The Latest Paediatric Emergency Medicine Journal Articles

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Keep up to date with the latest in paediatric emergency medicine. Check out the latest paediatric emergency medicine articles from leading medical journals in a single view, helping you discover relevant articles quickly and easily.

  • Severe Acute Neurologic Involvement in Children With Hemolytic-Uremic Syndrome.
    Acute severe neurologic involvement is the most threatening complication in children with hemolytic-uremic syndrome (HUS). Our primary study objectives were to describe the association between acute neurologic manifestations (ANMs) and in-hospital mortality among children with HUS.Using the Pediatric Health Information System database, in this retrospective multicenter cohort study, we identified the first HUS-related inpatient visit […]
  • Nonresection management of the pancreas for grade III and IV blunt pancreatic injuries in children: a single center’s experience.
    The treatment of high-grade (III/IV/V) blunt pancreatic injuries remains controversial. The study aims to summarize and evaluate nonresection management of the pancreas for grade III and IV blunt pancreatic injuries in children.Twenty children [6.9 (3-12) years] treated at our center between January 2010 and June 2018 were included in this study. Their medical records and […]
  • Clinical and genetic characteristics of concomitant Mucopolysaccharidosis type IVA and neurogenic bladder in children: two case reports and literature review.
    Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is a rare autosomal recessive lysosomal storage disorder. Up to now, reports on the clinical characteristics of MPS IVA mainly focused on patients with progressive bone dysplasia and multiple organ damage, while the effects of this disorder on neurogenic bladder have not been reported. Therefore, the aim of […]
  • Tourniquet application by schoolchildren- a randomized crossover study of three commercially available models.
    Life threatening hemorrhage is a major cause of preventable mortality in trauma. Studies have demonstrated the effectiveness and safety of commercial tourniquets when used by adult civilians. However, there is no data about tourniquet application by children.This study’s goal is to determine which of three commercially available tourniquets is most effective when used by children.A […]
  • Caught in the Crossfire: 37 Years of Firearm Violence Afflicting America’s Youth.
    Publicly available firearm data is difficult to access. Trauma registry data is excellent at documenting patterns of firearm-related injury. Law enforcement data excels at capturing national violence trends to include both circumstances and firearm involvement. The goal of this study was to utilize publicly available, law enforcement data from all 50 states to better define […]
  • A reappraisal of childhood drowning in a pediatric emergency department.
    In the present study, we aimed to investigate the demographic and clinical features, laboratory and radiologic characteristics, management, and outcomes of pediatric drowning patients in order to identify predictors of hospital admission, and to evaluate the need for respiratory support, and prognosis.In this retrospective chart review, children aged 0 to 18 years who presented to the […]
  • Managing the risk from children’s travel cups.
    UK national newspapers have reported cases of children (and adults) who have got their tongue trapped in a Disney travel mug lid, causing extreme distress to the patients, their parents and ED staff. Potential risks include oral endotracheal intubation necessitating emergency tracheostomy to secure the airway, tongue necrosis and dental trauma. Although Disney has withdrawn […]
  • Principles of Care for Young Adults With Co-Occurring Psychiatric and Substance Use Disorders.
    Over 50% of young adults (defined as individuals aged 18-25 years) with substance use disorders (SUDs) have at least 1 co-occurring psychiatric disorder, and the presence of co-occurring disorders worsens SUD outcomes. Treatment of both co-occurring psychiatric disorders and SUDs in young adults is imperative for optimal treatment, yet many barriers exist to achieving this […]
  • A Gut Feeling: Abdominal Symptoms as an Initial Presentation of EVALI.
    Electronic cigarette or vaping product use-associated lung injury (EVALI) is a disease process that has become prevalent in the United States.1 The Centers for Disease Control and Prevention reported there have been almost 2700 cases of this condition in the United States as of January 14, 2020, with >50% of these patients aged ≤24.2 We […]
  • Utilization of the electrocardiogram in the pediatric emergency department.
