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.

  • Whole Blood Hemostatic Resuscitation in Pediatric Trauma: A Nationwide Propensity-Matched Analysis.
    Whole blood (WB) has shown promise in pediatric trauma resuscitation following its prominent role in the resuscitation of adult trauma patients. Although WB in children has been shown to be feasible, its effectiveness has yet to be explored. The aim of this study is to examine the outcomes of WB transfusion as an adjunct to […]
  • Decreasing the Use of Restraints on Children Admitted for Behavioral Health Conditions.
    Pediatric behavioral health admissions to children’s hospitals for disposition planning are steadily increasing. These children may exhibit violent behaviors, which can escalate to application of physical limb restraints for safety. Using quality improvement methodology, we sought to decrease physical restraint use on children admitted to our children’s hospital for behavioral health conditions from a baseline […]
  • The effect of point-of-care ultrasound on length of stay in the emergency department in children with neck swelling.
    Ultrasound is the imaging modality of choice in children presenting to the emergency department (ED) with soft tissue neck swelling. Point of care ultrasound (POCUS) has good accuracy when compared to comprehensive radiology department ultrasound (RADUS). POCUS could potentially improve ED length of stay (LOS) by improving efficiency. We aimed to evaluate the LOS of […]
  • Pediatric point-of-care ultrasound of optic disc elevation for increased intracranial pressure: A pilot study.
    Papilledema is often difficult to detect in children. Ocular point-of-care ultrasound (POCUS) measurement of the optic nerve sheath diameter (ONSD) is a non-invasive test for increased intracranial pressure (ICP), but no consensus exists on normal pediatric ONSD values. Detection of optic disc elevation (ODE, a component of papilledema) using POCUS has recently been qualitatively described. […]
  • Venous Thromboembolic Risk Stratification in Pediatric Trauma: A Pediatric Trauma Society Research Committee Multicenter Analysis.
    Venous thromboembolism (VTE) in injured children is rare, but its consequences are significant. Several risk stratification algorithms for VTE in pediatric trauma exist with little consensus, and all are hindered in development by relying on registry data with known inaccuracies. We performed a multicenter review to evaluate trauma registry fidelity and confirm the effectiveness of […]
  • Collaborative Care in the Identification and Management of Psychosis in Adolescents and Young Adults.
    Pediatricians are often the first physicians to encounter adolescents and young adults presenting with psychotic symptoms. Although pediatricians would ideally be able to refer these patients immediately into psychiatric care, the shortage of child and adolescent psychiatry services may sometimes require pediatricians to make an initial assessment or continue care after recommendations are made by […]
  • Is Lactating in the Emergency Department a Letdown? Exploring Barriers and Supports to Workplace Lactation in Emergency Medicine.
    To explore the social and environmental conditions in emergency departments that contribute to perceived barriers and supports for workplace lactation among individuals working in emergency medicine.Constructivist grounded theory was used by our team to understand the social processes and behaviors associated with workplace lactation for health care professionals working in EDs. A total of 24 […]
  • Accuracy of point-of-care ultrasound for determining the adequacy of pediatric forearm fracture reductions.
    The objective of the present study was to the determine the accuracy of point-of-care ultrasound (POCUS) in assessing closed reduction (CR) of pediatric forearm fractures in a pediatric emergency setting.After determination of the need for CR using X-ray images by an orthopedic consultant, POCUS examinations were performed just before and after the reduction attempt. The […]
  • Criticality index conducted in pediatric emergency department triage.
    To develop and analyze the performance of a machine learning model capable of predicting the disposition of patients presenting to a pediatric emergency department (ED) based on triage assessment and historical information mined from electronic health records.We retrospectively reviewed data from 585,142 ED visits at a pediatric quaternary care institution between 2013 and 2020. An […]
  • Experience of emergency department patients after a visit for hyperglycaemia: implications for communication and factors affecting adherence postdischarge.
    While studies have reported factors affecting adherence to diabetic care plans from a chronic disease perspective, no studies have addressed issues with post-discharge adherence facing patients with diabetes after an emergency department (ED) presentation for hyperglycaemia. This study’s objectives were to describe patient perspectives on their experience during and after an ED visit for hyperglycaemia […]
  • Gastrointestinal failure score in children with traumatic brain injury.
    To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function.A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and […]
  • Evaluation of digital otoscopy in pediatric patients: A prospective randomized controlled clinical trial.
