patients with deformed upper limb fractures.
The primary objective was to assess if a computerized pop-up reminder increased splint application before X-ray in pediatric emergency department patients with deformed upper limb fractures.
Key Study: Using softcast to treat torus fractures in a paediatric emergency department
Callender O, Koe S
Callender O, Koe S
Wrist torus fractures in children are a frequent reason for Emergency Department (ED) visits. Torus fractures traditionally were treated with a backslab cast in the Children's ED and then referred to the Fracture Clinic. Guidelines were developed in order to standardise the care for children who attended the ED with a torus fracture. All patients who were seen & treated by the Advanced Nurse Practitioner (ANP) over a one year period with a diagnosis of a torus fracture were treated with immobilisation in a softcast. 119 patients met the criteria for inclusion. There were no adverse events recorded and no patient required subsequent visits to the Fracture Clinic. There was a cost savings of 18,596 as compared with the normal referral pathway to the Fracture Clinic.
Wrist torus fractures in children are a frequent reason for Emergency Department (ED) visits. Torus fractures traditionally were treated with a backslab cast in the Children's ED and then referred to the Fracture Clinic. Guidelines were developed in order to standardise the care for children who attended the ED with a torus fracture. All patients who were seen & treated by the Advanced Nurse Practitioner (ANP) over a one year period with a diagnosis of a torus fracture were treated with immobilisation in a softcast. 119 patients met the criteria for inclusion. There were no adverse events recorded and no patient required subsequent visits to the Fracture Clinic. There was a cost savings of 18,596 as compared with the normal referral pathway to the Fracture Clinic.
Key Study: Feasibility of a reduction protocol in the emergency department for diaphyseal forearm fractures in children
Pesenti S, Litzelmann E, Kahil M, Mallet C, Jehanno P, Mercier JC, Ilharreborde B, Mazda K
Pesenti S, Litzelmann E, Kahil M, Mallet C, Jehanno P, Mercier JC, Ilharrebor...
The purpose of this study was to analyze the results of diaphyseal forearm fractures in the emergency department in children.
The purpose of this study was to analyze the results of diaphyseal forearm fractures in the emergency department in children.
Key Study: A Practice Guideline for Postreduction Management of Intussusception of Children in the Emergency Department
Kwon H, Lee JH, Jeong JH, Yang HR, Kwak YH, Kim DK, Kim K
Kwon H, Lee JH, Jeong JH, Yang HR, Kwak YH, Kim DK, Kim K
Objective: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence.
Objective: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence.
Key Study: Is Intussusception a Middle-of-the-Night Emergency?
Lampl BS, Glaab J, Ayyala RS, Kanchi R, Ruzal-Shapiro CB
Lampl BS, Glaab J, Ayyala RS, Kanchi R, Ruzal-Shapiro CB
Objectives: Intussusception is the most common abdominal emergency in pediatric patients aged 6 months to 3 years. There is often a delay in diagnosis, as the presentation can be confused for viral gastroenteritis. Given this scenario, we questioned the practice of performing emergency reductions in children during the night when minimal support staff are available. Pneumatic reduction is not a benign procedure, with the most significant risk being bowel perforation. We performed this analysis to determine whether it would be safe to delay reduction in these patients until normal working hours when more support staff are available.
Objectives: Intussusception is the most common abdominal emergency in pediatric patients aged 6 months to 3 years. There is often a delay in diagnosis, as the presentation can be confused for viral gastroenteritis. Given this scenario, we questioned the practice of performing emergency reductions in children during the night when minimal support staff are available. Pneumatic reduction is not a benign procedure, with the most significant risk being bowel perforation. We performed this analysis to determine whether it would be safe to delay reduction in these patients until normal working hours when more support staff are available.
Key Study: The role of abdominal radiography in the diagnosis of intussusception when interpreted by pediatric emergency physicians
Morrison J, Lucas N, Gravel J,
Morrison J, Lucas N, Gravel J,
Objective: To evaluate the sensitivity and specificity of abdominal x-rays in the diagnosis of intussusception when interpreted by pediatric emergency physicians.
Objective: To evaluate the sensitivity and specificity of abdominal x-rays in the diagnosis of intussusception when interpreted by pediatric emergency physicians.
Key Study: Examining Emergency Department Treatment Processes in Severe Pediatric Traumatic Brain Injury
Ajdari A, Boyle LN, Kannan N, Rowhani-Rahbar A, Wang J, Mink R, Ries B, Wainwright M, Groner JI, Bell MJ, Giza C, Zatzick DF, Ellenbogen RG, Mitchell PH, Riv...
Ajdari A, Boyle LN, Kannan N, Rowhani-Rahbar A, Wang J, Mink R, Ries B, Wainw...
Our objectives were to examine the treatment process of acute pediatric TBI and the impact of non-value-added time (NVAT) on patient outcomes.
Our objectives were to examine the treatment process of acute pediatric TBI and the impact of non-value-added time (NVAT) on patient outcomes.
Key Study: Reducing Head CT Use for Children With Head Injuries in a Community Emergency Department
Jennings RM, Burtner JJ, Pellicer JF, Nair DK, Bradford MC, Shaffer M, Uspal NG, Tieder JS
Jennings RM, Burtner JJ, Pellicer JF, Nair DK, Bradford MC, Shaffer M, Uspal ...
Clinical decision rules have reduced use of computed tomography (CT) to evaluate minor pediatric head injury in pediatric emergency departments (EDs). CT use remains high in community EDs, where the majority of children seek medical care. We sought to reduce the rate of CT scans used to evaluate pediatric head injury from 29% to 20% in a community ED.
Clinical decision rules have reduced use of computed tomography (CT) to evaluate minor pediatric head injury in pediatric emergency departments (EDs). CT use remains high in community EDs, where the majority of children seek medical care. We sought to reduce the rate of CT scans used to evaluate pediatric head injury from 29% to 20% in a community ED.
Key Study: Clinical prediction models for young febrile infants at the emergency department: an international validation study
Vos-Kerkhof E, Gomez B, Milcent K, Steyerberg EW, Nijman RG, Smit FJ, Mintegi S, Moll HA, Gajdos V, Oostenbrink R
Vos-Kerkhof E, Gomez B, Milcent K, Steyerberg EW, Nijman RG, Smit FJ, Mintegi...
The objective of this study was to assess the diagnostic value of existing clinical prediction models in febrile young infants at risk for serious bacterial infections.
The objective of this study was to assess the diagnostic value of existing clinical prediction models in febrile young infants at risk for serious bacterial infections.
Key Study: Clinical Pathway Effectiveness: Febrile Young Infant Clinical Pathway in a Pediatric Emergency Department
Murray AL, Alpern E, Lavelle J, Mollen C
Murray AL, Alpern E, Lavelle J, Mollen C
The objective of this study was to evaluate the impact of a febrile young infant clinical pathway implemented in a large, urban children's hospital ED on the timeliness and consistency of care.
The objective of this study was to evaluate the impact of a febrile young infant clinical pathway implemented in a large, urban children's hospital ED on the timeliness and consistency of care.
Key study: A Randomized Controlled Study of Silver-Based Burns Dressing in a Pediatric Emergency Department
Brown M, Dalziel SR, Herd E, Johnson K, Wong She R, Shepherd M
Brown M, Dalziel SR, Herd E, Johnson K, Wong She R, Shepherd M
Objective: This study sought to determine whether silver sodium carboxymethyl cellulose dressing is a superior treatment to nanocrystalline silver-coated polyethylene dressing in pediatric patients with partial thickness burns.
Objective: This study sought to determine whether silver sodium carboxymethyl cellulose dressing is a superior treatment to nanocrystalline silver-coated polyethylene dressing in pediatric patients with partial thickness burns.
Key study: Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?
Niroshan Balasundaram, Dung Phan, Daniel Mazzoni, Elliot Duong, Amy Sweeny, Chris Del Mar and Gerben Keijzers
Niroshan Balasundaram, Dung Phan, Daniel Mazzoni, Elliot Duong, Amy Sweeny, C...
Objective: To describe the diagnostic and management practice in children with acute otitis media (AOM) presenting to the emergency department (ED) and compare diagnosis and management against existing guidelines.
Objective: To describe the diagnostic and management practice in children with acute otitis media (AOM) presenting to the emergency department (ED) and compare diagnosis and management against existing guidelines.
Key Study: Improving Emergency Department Management of Diabetic Ketoacidosis in Children
Baumer-Mouradian SH, Gray MP, Wolfgram PM, Kopetsky M, Chang F, Brousseau DC, Frenkel MM, and Ferguson CC
Baumer-Mouradian SH, Gray MP, Wolfgram PM, Kopetsky M, Chang F, Brousseau DC,...
Objectives: To use point-of-care (POC) testing to reduce DKA determination time from 86 to 30 minutes and to reduce IV placements in patients without DKA from 85% to 20% over 18 months.
Objectives: To use point-of-care (POC) testing to reduce DKA determination time from 86 to 30 minutes and to reduce IV placements in patients without DKA from 85% to 20% over 18 months.
Key Study: Improving Pediatric Diabetic Ketoacidosis Management in Community Emergency Departments Using a Simulation-Based Collaborative Improvement Program
Abulebda K, Whitfill T, Montgomery EE, Kirby ML, Ahmed RA, Cooper DD, Nitu ME, Auerbach MA, Lutfi R, and Abu-Sultaneh S
Abulebda K, Whitfill T, Montgomery EE, Kirby ML, Ahmed RA, Cooper DD, Nitu ME...