    Review pediatric electrocardiogram (ECG) result severity classification and describe the utilization of ECG testing, and rate of clinically significant results, in the pediatric emergency department (PED).This was a review of patients ≤18 years who had an ECG performed in a tertiary children’s hospital PED 2005-2017. Using established guidelines and expert consultation, ECG results were categorized: Class […]
  • Associations between initial serum pH value and outcomes of pediatric out-of-hospital cardiac arrest.
    Pediatric out-of-hospital cardiac arrest (OHCA) is one of the most critical conditions seen in the emergency department (ED). Although initial serum pH value is reported to be associated with outcome in adult OHCA patients, the association is unclear in pediatric OHCA patients. Thus, we aimed to identify the association between initial pH value and outcome […]
  • Paediatric emergencies and related mortality in Nicaragua: results from a multi-site paediatric emergency registry.
    We aim to describe the characteristics and outcomes of the severe spectrum of paediatric emergency visits using a multi-site registry developed as part of an international cooperation project.This observational registry-based study presented descriptive statistics of clinical and outcome data on urgent-emergency paediatric visits from 7 Nicaraguan hospitals, including the national referral paediatric hospital, between January […]
  • Parental satisfaction with waiting time in a Swiss tertiary paediatric emergency department.
    Patient numbers in paediatric emergency departments (PED) are steadily increasing. Parental perception of waiting time and reasons for attending a PED with non-emergencies have been investigated in the UK, Australia, Korea, Canada and the USA. We sought to examine which factors influence parental satisfaction with waiting time in a tertiary Swiss PED and whether these […]
  • Lymphocyte-to-monocyte ratio predicts mortality in cirrhotic patients with septic shock.
    Patients with liver cirrhosis and septic shock have a significantly higher risk of mortality and morbidity compared with non-cirrhotic patients. The peripheral blood lymphocyte-to-monocyte ratio (LMR) can determine the prognosis of cirrhotic patients. Our study aimed to investigate the usefulness of LMR as a predictive marker of mortality risk in cirrhotic patients with septic shock.This […]
  • A Survivor-Derived Approach to Addressing Trafficking in the Pediatric ED.
    Our objective was to elicit the perspectives of survivors of child trafficking on addressing trafficking in the pediatric emergency department (ED) and, secondarily, to provide a survivor-derived framework to help pediatric emergency medicine (PEM) providers discuss trafficking with their patients.We conducted in-depth, semistructured interviews with young adults who experienced trafficking as children and/or as adolescents. […]
  • A Survivor-Derived Approach to Addressing Trafficking in the Pediatric ED.
    Our objective was to elicit the perspectives of survivors of child trafficking on addressing trafficking in the pediatric emergency department (ED) and, secondarily, to provide a survivor-derived framework to help pediatric emergency medicine (PEM) providers discuss trafficking with their patients.We conducted in-depth, semistructured interviews with young adults who experienced trafficking as children and/or as adolescents. […]
  • Characteristics, clinical care, and disposition barriers for mental health patients boarding in the emergency department.
    Lack of mental health resources, such as inpatient psychiatric beds, has increased frequency and duration of boarding for mental health patients presenting to U.S. emergency departments (EDs). The purpose of this study is to describe characteristics of mental health patients with an ED length of stay of one week or longer and to identify barriers […]
  • Evidence base for point-of-care ultrasound (POCUS) for diagnosis of skull fractures in children: a systematic review and meta-analysis.
    Blunt head trauma is a common presentation to emergency departments (EDs). Identifying skull fractures in children is important as they are known factor of risk for traumatic brain injury (TBI). Currently, CT is the reference standard for diagnosing skull fractures and TBIs in children. Identifying skull fractures with point-of-care ultrasound (POCUS) may help risk-stratify children […]
  • Hearing Loss in Children: A Review.
    Hearing loss in children is common and by age 18 years, affects nearly 1 of every 5 children. Without hearing rehabilitation, hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children.Consequences of hearing loss in children include worse outcomes in speech, language, education, social functioning, cognitive abilities, and quality […]
  • A Randomized Trial of Laryngeal Mask Airway in Neonatal Resuscitation.
