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 had a CVC. Fever was defined as 38°C or higher orally. Patients were excluded from the study if they had received antibiotics within the previous 24 hours of presenting to the ED, if they had a peripherally inserted central catheter line or by parental refusal. On presentation to the ED, all patients had a complete blood cell count with differential, blood culture from the central line, and PCT levels drawn. All had empiric antibiotics initiated. Blood culture results were recorded, and in the case of positive cultures, time to positive culture was noted. RESULTS:Sixty-two patients (aged 5 months-18 y) were enrolled, and 14 (23%) had a positive culture. Mean PCT value in bacteremic patients was 18.47 ± 31.6 ng/mL and 0.65 ± 1.2 ng/mL in nonbacteremic patients (P < 0.001). Median PCT for negative blood culture was 0.23 ng/mL (interquartile range, 0.11-0.61) and 1.15 ng/mL for a positive blood culture (interquartile range, 0.45-29.16). The receiver operating characteristic analysis identified a level of PCT of 0.3 ng/mL as the best cutoff point that produced a sensitivity of 93% and a specificity of 63% (area under the curve, 0.82). CONCLUSIONS:The PCT levels are useful in identifying children with fever and a CVC who are bacteremic in the ED.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Kasem AJ,Bulloch B,Henry M,Shah K,Dalton Hdoi
10.1097/PEC.0b013e31826caac2subject
Has Abstractpub_date
2012-10-01 00:00:00pages
1017-21issue
10eissn
0749-5161issn
1535-1815journal_volume
28pub_type
杂志文章,随机对照试验abstract::To determine the rationale for using a community hospital's emergency department for minor illness care on weekdays, we surveyed 150 parents of children 15 years of age or younger. Fifty (33.3%) participants had no identified source of routine pediatric care, and 31 (20.7%) had pediatric providers not locally availabl...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198806000-00005
更新日期:1988-06-01 00:00:00
abstract::Anaphylaxis is a life-threatening, severe, generalized, or systemic hypersensitivity reaction. The incidence of anaphylaxis is increasing especially in pediatric age. Our aim in this study was to investigate the knowledge and attitudes of the physicians on the diagnosis and treatment of anaphylaxis. METHODS:A questio...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002064
更新日期:2020-02-24 00:00:00
abstract:BACKGROUND:Extreme leukocytosis, defined as a peripheral white blood cell count greater than 25,000/mm, may alarm clinicians and prompt extensive evaluation in infants with fever, especially in the pediatric emergency department. METHODS:We reviewed data from children aged 3 to 36 months with extreme leukocytosis, fev...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000454
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to understand parents' awareness of and reactions to a slide presentation based waiting-room educational initiative. METHODS:This was a prospective observational study at a Canadian tertiary-care pediatric emergency department (ED) with an annual census of 68,000 visits. An anonymou...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001140
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:Occult pneumothoraces (OPTXs) are defined by air within the pleural space that is not visible on conventional chest radiographs (CXR). The aim of this study was to understand how frequently the Extended Focused Assessment with Sonography for Trauma (eFAST) examination identifies occult PTX in a pediatric blun...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002303
更新日期:2020-12-01 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:Real-time audiovisual consultation (telemedicine) has been proven feasible and is a promising alternative to interfacility transfer. We sought to describe caregiver perceptions of the decision to transfer his or her child to a pediatric emergency department and the potential use of telemedicine as an alternat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000957
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:Head trauma is one of the main causes of death in childhood and often leaves severe disability with serious neurological damage. Appropriate treatment must be provided immediately to improve outcomes. This study was performed to identify factors associated with a poor prognosis at an early stage of severe he...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000001321
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:The objective was to derive a simple clinical scoring instrument for assessing children with croup by telephone for use in clinical research studies. METHODS:We reviewed published literature on croup scores, surveyed experienced pediatric emergency nurses and physicians, and conducted a prospective cohort st...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000796
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:To describe a case series of 4 children who developed acute rhabdomyolysis as a complication of acute respiratory failure secondary to status asthmaticus. METHODS:A retrospective review of all children who were admitted to our pediatric intensive care unit (PICU) with status asthmaticus from November 1998 t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000230711.81646.7a
更新日期:2006-08-01 00:00:00
abstract::Priapism is an adverse effect of medications used to treat psychiatric disorders. Often, this condition is self-limiting but may require urologic intervention involving aspiration and injection to induce detumescence. A case of a 15-year-old patient with priapism secondary to a long-acting stimulant is presented to de...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000485
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:Diabetic ketoacidosis (DKA) is a common emergency department presentation of both new-onset and established diabetes mellitus (DM). β-Hydroxybutyrate (BOHB) provides a direct measure of the pathophysiologic derangement in DKA as compared with the nonspecific measurements of blood pH and bicarbonate. Our objec...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002035
更新日期:2020-02-01 00:00:00