Objectives: The majority of pediatric patients with diabetic ketoacidosis (DKA) present to community emergency departments (CEDs) that are less prepared to care for acutely ill children owing to low pediatric volume and limited pediatric resources and guidelines. This has impacted the quality of care provided to pediatric patients in CEDs. We hypothesized that a simulation-based collaborative program would improve the quality of the care provided to simulated pediatric DKA patients presenting to CEDs.
Objectives: The majority of pediatric patients with diabetic ketoacidosis (DKA) present to community emergency departments (CEDs) that are less prepared to care for acutely ill children owing to low pediatric volume and limited pediatric resources and guidelines. This has impacted the quality of care provided to pediatric patients in CEDs. We hypothesized that a simulation-based collaborative program would improve the quality of the care provided to simulated pediatric DKA patients presenting to CEDs.
Key Study: Reducing Time to Pain Medication Administration for Pediatric Patients with Long Bone Fractures in the Emergency Department
Schuman, S S, Regen, R B, Stuart, L H, Harrell, C, Jones, T L, Stewart, B M, Berg, A M, Longjohn, M and Kink, R J
Schuman, S S, Regen, R B, Stuart, L H, Harrell, C, Jones, T L, Stewart, B M, ...
The purpose of this quality improvement project was to develop a protocol with the goal to administer pain medication to children presenting with suspected long bone fractures 47 minutes of emergency department arrival.
The purpose of this quality improvement project was to develop a protocol with the goal to administer pain medication to children presenting with suspected long bone fractures 47 minutes of emergency department arrival.
Key Study: Emergency room closed reduction versus in situ splinting in the treatment of paediatric supracondylar humerus fractures
Sylvia, SM, Maguire, KJ, Molho, DA, Levens, BJ, Stone, MEJ, Hanstein, R, Schulz, JF and Fornari, ED
Sylvia, SM, Maguire, KJ, Molho, DA, Levens, BJ, Stone, MEJ, Hanstein, R, Schu...
The purpose of this study was to investigate if outcomes or complications differ between two management methods.
The purpose of this study was to investigate if outcomes or complications differ between two management methods.
Key Study: Management of Paediatric Buckle (Torus) Wrist Fractures in Irish Emergency Departments: A National Survey
Abdelhady, A, Ahmed, A, Umana, E and O'Donnell, J
Abdelhady, A, Ahmed, A, Umana, E and O'Donnell, J
Buckle fractures are the most common wrist fractures reported in the paediatric age group. National Institute for Clinical Excellence (NICE) recommends using a non-rigid immobilisation with no follow up for these patients and appropriate discharge advice. A telephone survey was conducted to assess the variation in practice in Irish hospitals regarding the mpediatrianagement of buckle fractures.
Buckle fractures are the most common wrist fractures reported in the paediatric age group. National Institute for Clinical Excellence (NICE) recommends using a non-rigid immobilisation with no follow up for these patients and appropriate discharge advice. A telephone survey was conducted to assess the variation in practice in Irish hospitals regarding the mpediatrianagement of buckle fractures.
Key Study: Multiple interventions improve analgesic treatment of supracondylar humerus fractures in a pediatric emergency department
Porter, RN, Chafe, RE, Newhook, LA and Murnaghan, KD
Porter, RN, Chafe, RE, Newhook, LA and Murnaghan, KD
To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.
To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.
Key Study: Factors Affecting Family Presence During Fracture Reduction in the Pediatric Emergency Department
Zhang, A, Yocum, R M, Repplinger, M D, Broman, A T and Kim, M K
Zhang, A, Yocum, R M, Repplinger, M D, Broman, A T and Kim, M K
The aim of this study was to determine factors related to family members' choice to be present or absent during fracture reductions in a pediatric emergency department (ED), and their satisfaction with that choice.
The aim of this study was to determine factors related to family members' choice to be present or absent during fracture reductions in a pediatric emergency department (ED), and their satisfaction with that choice.
Key Study: Behavioral Changes in Children After Emergency Department Procedural Sedation
Pearce, J I, Brousseau, D C, Yan, K, Hainsworth, K R, Hoffmann, R G and Drendel, A L
Pearce, J I, Brousseau, D C, Yan, K, Hainsworth, K R, Hoffmann, R G and Drend...
The purpose of this study was to determine the proportion of children undergoing procedural sedation for fracture reduction in the emergency department (ED) observed to experience negative postdischarge behaviors. Predictors of negative behaviors were evaluated, including anxiety.
The purpose of this study was to determine the proportion of children undergoing procedural sedation for fracture reduction in the emergency department (ED) observed to experience negative postdischarge behaviors. Predictors of negative behaviors were evaluated, including anxiety.
Key Study: Etomidate Versus Ketamine: Effective Use in Emergency Procedural Sedation for Pediatric Orthopedic Injuries
Disel, N R, Yilmaz, H L, Sertdemir, Y, Yesilagac, H and Avci, A
Disel, N R, Yilmaz, H L, Sertdemir, Y, Yesilagac, H and Avci, A
The aim of this study was to compare the induction and recovery times, postsedation observation durations, and adverse effects of etomidate and ketamine in pediatric patients with fractures and/or dislocations requiring closed reduction in the emergency department.
The aim of this study was to compare the induction and recovery times, postsedation observation durations, and adverse effects of etomidate and ketamine in pediatric patients with fractures and/or dislocations requiring closed reduction in the emergency department.
Key Study: Utility of complete trauma series radiographs in alert pediatric patients presenting to Emergency Department of a Tertiary Care Hospital
Alam Khan T1,Jamil Khattak Y,Awais M,Alam Khan A,Husen Y,Nadeem N,Rehman A.
Alam Khan T1,Jamil Khattak Y,Awais M,Alam Khan A,Husen Y,Nadeem N,Rehman A.
To assess the utility of trauma series radiographs in the management of alert pediatric patients with traumatic injury and to ascertain whether it is necessary to acquire the entire trauma series in these children.
To assess the utility of trauma series radiographs in the management of alert pediatric patients with traumatic injury and to ascertain whether it is necessary to acquire the entire trauma series in these children.
Key study: Screening for Suicide Risk Among Youths With a Psychotic Disorder in a Pediatric Emergency Department
DeVylder, J. E., Ryan, T. C., Cwik, M., Jay, S. Y., Wilson, M. E., Goldstein, M., & Wilcox, H. C
DeVylder, J. E., Ryan, T. C., Cwik, M., Jay, S. Y., Wilson, M. E., Goldstein,...
Objective: youths in a pediatric emergency department with psychotic disorder diagnoses (N=87) were screened with the Ask Suicide-Screening Questions
Objective: youths in a pediatric emergency department with psychotic disorder diagnoses (N=87) were screened with the Ask Suicide-Screening Questions
Key study: The Importance of Screening Preteens for Suicide Risk in the Emergency Department
Lanzillo EC, Horowitz LM, Wharff EA, Sheftall AH, Pao M, Bridge JA
Lanzillo EC, Horowitz LM, Wharff EA, Sheftall AH, Pao M, Bridge JA
Objective: To describe the prevalence of screening positive for suicide risk in a sample of 10- to 12-year-olds presenting to the emergency department (ED).
Objective: To describe the prevalence of screening positive for suicide risk in a sample of 10- to 12-year-olds presenting to the emergency department (ED).
Key study: Identification of At-Risk Youth by Suicide Screening in a Pediatric Emergency Department
Ballard, E. D., Cwik, M., Van Eck, K., Goldstein, M., Alfes, C., Wilson, M. E., Virden, J. M., Horowitz, L. M., & Wilcox, H. C
Ballard, E. D., Cwik, M., Van Eck, K., Goldstein, M., Alfes, C., Wilson, M. E...
Objective: retrospective review of the implementation of a brief suicide screen for pediatric psychiatric ED patients as standard of care
Objective: retrospective review of the implementation of a brief suicide screen for pediatric psychiatric ED patients as standard of care
Key study: Columbia-suicide Severity Rating Scale: Predictive Validity With Adolescent Psychiatric Emergency Patients
Gipson PY, Agarwala P, Opperman KJ, Horwitz A, King CA
Gipson PY, Agarwala P, Opperman KJ, Horwitz A, King CA
Objective: examined the predictive validity of a highly promising instrument, the Columbia-Suicide Severity Rating Scale (C-SSRS).
Objective: examined the predictive validity of a highly promising instrument, the Columbia-Suicide Severity Rating Scale (C-SSRS).
Key study: The Current State of Mental Health Services in Canada's Paediatric Emergency Departments
Leon, S. L., Cappelli, M., Ali, S., Craig, W., Curran, J., Gokiert, R., Klassen, T., Osmond, M., Scott, S. D., Newton, A. S., for Pediatric Emergency Resear...
Leon, S. L., Cappelli, M., Ali, S., Craig, W., Curran, J., Gokiert, R., Klass...
Objective: To describe emergency mental health services in major paediatric centres across Canada.
Objective: To describe emergency mental health services in major paediatric centres across Canada.