    Face-mask ventilation is the most common resuscitation method for birth asphyxia. Ventilation with a cuffless laryngeal mask airway (LMA) has potential advantages over face-mask ventilation during neonatal resuscitation in low-income countries, but whether the use of an LMA reduces mortality and morbidity among neonates with asphyxia is unknown.In this phase 3, open-label, superiority trial in […]
  • Fever response to ibuprofen in viral and bacterial childhood infections.
    to compare the antipyretic effects of ibuprofen in febrile children with serious bacterial infections (SBI), and children with a presumed viral infection.A prospective cross- sectional study was conducted in a pediatric Emergency department between October 2018 and March 2020 for children aged 3 months to 4 years with a rectal temperature ≥ 38.5 °C. Patients received 10 mg/kg of ibuprofen oral […]
  • Follow-up Blood Cultures in Children With Staphylococcus aureus Bacteremia.
    Staphylococcusaureus is a common pathogen seen in pediatric bloodstream infections. Currently, no evidence-based recommendations are used to guide decisions on the number of follow-up blood cultures (FUBCs) needed to demonstrate infection clearance. Unnecessary cultures increase the risk of false-positives, add to health care costs, and create additional trauma to children and their families. In this […]
  • Shock index is better than conventional vital signs for assessing higher level of care and mortality in severe sepsis or shock.
    Conventional vital signs alone have limitations in determining the physiological status. Age-adjusted shock-index (SIPA), a comprehensive physiological variable, defined as the ratio of heart rate (HR) and systolic blood pressure (SBP) may be better at predicting hemodynamic stability and outcome than vital signs.To compare discriminatory power of SIPA against vital signs in assessing higher level […]
  • Duration of symptoms is the only predictor of testicular salvage following testicular torsion in children: A case-control study.
    Testicular torsion (TT) is an emergency requiring a prompt diagnosis and surgery to avoid irreversible changes and a complete loss of testis. The present study aimed to identify potential factors that may be predict a testicular salvage after TT in pediatric patients.Consecutive medical records of all children ≤16 years old with surgically confirmed TT over a […]
  • Amalgam restoration or just a deposit? A riveting incidental finding- a case report.
    Parafunctional oral habits are known to cause deleterious effects on maxillofacial structures. One such effect is traumatic injuries secondary to chewing inanimate objects like pencils. Following trauma, the lead of the pencil has been reported to embed in the soft tissue of the oral cavity, appearing as a grayish pigmentation (graphite tattoo). However, such pigmentation […]
  • Bacteriology of pediatric breast abscesses beyond the neonatal period.
    Limited data exist regarding the presentation and bacteriology of nonneonatal pediatric breast abscess.To determine the bacteriology and characteristic presentation of pediatric breast abscesses in a tertiary care center.Cross-sectional study of patients age 1 month to 21 years admitted to a pediatric Emergency Department (ED) between 1996 and 2018 with a breast abscess. Patients with pre-existing conditions were […]
  • Supporting children and adolescents following parental bereavement: guidance for health-care professionals.
    Death of a parent in childhood and adolescence is a distressing life event. Childhood grief reactions are distinct from those in adults, and are affected by developmental and contextual factors such as age of the child and changes in caregiving environments. Following parental bereavement, children and adolescents face unique emotional and behavioural challenges, and are […]
  • Characteristics of frequent paediatric users of emergency departments in England: an observational study using routine national data.
    Frequent attendances of the same users in emergency departments (ED) can intensify workload pressures and are common among children, yet little is known about the characteristics of paediatric frequent users in EDs.To describe the volume of frequent paediatric attendance in England and the demographics of frequent paediatric ED users in English hospitals.We analysed the Hospital […]
  • Improving Quality of Care Through a Mandatory Provincial Audit Program: Ontario’s Emergency Department Return Visit Quality Program.
    The Emergency Department Return Visit Quality Program was launched in Ontario, Canada, to promote a culture of quality. It mandates the province’s largest-volume emergency departments (EDs) to audit charts of patients who had a return visit leading to hospital admission, including some of their 72-hour all-cause return visits with admission and all of their 7-day […]
  • Association of air temperature with pediatric intussusception in northeastern China: A 10-year retrospective study.
