Abstract:
OBJECTIVES:1) To identify clinical features indicating a high risk of skull fracture (SF) and associated intracranial injury (ICI) in asymptomatic head-injured infants. 2) To develop a clinical decision rule to determine which asymptomatic head-injured infants require head imaging. METHODS:We performed a prospective cohort study of all asymptomatic head-injured infants 0-24 months of age presenting to the emergency department of an urban children's hospital. Infants were considered asymptomatic if they had no clinical signs of brain injury, or of basilar or depressed SF. Among subjects who had head imaging, we assessed the utility of age, scalp hematoma size, and scalp hematoma location for predicting SF and ICI. RESULTS:Of 422 study patients, 45 (11 %) were diagnosed with SF and 13 (3%) with ICI. In the 172 subjects who had head imaging, there was a stepwise relationship between hematoma size and likelihood of SF. Parietal and temporal hematomas were highly associated with SF; frontal hematomas were not. There was a trend toward higher rates of SF in younger patients. Both large scalp hematoma and parietal hematoma were associated with ICI. Using these data, we developed a clinical decision rule to determine which asymptomatic infants need head imaging. In our study population, this rule has a sensitivity of 0.98 and specificity of 0.49 for SF, and it detects all 13 cases of ICI. The clinical rule calls for imaging in 146/422 (35%) study subjects. CONCLUSIONS:Among asymptomatic head-injured infants, the risk of SF and associated ICI is correlated with scalp hematoma size, hematoma location, and weakly with patient age. We propose a clinical decision rule that could identify most cases of SF and ICI while not requiring head imaging for most patients. This decision rule should be validated in other study populations.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Greenes DS,Schutzman SAdoi
10.1097/00006565-200104000-00002subject
Has Abstractpub_date
2001-04-01 00:00:00pages
88-92issue
2eissn
0749-5161issn
1535-1815journal_volume
17pub_type
杂志文章abstract::Antidotes are playing an increasing role in therapy for pediatric poisonings. Although initial response to all pediatric poisonings begins with basic stabilization, knowledge of specific antidotes, their mechanisms of action, safety profile in pediatrics, and dosing regimens can be life-saving for pediatric victims of...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000245174.21041.bc
更新日期:2006-11-01 00:00:00
abstract::Brugada syndrome is an increasingly discussed entity in the emergency medicine and cardiology literature. However, there are few cases reported in the pediatric population. Seizure is a presentation common to pediatric emergency departments. This case report describes the clinical course, workup, and differential diag...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001508
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate cervical spine motion using 2 manual inline immobilization techniques with the use of a human simulator model. METHODS:Medical students, pediatric and family practice residents, and pediatric emergency medicine fellows were recruited to maintain cervical manual in line im...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000245
更新日期:2015-09-01 00:00:00
abstract::Bone and joint infection complicating tuberculosis is most likely to involve vertebrae. Pott disease, or tuberculous spondylitis, represents a small proportion of tuberculosis cases, but it can be associated with significant morbidity and mortality. Our case report details Pott disease in a teenage girl, which present...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181fb0e38
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:Lollapalooza (LP) is an annual 3-day outdoor music festival in Chicago. Underage drinking and drug use are believed to be common, but the burden on emergency departments (EDs) has not been documented. We assessed the burden on health care resources associated with this music festival. METHODS:We performed a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001072
更新日期:2019-06-01 00:00:00
abstract::Serious to fatal toxicity may occur with amanitin-containing mushrooms ingestions. A Lepiota brunneoincarnata familial poisoning with hepatic toxicity is reported. In such poisonings, acute gastroenteritis may be firstly misdiagnosed leading to delay in preventing liver dysfunction by silibinin or penicillin G. Mushro...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000399
更新日期:2015-04-01 00:00:00
abstract::Dilutional hyponatremia, although not uncommon, is an underestimated problem in the pediatric population. In most cases, it results from excessive hydration or water retention, also described as the so-called water intoxication. One of the most known causes is the use of desmopressin in enuretic children. This drug en...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181e5bf9e
更新日期:2010-07-01 00:00:00
abstract::We report a case involving accidental ingestion of a marble that was detected by point-of-care ultrasonography of the abdomen with the patient in the upright and slightly forward tilting position, which we term the "bowing position." Using this position for abdominal ultrasonography may be more useful than the usual s...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001125
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Emergency department (ED) boarding of admitted patients negatively impacts ED length of stay (LOS). Behavioral health (BH) patients are often challenging to safely discharge. We examined the association between daily BH census and non-BH LOS and left without being seen (LWBS) rates. METHODS:Retrospective ana...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001565
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:Radiographic survey of the entire aerodigestive tract (nares to anus) is common practice in children presenting to the emergency department following coin ingestion. The purpose of our study was to determine the optimal protocol for radiographic survey post-coin ingestion. We hypothesized that for children p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001688
更新日期:2018-11-19 00:00:00
abstract::Constipation is a common cause of pediatric abdominal pain seen in pediatric emergency departments (EDs). We present the case of an 11-year-old boy with a 4-month history of chronic constipation and abdominal pain who presented to the children's ED. He was found to have a large abdominal mass that was determined to be...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000166
更新日期:2014-07-01 00:00:00
abstract::Point-of-care ultrasound (POCUS) is being used for clinical decision making with increasing frequency across a broad range of indications in pediatric emergency medicine (PEM). We present a series of 4 patients in whom POCUS was used to facilitate a diagnosis of perforated appendicitis. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002082