Key study: The HEADS-ED: A Rapid Mental Health Screening Tool for Pediatric Patients in the Emergency Department
Cappelli, M., Gray, C., Zemek, R., Cloutier, P., Kennedy, A., Glennie, E., Doucet, G., Lyons, J. S.
Cappelli, M., Gray, C., Zemek, R., Cloutier, P., Kennedy, A., Glennie, E., Do...
Objective: developed the rapid screening tool home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources (HEADS-ED), which is a modification of "HEADS," a mnemonic widely used to obtain a psychosocial history in adolescents.
Objective: developed the rapid screening tool home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources (HEADS-ED), which is a modification of "HEADS," a mnemonic widely used to obtain a psychosocial history in adolescents.
Key study: Ask Suicide-Screening Questions (ASQ): A Brief Instrument for the Pediatric Emergency Department
Horowitz, L. M., Bridge, J. A., Teach, S. J., Ballard, E., Klima, J., Rosenstein, D. L., Wharff, E. A., Ginnis, K., Cannon, E., Joshi, P., Pao, M
Horowitz, L. M., Bridge, J. A., Teach, S. J., Ballard, E., Klima, J., Rosenst...
Objective: To develop a brief screening instrument to assess the risk for suicide in pediatric emergency department patients.
Objective: To develop a brief screening instrument to assess the risk for suicide in pediatric emergency department patients.
Key study: Patients' Opinions About Suicide Screening in a Pediatric Emergency Department
Ballard, E. D., Bosk, A., Snyder, D., Pao, M., Bridge, J. A., Wharff, E. A., Teach, S. J., & Horowitz, L.
Ballard, E. D., Bosk, A., Snyder, D., Pao, M., Bridge, J. A., Wharff, E. A., ...
Objective: describes pediatric patients' opinions regarding suicide screening in that setting.
Objective: describes pediatric patients' opinions regarding suicide screening in that setting.
Key study: Feasibility of Screening Patients With Nonpsychiatric Complaints for Suicide Risk in a Pediatric Emergency Department: A Good Time to Talk?
Horowitz, L., Ballard, E., Teach, S. J., Bosk, A., Rosenstein, D. L., Joshi, P., Dalton, M. E., Pao, M
Horowitz, L., Ballard, E., Teach, S. J., Bosk, A., Rosenstein, D. L., Joshi, ...
Objective: As part of an instrument validation study, ED patients (10-21 years old) with both psychiatric and nonpsychiatric presenting complaints were recruited to take part in suicide screening.
Objective: As part of an instrument validation study, ED patients (10-21 years old) with both psychiatric and nonpsychiatric presenting complaints were recruited to take part in suicide screening.
Key Study: Synthetic Cannabinoid Exposure in Adolescents Presenting for Emergency Care
Gilley MB, J.; Calello, D. P.; Wax, P.; Finkelstein, Y.; Toxicology Investigators, Consortium
Gilley MB, J.; Calello, D. P.; Wax, P.; Finkelstein, Y.; Toxicology Investiga...
The objective of this study was to characterize the clinical picture and management of synthetic cannabinoid exposure in a cohort of adolescents.
The objective of this study was to characterize the clinical picture and management of synthetic cannabinoid exposure in a cohort of adolescents.
Key Study: Drug Misuse in Adolescents Presenting to the Emergency Department
Finkelstein YG, G.; Hutson, J. R.; Armstrong, J.; Baum, C. R.; Wax, P.; Brent, J.; Toxicology Investigators, Consortium
Finkelstein YG, G.; Hutson, J. R.; Armstrong, J.; Baum, C. R.; Wax, P.; Brent...
Drug misuse is a disturbing, common practice among youth. One in 4 American adolescents reports consuming prescription medications without a clinical indication. We sought to explore current trends of drug misuse in adolescents.
Drug misuse is a disturbing, common practice among youth. One in 4 American adolescents reports consuming prescription medications without a clinical indication. We sought to explore current trends of drug misuse in adolescents.
Key study: Children with Covid-19 in pediatric emergency departments in Italy.
Parri N, Lenge M, Buonsenso D, Coronavirus Infection in Public Emergency Departments (CONFIDENCE) Research Group
Parri N, Lenge M, Buonsenso D, Coronavirus Infection in Public Emergency Depa...
Objective: The Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) study involved a cohort of 100 Italian children younger than 18 years of age with Covid-19 confirmed by reverse-transcriptasepolymerase-chain-reaction testing of nasal or nasopharyngeal swabs who were assessed between March 3 and March 27 in 17 pediatric emergency departments. Here, we describe the results of the CONFIDENCE study and compare them with those from three cohorts in previously published analyses.
Objective: The Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) study involved a cohort of 100 Italian children younger than 18 years of age with Covid-19 confirmed by reverse-transcriptasepolymerase-chain-reaction testing of nasal or nasopharyngeal swabs who were assessed between March 3 and March 27 in 17 pediatric emergency departments. Here, we describe the results of the CONFIDENCE study and compare them with those from three cohorts in previously published analyses.
Key study: Pointofcare lung ultrasound findings in the pediatric emergency clinic during the COVID19 pandemic.
Tre E, Korkmaz MF, Aksoy FD, et al.
Tre E, Korkmaz MF, Aksoy FD, et al.
Objective: To describe our experience concerning lung ultrasound (LUS) in the pediatric emergency clinic, and to investigate the diagnostic value of LUS in coronavirus disease-2019 (COVID-19).
Objective: To describe our experience concerning lung ultrasound (LUS) in the pediatric emergency clinic, and to investigate the diagnostic value of LUS in coronavirus disease-2019 (COVID-19).
Key study: Delayed presentations to emergency departments of children with head injury: A PREDICT Study
Borland ML, Dalziel SR, Phillips N, et al.
Borland ML, Dalziel SR, Phillips N, et al.
Objective: Existing clinical decision rules guide management for head-injured children presenting 24 hours or sooner after injury, even though some may present greater than 24 hours afterward. We seek to determine the prevalence of traumatic brain injuries for patients presenting to emergency departments greater than 24 hours after injury and identify symptoms and signs to guide management.
Objective: Existing clinical decision rules guide management for head-injured children presenting 24 hours or sooner after injury, even though some may present greater than 24 hours afterward. We seek to determine the prevalence of traumatic brain injuries for patients presenting to emergency departments greater than 24 hours after injury and identify symptoms and signs to guide management.
Key study: Derivation and initial validation of clinical phenotypes of children presenting with concussion acutely in the emergency department: latent class analysis of a multi-center, prospective cohort, observational study
Yeates KO, Tang K, Barrowman N, et al.
Yeates KO, Tang K, Barrowman N, et al.
This study used latent class analysis (LCA) to identify discernible phenotypes among children with acute concussion and examine the association between phenotypes and persistent post-concussive symptoms (PPCS) at 4 and 12 weeks post-injury. We conducted LCA of variables representing pre-injury history, clinical presentation, and parent symptom ratings, derived from a prospective cohort, observational study that recruited participants from August 2013 until June 2015 at nine pediatric emergency departments within the Pediatric Emergency Research Canada network.
This study used latent class analysis (LCA) to identify discernible phenotypes among children with acute concussion and examine the association between phenotypes and persistent post-concussive symptoms (PPCS) at 4 and 12 weeks post-injury. We conducted LCA of variables representing pre-injury history, clinical presentation, and parent symptom ratings, derived from a prospective cohort, observational study that recruited participants from August 2013 until June 2015 at nine pediatric emergency departments within the Pediatric Emergency Research Canada network.
Key study: Early versus delayed emergency department presentation following mild traumatic nrain injury and the presence of symptom at 1, 4 and 12 weeks in children
Gravel J, Ledoux AA, Tang K, et al.
Gravel J, Ledoux AA, Tang K, et al.
We evaluated the association between timing of presentation and postconcussive symptoms (PCS) at 1, 4 and 12 weeks after injury.
We evaluated the association between timing of presentation and postconcussive symptoms (PCS) at 1, 4 and 12 weeks after injury.
Key study: Low-value diagnostic imaging use in the pediatric emergency department in the United States and Canada
Cohen E, Rodean J, Diong C, et al.
Cohen E, Rodean J, Diong C, et al.
Objective To compare overall and low-value use of diagnostic imaging across pediatric ED visits in Ontario, Canada, and the United States.
Objective To compare overall and low-value use of diagnostic imaging across pediatric ED visits in Ontario, Canada, and the United States.
Key study: Reduction of computed tomography use for pediatric closed head injury evaluation at a nonpediatric community emergency department
Puffenbarger MS, Ahmad FA, Argent M, Gu H, Samson C, Quayle KS, Saito JM.
Puffenbarger MS, Ahmad FA, Argent M, Gu H, Samson C, Quayle KS, Saito JM.
The purpose of this study was to determine if implementation of a Pediatric Emergency Care Applied Research Network (PECARN)-based Closed Head Injury Assessment Tool could safely decrease computed tomography (CT) use for pediatric head injury evaluation at a nonpediatric community emergency department (ED).
The purpose of this study was to determine if implementation of a Pediatric Emergency Care Applied Research Network (PECARN)-based Closed Head Injury Assessment Tool could safely decrease computed tomography (CT) use for pediatric head injury evaluation at a nonpediatric community emergency department (ED).
Key study: Reliability of the visio-vestibular examination for concussion among providers in a pediatric emergency department
Corwin DJ, Arbogast KB, Swann C, et al.