    Acute otitis media is often misdiagnosed. Pediatric trainees learn otoscopy from supervisors who cannot concurrently view the eardrum. Digital, smartphone otoscopes show promise to improve the visibility and learning due to a concurrent view by trainees and supervisors. We aimed to determine whether use of digital otoscopes improved accuracy of the ear exams between medical […]
  • Explaining Sudden Unexpected Infant Deaths, 2011-2017.
    Sudden unexpected infant death (SUID) represents a broad group of explained and unexplained infant deaths (<1 year old). Explaining why SUID occurs is critical to understanding etiology and prevention. Death certificate data cannot differentiate explained from unexplained SUID cases nor describe the surrounding circumstances. We report SUID rates by explained and unexplained categories and describe […]
  • Epidemiology, risk factors and outcomes of bloodstream infection caused by ESKAPEEc pathogens among hospitalized children.
    Bloodstream infection (BSI) resulting from ESKAPEEc pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp) is relevant to high mortality and economic cost. Data concerning the impact of BSI due to ESKAPEEc in pediatric population was virtually scant. Our purpose was to summarize the epidemiology, risk factors and […]
  • Paediatric emergency department dog bite attendance during the COVID-19 pandemic: an audit at a tertiary children’s hospital.
    Responses to the COVID-19 pandemic include strict public health measures, such as national lockdowns. During these measures, paediatric emergency department attendances have declined and the prevalence of presenting complaints has changed. This study sought to identify whether dog bite attendance and victim demographics changed during COVID-19 public health measures.An audit was conducted of emergency department […]
  • Novel Trauma Composite Score Is A More Reliable Predictor Of Mortality Than Injury Severity Score In Pediatric Trauma.
    The equivalent injury severity score (ISS) cutoffs for severe trauma vary between adult (ISS>16) and pediatric (ISS>25) trauma patients. We hypothesized that a novel injury severity prediction model, which incorporates age and mechanism of injury, would outperform standard ISS cutoffs.The 2010-2016 NTDB was queried for pediatric trauma patients. Cut point analysis was used to determine […]
  • Early prediction of serious infections in febrile infants incorporating heart rate variability in an emergency department: a pilot study.
    Early differentiation of febrile young infants with from those without serious infections (SIs) remains a diagnostic challenge. We sought to (1) compare vital signs and heart rate variability (HRV) parameters between febrile infants with versus without SIs, (2) assess the performance of HRV and vital signs with reference to current triage tools and (3) compare […]
  • How much time do doctors spend providing care to each child in the ED? A time and motion study.
    The total time per patient doctors spend providing care in emergency departments (EDs) has implications for the development of evidence-based ED staffing models. We sought to measure the total time taken by doctors to assess and manage individual paediatric patients presenting to two EDs in the Western Cape, South Africa and to compare these averages […]
  • To prescribe or not to prescribe for paediatric sore throat: a retrospective cohort study comparing clinician-led antibiotic prescriptions to FeverPAIN and Centor scoring in a tertiary paediatric emergency department and a national review of practice.
    Tonsillopharyngitis is a common presentation to paediatric emergency departments (PEDs). FeverPAIN (FP) and Centor scoring systems are recommended in the UK to help delineate bacterial aetiology, despite being primarily evidenced in adult populations. We investigate how the use of FP or Centor compares to actual clinician practice in guiding antibiotic prescription rates in PED. We […]
  • Common diagnoses among pediatric attendances at emergency departments.
    Pediatric patients present to Emergency Departments (EDs) with a variety of medical conditions. An appreciation of the common presenting conditions can aid EDs in the provision of pediatric emergency care. In this study, we established the common pediatric diagnoses seen at the general EDs, with reference to a pediatric ED.A retrospective review of medical records […]
  • Crowding is the strongest predictor of left without being seen risk in a pediatric emergency department.
    Emergency Department (ED) patients who leave without being seen (LWBS) are associated with adverse safety and medico-legal consequences. While LWBS risk has been previously tied to demographic and acuity related factors, there is limited research examining crowding-related risk in the pediatric setting. The primary objective of this study was to determine the association between LWBS […]
  • Addition of Neurological Status to Pediatric Adjusted Shock Index to Predict Early Mortality in Trauma: A Pediatric TQIP Analysis.
    Pediatric adjusted shock index (SIPA) has demonstrated the ability to prospectively identify children at the highest risk for early mortality. The addition of neurological status to shock index has shown promise as a reliable triage tool in adult trauma populations. This study sought to assess the utility of combining SIPA with Glasgow Coma Scale (GCS) […]
  • Perceived Access to Handguns Among Colorado High School Students.