更新日期:2020-12-01 00:00:00
abstract::Hip pain and fever in children include a broad differential. Most concerning is the possible diagnosis of a septic joint, which carries significant morbidity. We describe the case of a 13-year-old boy with fever and hip pain who was referred to the emergency department with concern for septic hip. The etiology was lat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000328
更新日期:2015-01-01 00:00:00
abstract::The purpose of this study is to report 18 cases of membranous laryngotracheobronchitis (MLTB) and to review 143 published cases in order to accurately characterize the epidemiology, presentation, clinical course, treatment, and outcome of patients with this disorder. The male:female ratio was 2:1; mean age was four ye...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199112000-00004
更新日期:1991-12-01 00:00:00
abstract::Alcaligenes faecalis is a gram-negative organism that is commonly found in the environment and may also be a part of normal fecal flora in humans. Although various infections with this bacteria have been described in the pediatric population, it has not been previously identified in infections as the pathogen after a ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000645
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To identify the source of acquisition of infant walkers and attitudes regarding the continuing use of walkers following an injury to an infant in order to design preventive strategies. DESIGN:Descriptive and retrospective. SETTING:Emergency department of a children's hospital involved in primary, secondary ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199606000-00008
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess whether increased time from emergency department (ED) triage to appendectomy is associated with a greater risk of children developing appendiceal perforation. METHODS:We performed a multicenter retrospective cohort study of children younger than 18 years hospitalized with ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000000850
更新日期:2019-01-01 00:00:00
abstract::Adolescents infected with the human immunodeficiency virus (HIV) often confront the clinician with difficult medical problems. Besides the host of opportunistic infections, which can affect these patients, side effects from medications can be frequent and, at times, life-threatening. We report a case of aseptic mening...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199706000-00010
更新日期:1997-06-01 00:00:00
abstract::Superior ophthalmic vein thrombosis (SOVT) usually results from inflammatory, infectious, or malignant causes. This case describes a 2-year-old boy with severe prolapsing chemosis and proptosis due to thrombosis of the right superior ophthalmic vein resulting from midfacial and right orbital fractures 1 week after the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000066
更新日期:2014-02-01 00:00:00
abstract::We report the case of an unrestrained driver with achondroplastic dwarfism who suffered a fatal anterior neck injury when her airbag deployed as she rear-ended another vehicle at 30-40 mph. Her short stature and short limbs required her to sit within a handbreadth of the steering wheel, which probably allowed the airb...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract::Pneumocephalus or air within the cranial vault is usually associated with disruption of the skull caused by head trauma, neoplasms, or after craniofacial surgical interventions. We report a child who presented with headache and the pathognomonic "succussion splash" and was found to have atraumatic pneumocephalus from ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:
更新日期:1999-04-01 00:00:00
abstract::Since its introduction into clinical practice, it has been known that fentanyl and other synthetic opioids may cause skeletal muscle rigidity. Involvement of the respiratory musculature, laryngeal structures, or the chest wall may impair ventilation, resulting in hypercarbia and hypoxemia. Although most common with th...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182535a2a
更新日期:2012-05-01 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::Chlamydia trachomatis is a common cause of subacute, afebrile pneumonia with onset from 1 to 3 months of age. On physical examination, crepitant inspiratory rales are commonly heard. Infiltration is usually bilateral and interstitial; reticulonodular pattern and atelectasis have also been described, which distinct the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181b922e3
更新日期:2009-09-01 00:00:00
abstract::The etiology of acute liver failure varies widely in children, but the most common causes are viral hepatitis, drugs, and toxins. We report herein a case of autoimmune hepatitis and acute liver failure caused by leptospirosis, which is involved rarely in etiology. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182309e79
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To assess outcomes between 2 groups of patients receiving ketamine for procedural sedations in our pediatric emergency department. Our hypothesis is that there is no difference in the number of adverse events in ketamine sedations with and without morphine pretreatment. METHODS:This was a retrospective cohor...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000221339.26873.14
更新日期:2006-06-01 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 diagnosis of pulmonary thromboembolism (PE) is often delayed because it is usually misdiagnosed as pneumonia or deep vein thrombosis. We report an unusual case of PE misdiagnosed as viral pleuritis on the first arrival at the emergency department (ED) in our hospital. A 14-year-old girl with no previous significan...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001104
更新日期:2018-11-01 00:00:00
abstract::Securing the pediatric airway in the emergency setting is an uncommon event that is complicated by anatomic, physiologic, and environmental factors. Even more uncommonly, practitioners are faced with the added complication of a difficult airway, and the question of what alternatives to traditional endotracheal intubat...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000093
更新日期:2014-03-01 00:00:00
abstract::A two-year, eight-month-old boy was diagnosed clinically with perianal warts and treated with topical 5-Fluorouracil, with subsequent resolution of the lesions. The child disclosed sexual abuse, and subsequent physical abuse was also documented. Attempts to identify the perpetrator have been hampered by the child's yo...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199312000-00005
更新日期:1993-12-01 00:00:00