Corwin DJ, Arbogast KB, Swann C, et al.
Our objective was to determine the inter-rater (IRR) and test-retest reliability (TRR) of the VVE in a pediatric ED.
Our objective was to determine the inter-rater (IRR) and test-retest reliability (TRR) of the VVE in a pediatric ED.
Key study: Symptom-guided emergency department discharge instructions for children with concussion
Brooks TM, Smith MM, Silvis RM, et al.
Brooks TM, Smith MM, Silvis RM, et al.
Objectives: The objective was to evaluate the use and utility of a novel set of emergency department discharge instructions (DIs) for concussion based on a child's ongoing symptoms: symptom-guided DIs (symptom DIs). Differences in clinical outcomes were also assessed.
Objectives: The objective was to evaluate the use and utility of a novel set of emergency department discharge instructions (DIs) for concussion based on a child's ongoing symptoms: symptom-guided DIs (symptom DIs). Differences in clinical outcomes were also assessed.
Key study: The diagnosis of concussion in pediatric emergency departments: a prospective multicenter study
Boutis K, Gravel J, Freedman SB, et al.
Boutis K, Gravel J, Freedman SB, et al.
Objectives: We compared the frequency of persistent concussion symptoms in children who were provided the diagnosis of concussion by an emergency physician versus those who met Berlin/Zurich international criteria for this diagnosis. We also determined the clinical variables independently associated with a physician-diagnosed concussion.
Objectives: We compared the frequency of persistent concussion symptoms in children who were provided the diagnosis of concussion by an emergency physician versus those who met Berlin/Zurich international criteria for this diagnosis. We also determined the clinical variables independently associated with a physician-diagnosed concussion.
Key study: Use of the sport concussion assessment tools in the emergency department to predict persistent post-concussive symptoms in children
Bressan S, Clarke CJ, Anderson V, et al.
Bressan S, Clarke CJ, Anderson V, et al.
We aim to assess the predictive value of the main SCAT3/ChildSCAT3 components for PPCS when applied in the ED.
We aim to assess the predictive value of the main SCAT3/ChildSCAT3 components for PPCS when applied in the ED.
Key study: Use of the vestibular and oculomotor examination for concussion in a pediatric emergency department
Corwin DJ, Propert KJ, Zorc JJ, Zonfrillo MR, Wiebe DJ.
Corwin DJ, Propert KJ, Zorc JJ, Zonfrillo MR, Wiebe DJ.
We aimed to measure rates of exam performance after implementation of training and support tools in a pediatric emergency department.
We aimed to measure rates of exam performance after implementation of training and support tools in a pediatric emergency department.
Early predictors of unresponsiveness to high-flow nasal cannula therapy in a pediatric emergency department.
Er A, alar A, Akgl F, Ulusoy E, itlenbik H, Ylmaz D, et al.
Er A, alar A, Akgl F, Ulusoy E, itlenbik H, Ylmaz D, et al.
High-flow nasal cannula (HFNC) is a new treatment option for pediatric respiratory distress and we aimed to assess early predictive factors of unresponsiveness to HFNC therapy in a pediatric emergency department (ED). The low initial SpO2 and SF ratio, respiratory acidosis, and SF ratio less than 195 at the first hours of treatment were related to unresponsiveness to HFNC therapy in our pediatric emergency department.
High-flow nasal cannula (HFNC) is a new treatment option for pediatric respiratory distress and we aimed to assess early predictive factors of unresponsiveness to HFNC therapy in a pediatric emergency department (ED). The low initial SpO2 and SF ratio, respiratory acidosis, and SF ratio less than 195 at the first hours of treatment were related to unresponsiveness to HFNC therapy in our pediatric emergency department.
Is there a role for humidified heated high-flow nasal cannula therapy in paediatric emergency departments?
Long E, Babl FE, Duke T.
Long E, Babl FE, Duke T.
We introduced HFNC therapy into a paediatric ED and evaluated its use and failure rates. HFNC therapy may have a role in the paediatric ED as an easily administered and well tolerated form of non-invasive respiratory support, but about one-third of patients required escalation to a higher level of respiratory support. Further studies should assess the safety profile of HFNC in larger series, and define the role of HFNC in key respiratory conditions compared with other possible interventions.
We introduced HFNC therapy into a paediatric ED and evaluated its use and failure rates. HFNC therapy may have a role in the paediatric ED as an easily administered and well tolerated form of non-invasive respiratory support, but about one-third of patients required escalation to a higher level of respiratory support. Further studies should assess the safety profile of HFNC in larger series, and define the role of HFNC in key respiratory conditions compared with other possible interventions.
Use of high-flow nasal cannula support in the emergency department reduces the need for intubation in pediatric acute respiratory insufficiency.
Wing R, James C, Maranda LS, Armsby CC.
Wing R, James C, Maranda LS, Armsby CC.
The objective of this study was to determine whether the use of heated, humidified, high-flow nasal cannula (HFNC) therapy is associated with a decreased need for intubation in patients presenting to a pediatric emergency department (PED) and admitted to a pediatric intensive care unit (PICU) with acute respiratory insufficiency (ARI). High-flow nasal cannula used early in the development of pediatric ARI is associated with a decreased the need for intubation and mechanical ventilation.
The objective of this study was to determine whether the use of heated, humidified, high-flow nasal cannula (HFNC) therapy is associated with a decreased need for intubation in patients presenting to a pediatric emergency department (PED) and admitted to a pediatric intensive care unit (PICU) with acute respiratory insufficiency (ARI). High-flow nasal cannula used early in the development of pediatric ARI is associated with a decreased the need for intubation and mechanical ventilation.
High flow nasal cannula in the emergency department: indications, safety and effectiveness.
Wang J, Lee KP, Chong SL, Loi M, Lee JH.
Wang J, Lee KP, Chong SL, Loi M, Lee JH.
While there exists increasing enthusiasm in the use of HHHFNCT in the ED, constant monitoring of the patients and an experienced assessment of their response to treatment are critical and may require additional manpower deployment, which may be challenging, in the busy ED environment. Our experience with the use of HHHFNCT in children is still growing. Continual research in this area remains crucial in helping us better understand the patient types and conditions managed in ED that would most benefit from this device.
While there exists increasing enthusiasm in the use of HHHFNCT in the ED, constant monitoring of the patients and an experienced assessment of their response to treatment are critical and may require additional manpower deployment, which may be challenging, in the busy ED environment. Our experience with the use of HHHFNCT in children is still growing. Continual research in this area remains crucial in helping us better understand the patient types and conditions managed in ED that would most benefit from this device.
The use of high-flow nasal cannula in the pediatric emergency department.
Slain KN, Shein SL, Rotta AT.
Slain KN, Shein SL, Rotta AT.
To summarize the current literature describing high-flow nasal cannula use in children, the components and mechanisms of action of a high-flow nasal cannula system, the appropriate clinical applications, and its role in the pediatric emergency department. High-flow nasal cannula should be considered for pediatric emergency department patients with respiratory distress not requiring immediate endotracheal intubation; prospective, pediatric emergency department-specific trials are needed to better determine responsive patient populations, ideal high-flow nasal cannula settings, and comparative efficacy vs. other respiratory support modalities.
To summarize the current literature describing high-flow nasal cannula use in children, the components and mechanisms of action of a high-flow nasal cannula system, the appropriate clinical applications, and its role in the pediatric emergency department. High-flow nasal cannula should be considered for pediatric emergency department patients with respiratory distress not requiring immediate endotracheal intubation; prospective, pediatric emergency department-specific trials are needed to better determine responsive patient populations, ideal high-flow nasal cannula settings, and comparative efficacy vs. other respiratory support modalities.
Key Study: Assessment of non-routine events and significant physiological disturbances during emergency department evaluation after pediatric head trauma.
Alberto EC, Harvey AR, Amberson MJ, Zheng Y, Thenappan AA, Oluigbo C, et al
Alberto EC, Harvey AR, Amberson MJ, Zheng Y, Thenappan AA, Oluigbo C, et al
The purpose of this study was to determine the association of non-routine events (NREs) during the initial resuscitation phase with these physiological disturbances.
The purpose of this study was to determine the association of non-routine events (NREs) during the initial resuscitation phase with these physiological disturbances.
Key Study: Comparison of minor head trauma management in the emergency departments of a United States and Italian Children's hospital.
Stopa BM, Amoroso S, Ronfani L, Neri E, Barbi E, Lee LK.
Stopa BM, Amoroso S, Ronfani L, Neri E, Barbi E, Lee LK.
Pediatric head trauma management varies between emergency departments globally. Here we aim to compare the pediatric minor head trauma management between a US and Italian hospital.
Pediatric head trauma management varies between emergency departments globally. Here we aim to compare the pediatric minor head trauma management between a US and Italian hospital.
Key Study: Computed tomography practice standards for severe pediatric traumatic brain injury in the emergency department: a national survey.
Yoo G, Leach A, Woods R, Holt T, Hansen G.
Yoo G, Leach A, Woods R, Holt T, Hansen G.
Acute medical management of traumatic brain injury (TBI) can be challenging outside of the resuscitation bay, specifically while obtaining a computed tomography (CT) scan of the brain. We sought out to determine the management practices of Canadian traumatologists for pediatric patients with severe TBI requiring CT in the emergency department.