    Access to firearms among youth can increase the risk of suicide or other injury. In this study, we sought to estimate the population prevalence of adolescent perception of firearm access by demographic, geographic, and other individual health characteristics.The 2019 Healthy Kids Colorado Survey was an anonymous survey administered to a representative sample of high school […]
  • Sociodemographic Factors and Outcomes by Intent of Firearm Injury.
    Firearm injuries are a leading and preventable cause of morbidity and mortality among youth. We sought to explore differences in sociodemographic factors and youth firearm injury outcomes by injury intent (unintentional, assault, and self-harm).We conducted a repeated cross-sectional analysis of emergency department (ED) visits among youth aged 21 and younger presenting to an ED with […]
  • Implementation of a dual cervical spine and blunt cerebrovascular injury assessment pathway for pediatric trauma patients.
    Pediatric cervical spine (CSI) and blunt cerebrovascular injuries (BCVI) are challenging to evaluate as they are rare but carry high morbidity and mortality. CT scans are the traditional imaging modality to evaluate for CSI/BCVI, but involve radiation exposure and potential future increased risk of malignancy. Therefore, we present results from the implementation of a combined […]
  • United States trends in healthcare charges for pediatric firearm injuries.
    From 2009 to 2016, >21,000 children died and an estimated 118,000 suffered non-fatal injuries from firearms in the United States. Limited data is available on resource utilization by injury intent. We use hospital charges as a proxy for resource use and sought to: 1) estimate mean charges for initial ED and inpatient care for acute […]
  • Increasing the spectrum of white matter diseases with tigroid pattern on MRI: glutaric aciduria type 1 – case report.
    Most white matter diseases present on magnetic resonance imaging as focal or diffuse T2-hyperintensities. However, in a few of them, radially oriented stripes of low (relatively normal) signal intensity are observed within diffusely affected T2-hyperintense cerebral white matter and are called “tigroid pattern” in the literature. The fornix is a tiny white matter fibers bundle […]
  • Caring for American Indian and Alaska Native Children and Adolescents.
    American Indian and Alaska Native (AI/AN) populations have substantial health inequities, and most of their disease entities begin in childhood. In addition, AI/AN children and adolescents have excessive disease rates compared with the general pediatric population. Because of this, providers of pediatric care are in a unique position not only to attenuate disease incidence during […]
  • Impact of young age on outcomes of emergency department procedural sedation.
    Relatively little is known about outcomes of procedural sedation in very young children. Our objective was to examine the association between procedural sedation in young children (≤ 2 years) and the incidence of sedation-related adverse events.This is a secondary analysis of a prospective cohort study of children 0 to 18 years undergoing parenteral procedural sedation in six […]
  • NutriBrain: protocol for a randomised, double-blind, controlled trial to evaluate the effects of a nutritional product on brain integrity in preterm infants.
    The gut microbiota and the brain are connected through different mechanisms. Bacterial colonisation of the gut plays a substantial role in normal brain development, providing opportunities for nutritional neuroprotective interventions that target the gut microbiome. Preterm infants are at risk for brain injury, especially white matter injury, mediated by inflammation and infection. Probiotics, prebiotics and […]
  • Influence of agents and mechanisms of injury on anatomical burn locations in children <5 years old with a scald.
    To demonstrate how the mechanism and agent of injury can influence the anatomical location of a scald.Prospective multicentre cross-sectional study.20 hospital sites across England and Wales including emergency departments, minor injury units and regional burns units.Children aged 5 years and younger who attended hospital with a scald.Primary outcome: a descriptive analysis of the mechanism, agent […]
  • Is lymphangitic streaking associated with different pathogens?
    Little is known regarding the differences in microbiology associated with cellulitis or abscess with or without lymphangitic streaking. The objective of our study is to assess whether there are differences in the pathogens identified from wound cultures of patients with paronychia with and without associated lymphangitis.Retrospective cross-sectional study at a tertiary pediatric emergency department over […]
  • Examining black and white racial disparities in emergency department consultations by age and gender.
    While significant racial inequities in health outcomes exist in the United States, these inequities may also exist in healthcare processes, including the Emergency Department (ED). Additionally, gender has emerged in assessing racial healthcare disparity research. This study seeks to determine the association between race and the number and type of ED consultations given to patients […]
  • Pediatric emergency department utilization during the COVID-19 pandemic in New York City.