    The aim of this study was to determine whether an association existed between intussusception and air temperature.A retrospective study was performed between March 2006 and February 2016 to determine the relationship between pediatric primary intussusception (PPI) and air temperature. Information from hospital records of 5922 cases of PPI and Mean daily temperatures of Shenyang were […]
  • Effect of Implementing the Out-of-Hospital Traumatic Brain Injury Treatment Guidelines: The Excellence in Prehospital Injury Care for Children Study (EPIC4Kids).
    We evaluate the effect of implementing the out-of-hospital pediatric traumatic brain injury guidelines on outcomes in children with major traumatic brain injury.The Excellence in Prehospital Injury Care for Children study is the preplanned secondary analysis of the Excellence in Prehospital Injury Care study, a multisystem, intention-to-treat study using a before-after controlled design. This subanalysis included […]
  • Assessment of ED triage of anaphylaxis patients based on the Emergency Severity Index.
    To describe the emergency department (ED) triage of anaphylaxis patients based on the Emergency Severity Index (ESI), assess the association between ESI triage level and ED epinephrine administration, and determine characteristics associated with lower acuity triage ESI assignment (levels 3 and 4).We conducted a cohort study of adult and pediatric anaphylaxis patients between September 2010 […]
  • UK healthcare staff experiences and perceptions of a mass casualty terrorist incident response: a mixed-methods study.
    System learning from major incidents is a crucial element of improving preparedness for response to any future incidents. Sharing good practice and limitations stimulates further actions to improve preparedness and prevents duplicating mistakes.This convergent parallel mixed methods study comprises data from responses to an online survey and individual interviews with healthcare staff who took part […]
  • Technical factors associated with first-pass success during endotracheal intubation in children: analysis of videolaryngoscopy recordings.
    First-pass success (FPS) during intubation is associated with lower morbidity for paediatric patients. Using videolaryngoscopy (VL) recordings, we reviewed technical aspects of intubation, including factors associated with FPS in children.We performed a retrospective study of intubation attempts performed using video-assisted laryngoscopy in a paediatric ED between January 2014 and December 2018. Data were abstracted from […]
  • Abusive Head Trauma in Day Care Centers.
    Abusive head trauma (AHT) warrants particular attention in terms of prevention. One of the key questions asked is how often AHT occurs in infant day care centers compared with private parental or nonparental homes. To investigate this, we studied the caretaking arrangement and child’s location at the time of injury in a cohort of cases […]
  • Mean core to peripheral temperature difference and mean lactate levels in first 6 hours of hospitalisation as two indicators of prognosis: an observational cohort study.
    To study mean core to peripheral temperature difference (CPTD) and the mean lactate levels over the first 6 h of admission to hospital, as indicators of prognosis in critically ill children.A prospective observational study in a tertiary level Pediatrics ICU in Delhi, India. Seventy eight paediatric patients from 1 month to 12 years were studied. Children with physical […]
  • Imaging the infant with a head injury: a single-centre retrospective study.
    Head injury is the largest cause of mortality in paediatric trauma. Infants (<1 year old) are a high-risk group and vulnerable to non-accidental injury. A single-centre retrospective study at a major trauma centre collected data on infants presenting with a head injury over a 48-month period. 1127 infants presented with a head injury. 135 CT […]
  • Prothrombin Time ratio can predict mortality in severe pediatric trauma: Study in a French trauma center level 1.
    Injury results in more deaths in children than all other causes combined, but there is little data regarding the association of early coagulopathy on outcomes in pediatric patients with traumatic injuries. The aim of this study was to determine the optimal cut-off value for the Prothrombin Time ratio (PTr) and to show the diagnostic characteristics […]
  • Multisystem inflammatory syndrome in children associated with novel coronavirus SARS-CoV-2: Presentations to a pediatric emergency department in Michigan.
    The SARS-CoV-2 is a respiratory virus of the coronavirus family responsible for a global pandemic since December 2019. More than 35 million people have been affected with the novel coronavirus disease (COVID-19), with more than one million deaths worldwide. Michigan was one of the top three states in the United States that was severely affected […]
  • Feasibility and usefulness of rapid 2-channel-EEG-monitoring (point-of-care EEG) for acute CNS disorders in the paediatric emergency department: an observational study.