Acute medical management of traumatic brain injury (TBI) can be challenging outside of the resuscitation bay, specifically while obtaining a computed tomography (CT) scan of the brain. We sought out to determine the management practices of Canadian traumatologists for pediatric patients with severe TBI requiring CT in the emergency department.
Key Study: The use of Rotterdam CT score for prediction of outcomes in pediatric traumatic brain injury patients admitted to emergency service.
Katar S, Aydin Ozturk P, Ozel M, Arac S, Evran S, Cevik S, et al.
Katar S, Aydin Ozturk P, Ozel M, Arac S, Evran S, Cevik S, et al.
In this study, we aimed to evaluate the use of the Rotterdam scale on pediatric trauma patients in our country and assess its relationship with lesion type, location and severity, trauma type, and need for surgery.
In this study, we aimed to evaluate the use of the Rotterdam scale on pediatric trauma patients in our country and assess its relationship with lesion type, location and severity, trauma type, and need for surgery.
Key Study: Emergency department discharge following successful radiologic reduction of ileocolic intussusception in children: A protocol based prospective observational study.
Sujka JA, Dalton B, Gonzalez K, Tarantino C, Schroeder L, Giovanni J, et al
Sujka JA, Dalton B, Gonzalez K, Tarantino C, Schroeder L, Giovanni J, et al
The purpose of our study was to document the results of emergency department (ED) observation and discharge protocol after successful reduction of ileocolic intussusception.
The purpose of our study was to document the results of emergency department (ED) observation and discharge protocol after successful reduction of ileocolic intussusception.
Key Study: Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department.
Lee JY, Byun YH, Park JS, Lee JS, Ryu JM, Choi SJ.
Lee JY, Byun YH, Park JS, Lee JS, Ryu JM, Choi SJ.
We aimed to determine whether lactic acid levels are associated with pediatric intussusception outcomes.
We aimed to determine whether lactic acid levels are associated with pediatric intussusception outcomes.
Key Study: Management of Intussusception in the Pediatric Emergency Department: Risk Factors for Recurrence.
Vo A, Levin TL, Taragin B, Khine H.
Vo A, Levin TL, Taragin B, Khine H.
Our primary objective was to identify risk factors associated with early recurrence. Our secondary objectives included validating risk criteria from prior studies and identifying risk factors for ARE failures.
Our primary objective was to identify risk factors associated with early recurrence. Our secondary objectives included validating risk criteria from prior studies and identifying risk factors for ARE failures.
Key Study: Brief Report: Knowledge and Confidence of Emergency Medical Service Personnel Involving Treatment of an Individual with Autism Spectrum Disorder.
Wachob D, Pesci LJ.
Wachob D, Pesci LJ.
In order to best respond to an emergency situation, professionals need to have an understanding about Autism Spectrum Disorder (ASD) and techniques that will ensure proper care. The purpose of this study was to determine the knowledge and confidence of EMS personnel on interacting and treating an individual with ASD. Emergency Medical Technicians (EMT), and Paramedics were surveyed on their knowledge of ASD; familiarity or experience with ASD, and level of comfort responding to emergencies involving an individual with ASD. The results found that autism-specific training and resources were associated with higher comfort levels, but not knowledge. It was also determined that newer and younger professionals had higher knowledge and comfort when compared to the more experienced and older professionals.
In order to best respond to an emergency situation, professionals need to have an understanding about Autism Spectrum Disorder (ASD) and techniques that will ensure proper care. The purpose of this study was to determine the knowledge and confidence of EMS personnel on interacting and treating an individual with ASD. Emergency Medical Technicians (EMT), and Paramedics were surveyed on their knowledge of ASD; familiarity or experience with ASD, and level of comfort responding to emergencies involving an individual with ASD. The results found that autism-specific training and resources were associated with higher comfort levels, but not knowledge. It was also determined that newer and younger professionals had higher knowledge and comfort when compared to the more experienced and older professionals.
Key Study: An Australian Cross-Sectional Survey of Parents' Experiences of Emergency Department Visits Among Children with Autism Spectrum Disorder
Garrick A, Lee ML, Scarffe C, Attwood T, Furley K, Bellgrove MA, et al.
Garrick A, Lee ML, Scarffe C, Attwood T, Furley K, Bellgrove MA, et al.
Parents of children with ASD who had attended an Australian emergency department (ED; n = 421) completed a questionnaire relating to their experiences in the ED, including (1) child's reason for presentation and existing comorbidities, (2) quality of care during the visit (3) child's behaviour during visit, e.g. sensory responses to the ED environment, and disruptive behaviours. Children with comorbid ASD and intellectual disability were more likely to present with gastrointestinal issues and seizures, while those with comorbid ASD and oppositional defiant disorder were more likely to present with self-injury. ED staff awareness of ASD-related issues, including communication and expression of pain, were common difficulties for parents. The ED environment (e.g. lights, sounds, waiting areas), exacerbated child anxiety and led to disruptive behaviour.
Parents of children with ASD who had attended an Australian emergency department (ED; n = 421) completed a questionnaire relating to their experiences in the ED, including (1) child's reason for presentation and existing comorbidities, (2) quality of care during the visit (3) child's behaviour during visit, e.g. sensory responses to the ED environment, and disruptive behaviours. Children with comorbid ASD and intellectual disability were more likely to present with gastrointestinal issues and seizures, while those with comorbid ASD and oppositional defiant disorder were more likely to present with self-injury. ED staff awareness of ASD-related issues, including communication and expression of pain, were common difficulties for parents. The ED environment (e.g. lights, sounds, waiting areas), exacerbated child anxiety and led to disruptive behaviour.
Key Study: Assessing Ease of Delivering Emergency Care for Patients with Autism Spectrum Disorders.
Kouo T, Bharadwaj N, Kouo J, Tackett S, Ryan L.
Kouo T, Bharadwaj N, Kouo J, Tackett S, Ryan L.
The aim of this study was to develop a method for objectively assessing the delivery of care to children with autism spectrum disorder (ASD) in the emergency department (ED). The TCI reflects difficulty accomplishing core tasks necessary to complete an ED visit. Children with ASD have higher TCIs than neurotypical controls, which puts them at higher risk for care disruptions. Evaluation of initiatives to improve quality of care for children with ASD should focus not only on metrics of overall experience and satisfaction but also how these initiatives affect the ability to effectively administer care.
The aim of this study was to develop a method for objectively assessing the delivery of care to children with autism spectrum disorder (ASD) in the emergency department (ED). The TCI reflects difficulty accomplishing core tasks necessary to complete an ED visit. Children with ASD have higher TCIs than neurotypical controls, which puts them at higher risk for care disruptions. Evaluation of initiatives to improve quality of care for children with ASD should focus not only on metrics of overall experience and satisfaction but also how these initiatives affect the ability to effectively administer care.
Key Study: Emergency mental health presentations in children with autism spectrum disorder and attention deficit hyperactivity disorder.
Bourke EM, Say DF, Carison A, Hill A, Craig S, Hiscock H, et al
Bourke EM, Say DF, Carison A, Hill A, Craig S, Hiscock H, et al
To characterise the key features and management of young people presenting to the emergency department (ED) with a mental health (MH) complaint and a known diagnosis of autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD).
To characterise the key features and management of young people presenting to the emergency department (ED) with a mental health (MH) complaint and a known diagnosis of autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD).
Key Study: Patient- and Family-Centered Care in the Emergency Department for Children With Autism
Nicholas DB, Muskat B, Zwaigenbaum L, Greenblatt A, Ratnapalan S, Kilmer C, et al.
Nicholas DB, Muskat B, Zwaigenbaum L, Greenblatt A, Ratnapalan S, Kilmer C, e...
Emergency department (ED) care processes and environments impose unique challenges for children with autism spectrum disorder (ASD). The implementation of patient- and family-centered care (PFCC) emerges as a priority for optimizing ED care. In this article, as part of a larger study, we explore PFCC in the context of ASD. Our aims were to examine how elements of PFCC were experienced and applied relative to ED care for children with ASD. Findings amplify PFCC as integral to effectively serving children with ASD and their families in the ED. Resources that specifically nurture PFCC emerge as practice and program priorities.
Emergency department (ED) care processes and environments impose unique challenges for children with autism spectrum disorder (ASD). The implementation of patient- and family-centered care (PFCC) emerges as a priority for optimizing ED care. In this article, as part of a larger study, we explore PFCC in the context of ASD. Our aims were to examine how elements of PFCC were experienced and applied relative to ED care for children with ASD. Findings amplify PFCC as integral to effectively serving children with ASD and their families in the ED. Resources that specifically nurture PFCC emerge as practice and program priorities.
Key Study: Case Studies of Challenges in Emergency Care for Children With Autism Spectrum Disorder.
Gray JM, Roback MG.
Gray JM, Roback MG.
Autism spectrum disorder (ASD) affects more than 1% of children in the United States, with the rate of new diagnoses climbing significantly in the last 15 years. Emergent conditions and subsequent visits to the emergency department (ED) can be particularly challenging for children with ASD, most of whom also have comorbidities in addition to their deficits in social communication and interaction. In the emergency setting, these conditions can cause a range of behaviors that result in challenges for health care providers and may result in suboptimal experiences for children with ASD and their families. We present the ED course of 3 children with ASD to illustrate these challenges, emphasize successful strategies, and highlight opportunities for improvement.
