Abstract:
OBJECTIVES:Vascular injury in pediatric trauma patients is uncommon but associated with a reported mortality greater than 19% in some series. The purpose of this study was to characterize pediatric major vascular injuries (MVIs) and analyze mortality at a high-volume combined adult and pediatric trauma center. METHODS:A retrospective review (January 2000 to May 2016) was conducted of all pediatric (<18 years old) trauma patients who presented with a vascular injury. A total of 177 patients were identified, with 60 (34%) having an MVI, defined as injury in the neck, torso, or proximal extremity. Patients were then further analyzed based on location of injury, mechanism, age, and race. P ≤ 0.05 was deemed significant. RESULTS:Of the 60 patients with MVI, the mean age was 14.3 years (range, 4-17 years). Mean intensive care unit length of stay (LOS) was 5.4 days, and mean hospital LOS was 12.5 days. Blunt mechanism was more common in patients 14 years or younger; penetrating trauma was more common amongst patients older than 14 years. Overall, blunt injuries had a longer intensive care unit LOS compared with penetrating trauma (7.8 vs 3.1 days; P = 0.016). A total of 33% (n = 20) of MVIs occurred in the torso, with 50% (n = 10) of these from blunt trauma. Location of injury did correlate with mortality; 45% (n = 9) of torso MVIs resulted in death (penetrating n = 7, blunt n = 2). Overall mortality from an MVI was 15.3% (n = 9); all were torso MVIs. Higher Injury Severity Score and Glasgow Coma Scale score were found to be independently associated with mortality. CONCLUSIONS:Our experience demonstrates that MVIs are associated with a significant mortality (15.3%), with a majority of those resulting from gunshot wounds, more than 9-fold greater than the overall mortality of pediatric trauma patients at our institution (1.6%). Further research should be aimed at improving management strategies specific for MVIs in the pediatric trauma patient as gun violence continues to afflict youth in the United States.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Perea LL,Hazelton JP,Fox N,Gaughan JP,Porter J,Goldenberg Adoi
10.1097/PEC.0000000000001642subject
Has Abstractpub_date
2018-10-17 00:00:00eissn
0749-5161issn
1535-1815pub_type
杂志文章abstract:INTRODUCTION:Since 1987 the average length of stay for infants following hospital delivery has decreased 1.8 days. This study was undertaken to evaluate the null hypothesis that early discharge of newborns from nurseries does not result in increased emergency department (ED) utilization during the first 10 days of life...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199712000-00001
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVES:To develop a mathematical model to predict the probability of having community-acquired pneumonia and to evaluate an already developed prediction rule that has not been validated in a clinical scenario. METHODS:Children who presented with fever and had presumptive clinical diagnosis of pneumonia were evalua...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3181e05779
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:Determine prevalence of participation and underimmunization rate in a regional immunization registry (IR) among patients presenting to a university pediatric emergency department (PED). Rate of agreement between parental report and documented immunization status was also measured. METHODS:A convenience samp...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000125657.05196.55
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVES:Previous research has demonstrated that accidental unsupervised ingestions (AUIs) were responsible for the majority of cough and cold medication (CCM) ingestions leading to significant adverse events (AEs) in children. The objective of this analysis was to characterize the role of AUIs in the morbidity assoc...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002166
更新日期:2020-06-22 00:00:00
abstract::We report a case of baby powder inhalation (BPI), causing adult respiratory distress syndrome (ARDS) in a 16-month-old girl, with follow-up after six years. Pulmonary function studies in the child and her monozygotic twin, used as a control, were normal. The testing consisted of diffusing capacity to carbon monoxide a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198903000-00014
更新日期:1989-03-01 00:00:00
abstract::Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initi...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000817
更新日期:2016-10-01 00:00:00
abstract::Rhabdomyosarcoma is the most common soft tissue tumor of childhood, frequently presenting in the head and neck, genitourinary tract, or extremities. We present a case of rhabdomyosarcoma in which an 18-year-old woman presented with abrupt onset unilateral hearing loss, tinnitus, dysarthria, dysphagia, and a new painle...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181b0a482
更新日期:2009-08-01 00:00:00
abstract:STUDY OBJECTIVE:To document the current epidemiology of pediatric injury-related deaths in a rural state and evaluate changes over time. DESIGN:Retrospective review of injury-related deaths in children less than 15 years of age. Data were obtained from death certificates and coroner, autopsy, prehospital, and hospital...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199812000-00002
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVES:This study aimed to determine the most important reasons for pediatric nonurgent (NU) emergency department (ED) visits as perceived by caregivers, primary care pediatricians (PCPs), and ED personnel and to assess the differences among these 3 groups in perceived reasons and solutions to NUED visits. METHODS...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823f2412
更新日期:2012-01-01 00:00:00
abstract::A case of bilateral primary spontaneous pneumothorax ("buffalo chest") in a previously healthy man is described. The clinical presentation and treatment options are discussed. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318191db2b
更新日期:2009-01-01 00:00:00
abstract::Rubber band syndrome is a rare entity seen in younger children mainly in communities where rubber bands are worn around the wrist for decorative purposes. When the band is worn for a long duration, it burrows through the skin and soft tissues resulting in distal edema, loss of function, and even damage to the neurovas...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000992
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:The duration of a specific event during an emergency and the duration of time from the event until medical evaluation are important components of a detailed history and may influence management decisions. We sought to determine whether a caregiver is accurate in their recollection of the passage of time relat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000278398.70870.4f
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the accuracy of the initial impression of emergency department providers on the disposition of children with asthma exacerbation. METHODS:We conducted a prospective survey of physicians and other providers in the emergency department of a children's hospital and parents ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001723