    The aim of this study was to determine the feasibility and clinical utility of point-of-care electroencephalogram (pocEEG) in the paediatric emergency department (ED) for children presenting with acute non-traumatic central nervous system (CNS) disorders.Retrospective observational study of prospectively collected data in paediatric patients (0-16 years) with acute non-traumatic CNS-disorders presenting between April 2014 and February […]
  • Evaluation of a novel approach to recognising community-acquired paediatric sepsis at ED triage by combining an electronic screening algorithm with clinician assessment.
    We report the utilisation and impact of a novel triage-based electronic screening tool (eST) combined with clinical assessment to recognise sepsis in paediatric ED.An electronic sepsis screening tool was implemented in the paediatric EDs of two large UK secondary care hospitals between June 2018 and January 2019. Patients eligible for screening were children < 16 […]
  • Management and Outcomes of Children With Nursemaid’s Elbow.
    We identify the incidence and predictors of missed fracture and characterize patterns of radiography performance in children with a diagnosis of radial head subluxation in the emergency department (ED) setting.We queried the Pediatric Health Information System database for visits by children younger than 10 years and with a diagnosis of radial head subluxation at 1 […]
  • Intracranial injuries on computed tomography head scans in infants investigated for suspected physical abuse: a retrospective review.
    UK national guidelines recommend that investigation of infants (aged <12 months) with suspected physical abuse should always include CT head scans. Such imaging carries small but recognised risks from radiation exposure. Studies report a range of yields for occult intracranial injuries in suspected physical abuse.To report the yield of intracranial injuries on CT head scans […]
  • Head computed tomography in suspected physical abuse: time to rethink?
    National guidance recommends CT-head for all children <1 year old with suspected physical abuse, and to be considered for those <2 years old to exclude abusive head trauma.To investigate whether this guidance is followed, and the associations between clinical presentation and CT findings, to determine whether guidance could be refined.A retrospective case note review of […]
  • Chronic Ulcers and Malnutrition in an African Patient.
    An 11-year-old girl with a congenitally malformed left hand, sickle cell trait, asthma, and history of appendicitis was transferred from Zambia for evaluation and treatment of widespread suppurative and ulcerative skin lesions that typically appeared after trauma to her skin. The ulcers first presented 3 years earlier but had markedly worsened in the 9 months before […]
  • Classic Ehlers-Dalnos syndrome presenting as atypical chronic haematoma: a case report with novel frameshift mutation in COL5A1.
    Ehlers-Danlos syndrome (EDS) is a group of inherited connective tissue disorders characterized by skin hyperextensibility, joint hypermobility and soft tissue vulnerable to blunt injury. Early recognition and diagnosis are crucial to patients to provide appropriate treatment, as well as to screen for life-threatening conditions such as aortic dissection and hollow organ perforation. The diagnosis of […]
  • Routine Neuroimaging of the Preterm Brain.
    Neuroimaging of the preterm infant is a common assessment performed in the NICU. Timely and focused studies can be used for diagnostic, therapeutic, and prognostic information. However, significant variability exists among neonatal units as to which modalities are used and when imaging studies are obtained. Appropriate timing and selection of neuroimaging studies can help identify […]
  • Vaping-related injury and illness among Canadian children and adolescents: a one-time survey of paediatric providers.
    A one-time survey distributed to 2693 Canadian paediatricians enrolled in the Canadian Paediatric Surveillance Programme was conducted between October and December 2019. We identified a wide range of severe vaping-related injuries and illnesses among children ages 0-17 (n=88), which were associated with the routine use or malfunctioning of a vaping device or the ingestion of […]
  • Road Traffic Accidents and Disparities in Child Mortality.
    Road traffic accidents are a leading cause of child deaths in the United States. Although this has been examined at the national and state levels, there is more value in acquiring information at the county level to guide local policies. We aimed to estimate county-specific child mortality from road traffic accidents in the United States.We […]
  • External validation of the DIVA and DIVA3 clinical predictive rules to identify difficult intravenous access in paediatric patients.
    Intravenous (IV) peripheral access is often a difficult procedure in the paediatric ED, causing pain and significant distress. Clinical prediction tools including reproducible variables have been developed to help clinicians identify children at risk of difficult IV access, likely to need additional resources/interventions to maximise success at first attempt. We aimed to externally validate the […]
  • Use of the BIG score to predict mortality in pediatric trauma.