Autism spectrum disorder (ASD) affects more than 1% of children in the United States, with the rate of new diagnoses climbing significantly in the last 15 years. Emergent conditions and subsequent visits to the emergency department (ED) can be particularly challenging for children with ASD, most of whom also have comorbidities in addition to their deficits in social communication and interaction. In the emergency setting, these conditions can cause a range of behaviors that result in challenges for health care providers and may result in suboptimal experiences for children with ASD and their families. We present the ED course of 3 children with ASD to illustrate these challenges, emphasize successful strategies, and highlight opportunities for improvement.
Key Study: Caring for Children With Autism in an Emergency Department Setting
Mannenbach MS, Passe RL, Lovik KK, Larson EM, Laudon SM, Naeve A, et al.
Mannenbach MS, Passe RL, Lovik KK, Larson EM, Laudon SM, Naeve A, et al.
Patients with autism spectrum disorder (ASD) and other developmental delays represent a unique patient population. We described a cohort of children with ASD cared for in an emergency department (ED) setting and the specific health care resources used for their care. The care for children with ASD varied with age and health care issues. There was a high prevalence of psychiatric complaints, and many of these children were boarded in the ED waiting for an inpatient psychiatric bed. Those with psychiatric complaints were more likely to have multiple tests ordered and were more likely to be admitted.
Patients with autism spectrum disorder (ASD) and other developmental delays represent a unique patient population. We described a cohort of children with ASD cared for in an emergency department (ED) setting and the specific health care resources used for their care. The care for children with ASD varied with age and health care issues. There was a high prevalence of psychiatric complaints, and many of these children were boarded in the ED waiting for an inpatient psychiatric bed. Those with psychiatric complaints were more likely to have multiple tests ordered and were more likely to be admitted.
Key Study: Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study.
Lunsky Y, Weiss JA, Paquette-Smith M, Durbin A, Tint A, Palucka AM, et al.
Lunsky Y, Weiss JA, Paquette-Smith M, Durbin A, Tint A, Palucka AM, et al.
To determine predictors of emergency department (ED) visits in a cohort of adolescents and adults with autism spectrum disorder (ASD). A combination of individual and contextual variables may be important for targeting preventative community-based supports for individuals with ASD and their families. In particular, attention should be paid to how caregiver supports, integrative crisis planning and community-based services may assist in preventing or minimising ED use for this vulnerable population.
To determine predictors of emergency department (ED) visits in a cohort of adolescents and adults with autism spectrum disorder (ASD). A combination of individual and contextual variables may be important for targeting preventative community-based supports for individuals with ASD and their families. In particular, attention should be paid to how caregiver supports, integrative crisis planning and community-based services may assist in preventing or minimising ED use for this vulnerable population.
Key Study: An Exploration of Emergency Department Visits for Home Unintentional Injuries Among Children With Autism Spectrum Disorder for Evidence to Modify Injury Prevention Guidelines
Jones V, Ryan L, Rooker G, Debinski B, Parnham T, Mahoney P, et al.
Jones V, Ryan L, Rooker G, Debinski B, Parnham T, Mahoney P, et al.
Current childhood injury prevention guidance is anchored by a child's age. For example, children are considered at high risk for falls at ages 4 years and less, and guidance for prevention focuses on these ages. However, these guidelines may not be adequate for children with autism spectrum disorders (ASD). Analyses suggest that unintentional home injury prevention for children with ASD may require prevention guidance extended through older ages.
Current childhood injury prevention guidance is anchored by a child's age. For example, children are considered at high risk for falls at ages 4 years and less, and guidance for prevention focuses on these ages. However, these guidelines may not be adequate for children with autism spectrum disorders (ASD). Analyses suggest that unintentional home injury prevention for children with ASD may require prevention guidance extended through older ages.
Diabetic Ketoacidosis at Emergency Department Presentation During the First Months of the SARS-CoV-2 Pandemic in Israel: A Multicenter Cross-Sectional Study.
Jacob R, Weiser G, Krupik D, Takagi D, Peled S, Pines N, et al.
Jacob R, Weiser G, Krupik D, Takagi D, Peled S, Pines N, et al.
We aimed to examine the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on diabetic ketoacidosis (DKA) rates in children with type 1 diabetes (T1D).
We aimed to examine the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on diabetic ketoacidosis (DKA) rates in children with type 1 diabetes (T1D).
Short-term outcomes of pediatric emergency department febrile illnesses.
Mistry RD, Stevens MW, Gorelick MH.
Mistry RD, Stevens MW, Gorelick MH.
To describe short-term outcomes relevant to children and their caregivers after evaluation in the emergency department (ED) for febrile illnesses.
To describe short-term outcomes relevant to children and their caregivers after evaluation in the emergency department (ED) for febrile illnesses.
Comparing different patterns for managing febrile children in the ED between emergency and pediatric physicians: impact on patient outcome.
Seow VK, Lin AC, Lin IY, Chen CC, Chen KC, Wang TL, Chong CF.
Seow VK, Lin AC, Lin IY, Chen CC, Chen KC, Wang TL, Chong CF.
The management of children with fever of indefinite source still remains controversial. This study aimed to compare different practice patterns between pediatric physicians (PPs) and emergency physicians (EPs) in the management of pediatric fever in the emergency department (ED) and correlate them to existing practice guidelines. Their impact on patient outcomes was also discussed.
The management of children with fever of indefinite source still remains controversial. This study aimed to compare different practice patterns between pediatric physicians (PPs) and emergency physicians (EPs) in the management of pediatric fever in the emergency department (ED) and correlate them to existing practice guidelines. Their impact on patient outcomes was also discussed.
Pediatric emergency department nurses' perspectives on fever in children.
Poirier MP, Davis PH, Gonzalez-del Rey JA, Monroe KW.
Poirier MP, Davis PH, Gonzalez-del Rey JA, Monroe KW.
Fever is the most common complaint of children seen in a Pediatric Emergency Department (PED). Since pediatric emergency nurses commonly educate parents on fever management, this study sought to examine their knowledge base regarding fever in children.
Fever is the most common complaint of children seen in a Pediatric Emergency Department (PED). Since pediatric emergency nurses commonly educate parents on fever management, this study sought to examine their knowledge base regarding fever in children.
Prospective evaluation of the risk of serious bacterial infection in children who present to the emergency department with hyperpyrexia (temperature of 106 degrees F or higher).
Trautner BW, Caviness AC, Gerlacher GR, Demmler G, Macias CG.
Trautner BW, Caviness AC, Gerlacher GR, Demmler G, Macias CG.
The purpose of this study was to determine (1) the risk of serious bacterial infection in children with hyperpyrexia and (2) whether clinical presentation can identify hyperpyrexic patients at risk for serious bacterial infection.
The purpose of this study was to determine (1) the risk of serious bacterial infection in children with hyperpyrexia and (2) whether clinical presentation can identify hyperpyrexic patients at risk for serious bacterial infection.
Levetiracetam as an alternative to phenytoin for second-line emergency treatment of children with convulsive status epilepticus: the EcLiPSE RCT
Appleton RE, Rainford NE, Gamble C, Messahel S, Humphreys A, Hickey H, et al.
Appleton RE, Rainford NE, Gamble C, Messahel S, Humphreys A, Hickey H, et al.
To determine whether phenytoin or levetiracetam (Keppra, UCB Pharma, Brussels, Belgium) is the more clinically effective intravenous second-line treatment of paediatric convulsive status epilepticus and to help better inform its management.
To determine whether phenytoin or levetiracetam (Keppra, UCB Pharma, Brussels, Belgium) is the more clinically effective intravenous second-line treatment of paediatric convulsive status epilepticus and to help better inform its management.
Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: a randomised controlled trial
McIntyre J, Robertson S, Norris E, Appleton R, Whitehouse WP, Phillips B, et al.
McIntyre J, Robertson S, Norris E, Appleton R, Whitehouse WP, Phillips B, et al.
Rectal diazepam and buccal midazolam are used for emergency treatment of acute febrile and afebrile (epileptic) seizures in children. We aimed to compare the safety and efficacy of these drugs.
Rectal diazepam and buccal midazolam are used for emergency treatment of acute febrile and afebrile (epileptic) seizures in children. We aimed to compare the safety and efficacy of these drugs.
Emergency management of pediatric convulsive status epilepticus: a multicenter study of 542 patients
Lewena S, Pennington V, Acworth J, Thornton S, Ngo P, McIntyre S, et al.
Lewena S, Pennington V, Acworth J, Thornton S, Ngo P, McIntyre S, et al.
To perform a multicenter study examining the presentations and emergency management of children with convulsive status epilepticus (CSE) to sites within the Paediatric Research in Emergency Departments International Collaborative.
To perform a multicenter study examining the presentations and emergency management of children with convulsive status epilepticus (CSE) to sites within the Paediatric Research in Emergency Departments International Collaborative.
Key Study: Music to reduce pain and distress in the pediatric emergency department: a randomized clinical trial
Hartling L, Newton AS, Liang Y, Jou H, Hewson K, Klassen TP, Curtis S
Hartling L, Newton AS, Liang Y, Jou H, Hewson K, Klassen TP, Curtis S
Objective: To compare music with standard care to manage pain and distress.
Objective: To compare music with standard care to manage pain and distress.