    This study describes the utilization of a pediatric emergency department (ED) during the early months of the COVID-19 pandemic in the initial U.S. epicenter, including the impact on visit acuity and incidences of common diagnoses.We performed an observational retrospective review of patients younger than 18 years old seen in a New York City pediatric ED […]
  • Body composition in term offspring after maternal gestational diabetes does not predict postnatal hypoglycemia.
    Offspring of mothers with gestational diabetes mellitus (GDM) have an increased risk of neonatal complications like birth trauma due to macrosomia or postnatal hypoglycemia, as well as long-term metabolic sequelae. Neonatal body composition may be a sensitive marker of metabolic effects on the fetus caused by suboptimal glycemic control during pregnancy.To determine body composition in […]
  • A systematic mixed studies review of patient experiences in the ED.
    Understanding patient experiences is crucial to evaluating care quality in EDs. However, while previous reviews describe the determinants of ED patient experiences (ie, factors that influence patient experiences), few have described actual patient experiences. The aim of this systematic mixed studies review was to describe patient experiences in the ED from the patient’s perspective.Embase, Medline, […]
  • Minor head injury transfers: Trends and outcomes.
    Children with traumatic head injury are often transferred from community Emergency Departments (ED) to a Pediatric Emergency Department (PED). The primary objective of this study was to describe the outcomes of minor head injury (MHI) transfers to a PED. The secondary objective was to report Computed Tomography (CT) utilization rates for MHI.We conducted a retrospective […]
  • Pediatric minor head injury related return visits to the emergency department and their outcome.
    Minor head injury (MHI) in children is a common emergency department (ED) presentation. It is well established that majority of these patients don’t require imaging and can be safely discharged. What is less known is how often these children come back to the ED and the outcome of their revisits? The objective of this study […]
  • Can TEN4 distinguish bruises from abuse, inherited bleeding disorders or accidents?
    Does TEN4 categorisation of bruises to the torso, ear or neck or any bruise in <4-month-old children differentiate between abuse, accidents or inherited bleeding disorders (IBDs)?Prospective comparative longitudinal study.Community.Children <6 years old.The number and location of bruises compared for 2568 data collections from 328 children in the community, 1301 from 106 children with IBD and […]
  • A Comprehensive Analysis of Undertriage in a Mature Trauma System Using Geospatial Mapping.
    The correct triage of trauma patients to trauma centers (TCs) is essential. We sought to determine the percentage of patients who were undertriaged (UTR) within the Pennsylvania (PA) trauma system and spatially analyze areas of UTR in PA for all age groups: pediatric, adult and geriatric. We hypothesized that there would be certain areas that […]
  • Association Between Access to Pediatric Trauma Care and Motor Vehicle Crash Death in Children: An Ecologic Analysis of United States Counties.
    Access to pediatric trauma care is highly variable across the United States (US). The purpose of this study was to measure the association between pediatric trauma center (TC) care and motor vehicle crash (MVC) mortality in children (<15 years) at the US county level over 5 years (2014-2018).The exposure was defined as the highest level […]
  • Global trends in adolescents’ road traffic injury mortality, 1990-2019.
    The aim of this study was to determine the trends of road traffic injury (RTI) mortality among adolescents aged 10-14 years and 15-19 years across different country income levels with respect to the type of road users from 1990 to 2019.We conducted an ecological study. Adolescents’ mortality rates from RTIs at the level of high-income […]
  • 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 […]
  • Docosahexaenoic Acid Decreased Inflammatory Gene Expression, but not TSPO Binding, in Rat Pup Brain after Controlled Cortical Impact.
    Traumatic brain injury (TBI) is the leading cause of acquired neurologic disability in children. In our model of pediatric TBI, controlled cortical impact (CCI) in rat pups, Docosahexaenoic Acid (DHA) improved lesion volume and cognitive testing as late as Post Injury Day (PID) 50. DHA decreased pro-inflammatory mRNA in microglia and macrophages at PID 3 […]
  • 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 […]
  • 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 […]
  • 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 […]
  • 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. […]
  • Effectiveness of seasonal malaria chemoprevention at scale in west and central Africa: an observational study.
    Seasonal malaria chemoprevention (SMC) aims to prevent malaria in children during the high malaria transmission season. The Achieving Catalytic Expansion of SMC in the Sahel (ACCESS-SMC) project sought to remove barriers to the scale-up of SMC in seven countries in 2015 and 2016. We evaluated the project, including coverage, effectiveness of the intervention, safety, feasibility, […]