    The BIG score, which is comprised of admission base deficit (B), International Normalized Ratio (I), and GCS (G), is a severity of illness score that can be used to rapidly predict in-hospital mortality in pediatric patients presenting following traumatic injury. We sought to compare the mortality prediction of the pediatric trauma BIG score with other […]
  • Surge activation by the emergency department for COVID-19.
    In March 2020, the American College of Emergency Physicians (ACEP) published a national strategic plan for COVID-19, which provides general guidelines yet leaves logistical details for institutions to determine. Key capabilities from this plan provided a crucial foundation for a 16-day Emergency Department (ED) surge planning process at one pediatric institution. This paper describes critical […]
  • Publishing trends in the field of urgent care medicine from 2000 to 2020: A bibliometric analysis.
    With a steady rise in the number of urgent care centers in the United States and the establishment of urgent care medicine as a specialty, research in the field is likely to emerge.To perform a bibliometric analysis of published studies in the field of urgent care medicine over the past two decades.A comprehensive literature review […]
  • Diagnostic modalities to determine ventriculoperitoneal shunt malfunction: A systematic review and meta-analysis.
    Ventriculoperitoneal (VP) shunt malfunction is an emergency. Timely diagnosis can be challenging because shunt malfunction often presents with symptoms mimicking other common pediatric conditions.We performed a systematic review and meta-analysis to determine which commonly used imaging modalities; Magnetic resonance imaging (MRI), Computed Tomography (CT), X-ray Shunt series or Optic Nerve Sheath Diameter (ONSD) ultrasound, are […]
  • Young children with psychiatric complaints in the pediatric emergency department.
    Children are increasingly diagnosed with mental illnesses and self-harm behaviors. They present frequently to the emergency department (ED) for evaluation. The aim of this study is to describe the youngest children in the ED with psychiatric issues.This is a retrospective chart review of all consecutive children less than 10 years of age with a psychiatric complaint […]
  • Planning for success: overcoming challenges to recruitment and conduct of an open-label emergency department-led paediatric trial.
    Key challenges to the successful conduct of The Emergency treatment with Levetiracetam or Phenytoin in Status Epilepticus in children (EcLiPSE) trial were identified at the pre-trial stage. These included practitioner anxieties about conducting research without prior consent (RWPC), inexperience in conducting an ED-led trial and use of a medication that was not usual ED practice. […]
  • Exhaled end-tidal carbon dioxide as a predictor of lactate and pediatric sepsis.
    The objective of this study was to investigate the relationship between exhaled end-tidal carbon dioxide (ETCO2) and serum lactate via nasal capnography and to assess the ability of ETCO2 to predict disease severity in children with suspected sepsis in a pediatric emergency department.This prospective study included patients (≥ 30 days to ≤21 years of age) who presented […]
  • Cluster cross-over randomised trial of paediatric airway management devices in the simulation lab and operating room among paramedic students.
    The objective of this study was to compare paediatric emergency airway management strategies in the simulation lab and operating room environments.This was a two-part cluster cross-over randomised trial including simulation lab and operating room environments conducted between January 2017 and June 2018 in Portland, Oregon, USA. In simulated infant cardiac arrests, paramedic students placed an […]
  • Impact of personal protective equipment on the effectiveness of chest compression – A systematic review and meta-analysis.
    To assess the impact of personal protective equipment (PPE) on different aspects of chest compression (CC) during cardiopulmonary resuscitation, we conducted this study.This systematic review was performed according to the PRISMA. We searched PubMed, EMBASE and Web of Science from inception to June-6, 2020, limiting to the studies that reported the comparison of the effectiveness […]
  • Factors associated with avoidable interhospital transfers for children with a minor head injury.
    Children with minor head injuries (MHI) are routinely transferred to a pediatric trauma center for definitive care. Unwarranted transfers result in minimal benefit to the patient and add substantially to healthcare costs. The purpose of this study is to explore the factors associated with avoidable interhospital transfers of children with MHI.We conducted a retrospective cohort […]