Emergency department strategies to combat the opioid crisis in children and adolescents
Cindy D Chang1,Mohsen Saidinejad1,Zaza Atanelov2,Ann M Dietrich3,Samuel Hiu-Fung Lam4,Emily Rose5,Tim Ruttan6,Sam Shahid7,Michael J Stoner8,Carmen Sulton9,Co...
Cindy D Chang1,Mohsen Saidinejad1,Zaza Atanelov2,Ann M Dietrich3,Samuel Hiu-F...
The opioid crisis has greatly affected not only adults but also children as well. As clinicians develop effective approaches to minimize pain and distress in children, the risks and benefits of opioids must be carefully considered. Children of parents wit
The opioid crisis has greatly affected not only adults but also children as well. As clinicians develop effective approaches to minimize pain and distress in children, the risks and benefits of opioids must be carefully considered. Children of parents wit
Emergency Medicine Cases Podcast: Recognition and management of pediatric sepsis and septic shock
Dr. Sarah Reid & Dr. Gina Neto
Dr. Sarah Reid & Dr. Gina Neto
Episode 50:In this episode, a continuation of our discussion on Fever from with Ottawa PEM experts, Sarah Reid and Gina Neto, we discuss the pearls and pitfalls in the recognition and management of pediatric sepsis and septic shock. We review the subtle clinical findings that will help you pick up septic shock before its too late as well as key maneuvers and algorithms to stabilize these patients. We cover tips for using IO in children, induction agents of choice, timing of intubation, ionotropes of choice, the indications for steroids in septic shock, and much more.Posted online: August 2014.
Episode 50:In this episode, a continuation of our discussion on Fever from with Ottawa PEM experts, Sarah Reid and Gina Neto, we discuss the pearls and pitfalls in the recognition and management of pediatric sepsis and septic shock. We review the subtle clinical findings that will help you pick up septic shock before its too late as well as key maneuvers and algorithms to stabilize these patients. We cover tips for using IO in children, induction agents of choice, timing of intubation, ionotropes of choice, the indications for steroids in septic shock, and much more.Posted online: August 2014.
Emergency Medicine Cases Podcast: Pediatric fever without a source
Dr. Sarah Reid & Dr. Gina Neto
Dr. Sarah Reid & Dr. Gina Neto
Episode 48:In this episode, with the help of Dr. Sarah Reid and Dr. Gina Neto from the Childrens Hospital of Eastern Ontario, we will elucidate how to deal with fever phobia, when a rectal temp is necessary, how to pick out the kids with fever that we need to worry about, how to work up kids with fever depending on their age, risk factors and clinical picture, who needs a urinalysis, who needs a CXR, who needs blood cultures and who needs an LP, and much more. Posted online: August 2014.
Episode 48:In this episode, with the help of Dr. Sarah Reid and Dr. Gina Neto from the Childrens Hospital of Eastern Ontario, we will elucidate how to deal with fever phobia, when a rectal temp is necessary, how to pick out the kids with fever that we need to worry about, how to work up kids with fever depending on their age, risk factors and clinical picture, who needs a urinalysis, who needs a CXR, who needs blood cultures and who needs an LP, and much more. Posted online: August 2014.
Emergency Medicine Cases Podcast: Pediatric abdominal pain & appendicitis
Dr. Anna Jarvis & Dr. Stephen Freedman
Dr. Anna Jarvis & Dr. Stephen Freedman
Episode 19 Part 1:In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis & Dr. Stephen Freedman discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. Published online: December 2011.
Episode 19 Part 1:In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis & Dr. Stephen Freedman discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. Published online: December 2011.
Emergency Medicine Cases Podcast: Pediatric Pain Management
Dr. Samina Ali & Dr. Anthony Crocco
Dr. Samina Ali & Dr. Anthony Crocco
Episode 67: Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
Episode 67: Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
Emergency Medicine Cases Podcast: Pediatric Procedural Sedation (2016)
Dr. Amy Drendel
Dr. Amy Drendel
Episode 76: Join Dr. Amy Drendel, a world leader in pediatric pain management and procedural sedation research, as she discusses how best to manage pain and anxiety in
Episode 76: Join Dr. Amy Drendel, a world leader in pediatric pain management and procedural sedation research, as she discusses how best to manage pain and anxiety in
Emergency Medicine Cases Podcast: Cyanotic Infant
Dr. Gary Joubert & Dr. Anton Helman
Dr. Gary Joubert & Dr. Anton Helman
Best Case Ever #48: In anticipation of EM Cases’ upcoming episode, Congenital Heart Disease Emergencies, Dr. Gary Joubert discusses his Best Case Ever of a four month old infant who presents with intermittent cyanosis. The Cyanotic Infant can present a significant challenge to the EM provider as the differential is wide, ranging from benign causes such as GERD to life threatening heart disease that may present atypically in a well-appearing child. Dr. Joubert provides some simple clinical pearls to help ED providers along the way. Published online: July 2016.
Best Case Ever #48: In anticipation of EM Cases’ upcoming episode, Congenital Heart Disease Emergencies, Dr. Gary Joubert discusses his Best Case Ever of a four month old infant who presents with intermittent cyanosis. The Cyanotic Infant can present a significant challenge to the EM provider as the differential is wide, ranging from benign causes such as GERD to life threatening heart disease that may present atypically in a well-appearing child. Dr. Joubert provides some simple clinical pearls to help ED providers along the way. Published online: July 2016.
Emergency Medicine Cases Podcast: Congenital Heart Disease Emergencies
Dr. Gary Joubert & Dr. Ashley Strobel
Dr. Gary Joubert & Dr. Ashley Strobel
Episode 84: You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. Critical congenital heart defects are often missed in the ED. For a variety of reasons, there are currently more children with congenital heart disease presenting to the ED than ever before and these numbers will continue to grow in the future. With the goal of learning a practical approach to congenital heart disease emergencies using the child’s age, colour and few simple tests, Dr. Strobel and Dr. Joubert will discuss some key actions, pearls and pitfalls so that the next time you’re faced with that crashing baby in the resuscitation room, you’ll know exactly what to do. This podcast topic was chosen based on a Canada-wide needs assessment by TREKK – translating emergency knowledge for kids.
Published online: August 2016.
Episode 84: You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. Critical congenital heart defects are often missed in the ED. For a variety of reasons, there are currently more children with congenital heart disease presenting to the ED than ever before and these numbers will continue to grow in the future. With the goal of learning a practical approach to congenital heart disease emergencies using the child’s age, colour and few simple tests, Dr. Strobel and Dr. Joubert will discuss some key actions, pearls and pitfalls so that the next time you’re faced with that crashing baby in the resuscitation room, you’ll know exactly what to do. This podcast topic was chosen based on a Canada-wide needs assessment by TREKK – translating emergency knowledge for kids.
Published online: August 2016.
Emergency Medicine Cases Podcast: Pediatric Trauma
Dr. Sue Beno, Dr. Faud Alnaji
Dr. Sue Beno, Dr. Faud Alnaji
Management of the pediatric trauma patient is challenging regardless of where you work. In this EM Cases episode, two leading pediatric trauma experts, Dr. Sue Beno from Hospital for Sick Children in Toronto and Dr. Faud Alnaji from Children’s Hospital of Eastern Ontario in Ottawa answer such questions as: what are the most important physiologic and anatomic differences between children and adults that are key to managing the trauma patient? How much fluid should be given prior to blood products? What is the role of POCUS in abdominal trauma? Which patients require abdominal CT?
Management of the pediatric trauma patient is challenging regardless of where you work. In this EM Cases episode, two leading pediatric trauma experts, Dr. Sue Beno from Hospital for Sick Children in Toronto and Dr. Faud Alnaji from Children’s Hospital of Eastern Ontario in Ottawa answer such questions as: what are the most important physiologic and anatomic differences between children and adults that are key to managing the trauma patient? How much fluid should be given prior to blood products? What is the role of POCUS in abdominal trauma? Which patients require abdominal CT?
Emergency Medicine Cases Rapid Review: Congenital Heart Disease Part 1
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Emergency Medicine Cases Rapid Review: Congenital Heart Disease Part 2
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Emergency Medicine Cases Podcast: Pediatric Physical Abuse Recognition and Management
Dr. Carmen Coombs and Dr. Alyson Holland
Dr. Carmen Coombs and Dr. Alyson Holland
Episode 108: In this EM Cases main episode podcast on Pediatric Physical Abuse Recognition and Management Dr. Carmen Coombs and Dr. Alyson Holland discuss the 6 B’s of child abuse, the TEN-4 FACE decision rule, the Pittsburgh Infant Brain Injury Score, disclosure tips, screening tests, reporting responsibilities and more.
Published online: March 2018
Episode 108: In this EM Cases main episode podcast on Pediatric Physical Abuse Recognition and Management Dr. Carmen Coombs and Dr. Alyson Holland discuss the 6 B’s of child abuse, the TEN-4 FACE decision rule, the Pittsburgh Infant Brain Injury Score, disclosure tips, screening tests, reporting responsibilities and more.