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:To determine the requirements in all states and the District of Columbia for use of restraints on patients in ambulances. MATERIALS AND METHODS:A structured telephone survey was conducted with all state Emergency Medical Services (EMS) agencies or the agency responsible for the regulation of ambulances. Questi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199806000-00014
更新日期:1998-06-01 00:00:00
abstract::Posttraumatic pseudoaneurysms are extremely rare in pediatric populations. In many cases, pseudoaneurysms may be confused with abscesses, epidermoid cysts, arteriovenous fistula, foreign objects, and ganglion cysts, as well as tumors. They are associated with distinguishing findings of "pulsatile mass, a palpable thri...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001236
更新日期:2019-12-01 00:00:00
abstract::The initial emergency department (ED) evaluation of infants with an apparent life-threatening event (ALTE) often fails to identify a definitive cause for the event. Many children that present with an ALTE appear normal by the time they arrive to the ED. These factors can desensitize clinicians into prematurely discoun...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000159055.49683.cd
更新日期:2005-02-01 00:00:00
abstract::This article reviews the mechanisms of pulmonary injury associated with smoke inhalation and the pathophysiology of carbon monoxide poisoning. In addition, the temporal stages of pulmonary injury and evaluation and treatment of the pediatric patient are discussed. Maintaining a high index of suspicion when treating th...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198603000-00010
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:To evaluate computed tomography (CT) findings in pediatric patients with viral gastroenteritis who presented with clinical features of acute abdomen. PATIENTS AND METHODS:During 2 seasons of viral gastroenteritis from 2005 to 2007, 302 children with acute gastrointestinal symptoms were admitted to our center...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181850cc8
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To determine outpatient pediatricians' self-reported experience with and preparation for patient emergencies, and their awareness of the American Academy of Pediatrics (AAP) policy statement on outpatient emergency preparedness. METHODS:A 34-question cross-sectional survey of outpatient pediatric faculty and...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000310
更新日期:2015-07-01 00:00:00
abstract::The diagnosis of septic arthritis should be considered in all children with hip pain. We review the evaluation of children who present with fever and hip pain, emphasizing features that may assist in distinguishing septic arthritis of the hip from transient synovitis. We also discuss the impact of the increased preval...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000159063.24820.73
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:In 1997, a Canadian task force published evidence-based guidelines for diagnosing pediatric pneumonia, concluding that the absence of each of four signs (ie, respiratory distress, tachypnea, crackles, and decreased breath sounds) accurately excludes pneumonia. The study was performed to evaluate the accuracy...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200108000-00003
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the clinical use of procalcitonin (PCT) as a rapid marker for the identification of bacteremia in the emergency department (ED) population of children with fever and a central venous catheter (CVC). METHODS:Children were identified on presentation to the ED with a chief complaint of fever and who...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0b013e31826caac2
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:Enterocolitis remains the most significant cause of morbidity and mortality in Hirschsprung disease (HD). It could progress into toxic megacolon (TM)-acute dilatation of the colon as accompanying toxic complication of Hirschsprung enterocolitis. It is a devastating complication, especially in infants with so...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000444
更新日期:2016-11-01 00:00:00
abstract::Honeycomb gallbladder is a rare congenital malformation of the gallbladder. In some cases, it may be asymptomatic, whereas in others, it may lead to symptoms consistent with biliary colic even in the absence of cholelithiasis. We present the clinical and imaging findings of a case of a 10-year-old boy who was admitted...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000030
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVES:The objectives of the study were to identify factors associated with adolescent emergency department (ED) visits for substance abuse, including those complicated by mental health (dual diagnosis), and to analyze their effect on ED length of stay (LOS) and disposition. METHODS:We performed a secondary analys...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000421
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Pediatric traumatic brain injury (TBI) and abusive head trauma (AHT) are leading causes of morbidity and mortality. Clinicians may not be aware of AHT at presentation to the emergency department (ED). OBJECTIVE:The objective of this study was to determine which clinical features associated with head injury ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002239
更新日期:2020-09-10 00:00:00
abstract::A combined retrospective and prospective analysis of infants 60 days of age or less evaluated for fever (greater than or equal to 38.3 degrees C) or history of fever who received chest roentgenogram over a one-year period was performed to determine whether clinical characteristics were predictive of pneumonia. Of the ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198909000-00001
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:Evaluation of a child with POC/OC is complicated due difficulties in physical examination and risks of imaging by computed tomography. METHOD:Retrospective review of children 0-16 years admitted to the pediatric emergency department for POC/OC from 2009 to 2019. RESULTS:Ten years study period, 243 children...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002083
更新日期:2020-03-19 00:00:00
abstract:OBJECTIVE:To develop a computer-assisted learning (CAL) model and evaluate its effectiveness in improving medical trainees' knowledge of pediatric emergency procedures. METHODS:Three common pediatric emergency procedures were selected: laceration repair, splinting of fractures, and lumbar puncture. Web-based computeri...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0b013e31816ecb5c
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the patterns of ceftriaxone use in an urban pediatric emergency department (PED) and to determine if overuse exists based on published guidelines for management of febrile infants. METHODS:We conducted a retrospective study of 229 young febrile patients who received ceftriaxone between January 1 ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200208000-00007
更新日期:2002-08-01 00:00:00