abstract::Enterobius vermicularis may cause infections of the gastrointestinal tract and occurs approximately in 4% to 28% of children worldwide. It is most common in children aged 5 to 14 years.The most commonly reported symptoms are pruritus in the perianal region, abdominal pain, urinary tract infection, insomnia, irritabili...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000480
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:This study examined whether utilization of the Florida State Health Online Tracking System (SHOTS) immunization registry to determine Haemophilus influenzae type B and heptavalent pneumococcal conjugate (PCV7) vaccine status impacts the protocolized decision to perform a screening blood draw for occult bacte...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31825cfd3e
更新日期:2012-07-01 00:00:00
abstract::Scorpion envenomation is a dangerous and common global event that can result in a variety of toxic clinical effects. These are typically managed with supportive care or antivenom. Antivenom use is controversial because of conflicting evidence of effectiveness for adrenergic toxicity. However, both controlled and uncon...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182228dfa
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess predictors of emergency department (ED) ketamine-associated laryngospasm using case-control techniques. METHODS:We performed a matched case-control analysis of a sample of 8282 ED ketamine sedations (including 22 occurrences of laryngospasm) assembled from 32 prior p...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e3181fa8737
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare admission rates and medical interventions among children whose caregivers called their child's primary care provider (PCP) before taking an ambulance to the pediatric emergency department (PED) versus those who did not. METHODS:This was a prospective cohort study of...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318294dd98
更新日期:2013-06-01 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:BACKGROUND:Head trauma is one of the most common reasons for pediatric emergency medicine department (PED) visits. Computerized tomography (CT) scan is considered the criterion standard for the diagnosis of traumatic brain injury but was shown to increases the risk of malignancies. METHODS:We retrospectively analyzed ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002143
更新日期:2020-06-16 00:00:00
abstract:OBJECTIVES:Helicopter emergency medical services (HEMS) are used for 16% of pediatric trauma. National HEMS guidelines advised that triage criteria be standardized for pediatric patients. A national report found pediatric HEMS associated with decreased mortality compared with ground emergency medical services (GEMS) bu...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002263
更新日期:2020-10-22 00:00:00
abstract::Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have b...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e31826d1e9a
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:The purposes of the study were (1) to assess the acceptability of mental health screening in the pediatric emergency department (ED) for children and their parents; (2) to measure providers' perceptions on whether screening has an impact on patient care; and (3) to determine the impact of screening status on...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318222554e
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:National rates of left (or leaving) without being seen (LWBS) in pediatric emergency departments (PED) are higher than general emergency departments. We investigated coexisting perspectives on LWBS. METHODS:Q-methodology was implemented through a mixed-methods design. Semistructured interviews elicited a con...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001792
更新日期:2019-04-11 00:00:00
abstract::This case provides the first report of a young healthy child presenting in septic shock from Clostridium difficile colitis. This child had no identifiable risk factors for C. difficile, raising the suspicion for a hypervirulent strain. Once infection was recognized and treated appropriately, the child made a full reco...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000496
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to determine whether adolescents in emergency departments (EDs) who report engaging in high-risk sexual behaviors are less likely to identify a primary care provider (PCP) and more likely to access the ED than their sexually inexperienced peers. METHODS:This was a secondary a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001456
更新日期:2020-07-01 00:00:00
abstract::The expression of cardiac dysfunction in pediatric patients with myocarditis may not be conspicuous. While older children with myocarditis may abruptly present with pleuritic or angina-like pain, infants and toddlers with fulminant disease are unable to verbalize such complaints. Cardiac compromise in preverbal childr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199204000-00017
更新日期:1992-04-01 00:00:00
abstract::Young female patients with gynecologic complaints, including vaginal discharge, commonly seek care in the emergency department. Prepubertal vaginal discharges have various potential etiologies including nonspecific vulvovaginitis, infections, inflammatory or dermatologic processes, precocious puberty, malignancy, anat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/pec.0b013e31815c9dd2
更新日期:2007-12-01 00:00:00
abstract::Radial neck fractures in children are not uncommon. Most are minimally displaced or nondisplaced. Severely displaced fractures or angulated radial neck fractures in children often have poor outcomes, especially if not reduced, and even after open reduction. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000235839.44449.36
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. METHODS:We analyzed data from the National Pediatric Readines...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001920
更新日期:2019-11-13 00:00:00
abstract::Although brachial plexus injury occurring during multitrauma is frequent in adults, it is rarely observed in childhood. The most common cause of pediatric traumatic brachial palsy is motor vehicle accidents followed by pedestrian struck. Generally, phrenic nerve palsy accompanying brachial plexus trauma is observed in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31829ec20b
更新日期:2013-08-01 00:00:00