Published online: March 2018
Emergency Medicine Cases Podcast: Burn and Inhalation Injuries
Episode 124: Burn and inhalation injury patients present to the ED more often than one might think, with a staggering half a million annual visits in the USA alone. It turns out that for all burn patients—from minor to severe—there is a lot of room for improvement in ED management, counselling and disposition. Things like inaccurate estimation of burn size, unnecessary endotracheal intubation, over- and under-estimation of fluid resuscitation volumes, inadequate analgesia and inappropriate wound dressings are just some of the issues where a small change to ED practice patterns could have a huge impact on patient care. In this EM Cases main episode podcast we have the director of the Burn Unit at Hospital for Sick Children, Dr. Joel Fish and EM educator Dr. Maria Ivankovic discuss dozens of pearls and pitfalls in the management of both pediatric and adult burn and inhalation injuries management with a special appearance by airway master George Kovacs to talk about awake intubation in the burn and inhalation injuries patient. Published online: May 2019
Episode 124: Burn and inhalation injury patients present to the ED more often than one might think, with a staggering half a million annual visits in the USA alone. It turns out that for all burn patients—from minor to severe—there is a lot of room for improvement in ED management, counselling and disposition. Things like inaccurate estimation of burn size, unnecessary endotracheal intubation, over- and under-estimation of fluid resuscitation volumes, inadequate analgesia and inappropriate wound dressings are just some of the issues where a small change to ED practice patterns could have a huge impact on patient care. In this EM Cases main episode podcast we have the director of the Burn Unit at Hospital for Sick Children, Dr. Joel Fish and EM educator Dr. Maria Ivankovic discuss dozens of pearls and pitfalls in the management of both pediatric and adult burn and inhalation injuries management with a special appearance by airway master George Kovacs to talk about awake intubation in the burn and inhalation injuries patient. Published online: May 2019
Video: Managing Procedural Anxiety in Children
Krauss BS, Krauss BA, Green SM.
Krauss BS, Krauss BA, Green SM.
This video describes the signs of acute anxiety in children and demonstrates approaches to interacting with children that minimize anxiety and maximize cooperation. Published: April 2016.
This video describes the signs of acute anxiety in children and demonstrates approaches to interacting with children that minimize anxiety and maximize cooperation. Published: April 2016.
Emergency management of the paediatric patient with convulsive status epilepticus
McKenzie KC, Hahn CD, Friedman JN
McKenzie KC, Hahn CD, Friedman JN
This guideline addresses the emergency management of convulsive status epilepticus (CSE) in children and infants older than one month of age. It replaces a previous position statement from 2011, and includes a new treatment algorithm and table of recommended medications based on new evidence and reflecting the evolution of clinical practice over the past several years. This statement emphasizes the importance of timely pharmacological management of CSE, and includes some guidance for diagnostic approach and supportive care.
This guideline addresses the emergency management of convulsive status epilepticus (CSE) in children and infants older than one month of age. It replaces a previous position statement from 2011, and includes a new treatment algorithm and table of recommended medications based on new evidence and reflecting the evolution of clinical practice over the past several years. This statement emphasizes the importance of timely pharmacological management of CSE, and includes some guidance for diagnostic approach and supportive care.
Hospital Emergency Treatment of Convulsive Status Epilepticus: Comparison of Pathways From Ten Pediatric Research Centers
aa
aa
We aimed to evaluate and compare the status epilepticus treatment pathways used by pediatric status epilepticus research group (pSERG) hospitals in the United States and the American Epilepsy Society (AES) status epilepticus guideline.
We aimed to evaluate and compare the status epilepticus treatment pathways used by pediatric status epilepticus research group (pSERG) hospitals in the United States and the American Epilepsy Society (AES) status epilepticus guideline.
An Evidence-Based Approach to Minimizing Acute Procedural Pain in the Emergency Department and Beyond. Pediatr Emerg Care 2016;32(1):36-42.
Ali S, McGrath T, Drendel AL
Ali S, McGrath T, Drendel AL
Objective: This review article aims to provide a summary of several strategies, which are supported by definitive and systematically reviewed evidence, that can be implemented alone or in combination to reduce procedural pain and anxiety for children in t
Objective: This review article aims to provide a summary of several strategies, which are supported by definitive and systematically reviewed evidence, that can be implemented alone or in combination to reduce procedural pain and anxiety for children in t
Managing adolescent behavioural and mental health problems in the Emergency Department
McCaskill, M. E. and E. Durheim
McCaskill, M. E. and E. Durheim
Piloting a comprehensive, familycentered resource for the management of pediatric agitation and aggression in pediatric emergency and inpatient psychiatry
Malas, N., M. K. Eter and N. Figueroa
Malas, N., M. K. Eter and N. Figueroa
How to manage agitation and aggression in emergency service
Bahali, K.
Bahali, K.
Challenges of Managing Pediatric Mental Health Crises in the Emergency Department
Chun, T. H., E. R. Katz, S. J. Duffy and R. S. Gerson
Chun, T. H., E. R. Katz, S. J. Duffy and R. S. Gerson
Agitation treatment for pediatric emergency patients
Hilt, R. J. and T. A. Woodward
Hilt, R. J. and T. A. Woodward
Factors associated with agitation in a pediatric emergency room
Samuels, A., E. Rollhaus and Y. Lerea
Samuels, A., E. Rollhaus and Y. Lerea
A research agenda for assessment and management of psychosis in emergency department patients
Peltzer-Jones, J., K. Nordstrom, G. Currier, J. S. Berlin, C. Singh and S. Schneider
Peltzer-Jones, J., K. Nordstrom, G. Currier, J. S. Berlin, C. Singh and S. Sc...
Intranasal Lorazepam for Treatment of Severe Agitation in a Pediatric Behavioral Health Patient in the Emergency Department
Bregstein, J. S., A. M. Wagh and D. S. Tsze
Bregstein, J. S., A. M. Wagh and D. S. Tsze
Pharmacologic Management of Agitation and Aggression in a Pediatric Emergency Department - A Retrospective Cohort Study
Kendrick, J. G., R. D. Goldman and R. R. Carr
Kendrick, J. G., R. D. Goldman and R. R. Carr
Randomized clinical trial comparing intravenous midazolam and droperidol for sedation of the acutely agitated patient in the emergency department
Knott, J. C., D. M. Taylor and D. J. Castle
Knott, J. C., D. M. Taylor and D. J. Castle
A pilot, open-label safety study of quetiapine for treatment of moderate psychotic agitation in the emergency setting
Currier, G. W., A. J. Trenton, P. G. Walsh and E. van Wijngaarden
Currier, G. W., A. J. Trenton, P. G. Walsh and E. van Wijngaarden
Ketamine use for acute agitation in the emergency department
Hopper, A. B., G. M. Vilke, E. M. Castillo, A. Campillo, T. Davie and M. P. Wilson
Hopper, A. B., G. M. Vilke, E. M. Castillo, A. Campillo, T. Davie and M. P. W...
Comparison of the safety and efficacy of ketamine versus olanzapine for sedation of violent agitated patients in a community emergency department
Hibbs, N. T., S. E. Kirby and C. S. Seitz
Hibbs, N. T., S. E. Kirby and C. S. Seitz
A novel agent for agitated delirium: A case series of ketamine utilization in the emergency department (ED)
Kopec, K. T., J. Lavelle, K. C. Osterhoudt and J. M. Kowalski
Kopec, K. T., J. Lavelle, K. C. Osterhoudt and J. M. Kowalski
Drug use in adolescents attending the emergency department for mental health problems
Buttera, M., A. Clavenna, E. Maselli, L. Tansini, M. P. Canevini and M. Bonati
Buttera, M., A. Clavenna, E. Maselli, L. Tansini, M. P. Canevini and M. Bonati
Emergency department presentations of naltrexone-accelerated detoxification
Armstrong, J., M. Little and L. Murray
Armstrong, J., M. Little and L. Murray
Randomized clinical trial comparing intravenous midazolam and droperidol for sedation of the acutely agitated patient in the emergency department
Knott, J. C., D. M. Taylor and D. J. Castle
Knott, J. C., D. M. Taylor and D. J. Castle
An unusual case of subterfuge in the emergency department: covert administration of antipsychotic and anxiolytic medications to control an agitated patient
Lewin, M. R., L. Montauk, M. Shalit and F. Nobay
Lewin, M. R., L. Montauk, M. Shalit and F. Nobay
Management of acute undifferentiated agitation in the emergency department: a randomized double-blind trial of droperidol, ziprasidone, and midazolam
Martel, M., A. Sterzinger, J. Miner, J. Clinton and M. Biros
Martel, M., A. Sterzinger, J. Miner, J. Clinton and M. Biros
Pharmacological management of agitation in emergency settings
Yildiz, A., G. S. Sachs and A. Turgay
Yildiz, A., G. S. Sachs and A. Turgay
Rapid-acting IM ziprasidone in a psychiatric emergency service: a naturalistic study
Preval, H., S. G. Klotz, R. Southard and A. Francis
Preval, H., S. G. Klotz, R. Southard and A. Francis
Droperidol use in pediatric emergency department patients
Szwak, K. and A. Sacchetti
Szwak, K. and A. Sacchetti
The use, safety, and efficacy of olanzapine in a pediatric emergency department over a 10-year period
Cole, J. B., A. M. Strobel, L. R. Klein, S. R. Blanchard, R. H. Nahum and M. L. Martel
Cole, J. B., A. M. Strobel, L. R. Klein, S. R. Blanchard, R. H. Nahum and M. ...