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Traumatic Pediatric Orthopedic Emergencies: An Approach to Evaluation and Management
Pediatric orthopedic injuries are commonly seen in emergency departments, and each injury has a unique management plan that differs from interventions in the adult population. This is largely attributed to the open physes in skeletally immature children, creating a “weak link” for fracture sites to occur. With advancements in the evaluation and management of traumatic orthopedic emergencies, it is important to review current management trends. This review focuses on changes seen in neurological compromise, vascular compromise, acute compartment syndrome, open fractures and fractures requiring urgent reduction. (Source:...
Source: Clinical Pediatric Emergency Medicine - February 1, 2016 Category: Emergency Medicine Authors: Danielle M. Graff, Jennifer Brey, Sandra Herr Source Type: research

Parental Presence at the Bedside of a Child with Suspected Ebola: An Expert Discussion
The Ebola virus disease (Ebola) outbreak in West Africa (2014-2015) prompted domestic planning to address the scenario in which a traveler imports Ebola into the United States. Parental presence at the bedside of a child with suspected or confirmed Ebola emerged as a challenging issue for pediatric health care providers and public health practitioners. At the heart of the issue was the balance of family-centered care and appropriate infection control, which are not easily aligned in the setting of Ebola. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - January 30, 2016 Category: Emergency Medicine Authors: Cynthia F. Hinton, H. Dele Davies, Susan N. Hocevar, Steven E. Krug, Aaron M. Milstone, Leonard Ortmann, Cynthia H. Cassell, Georgina Peacock, Stephanie E. Griese Source Type: research

Computed Tomography in the Evaluation of Pediatric Trauma
The objective of this article is to review the use of computed tomography (CT) for the purpose of injury evaluation in pediatric trauma patients. The relative risk of radiation-induced cancer mortality is discussed. Evidence-based indications for obtaining CT and optimization of CT scanner protocols are provided. CT use specific to pediatric trauma is discussed for the following anatomic regions: thorax, abdomen, head, spine, vascular, and musculoskeletal. Limiting unnecessary CT use by understanding when and how to order an appropriate scan in order to adequately diagnose and treat a specific injury is the most practical ...
Source: Clinical Pediatric Emergency Medicine - December 2, 2015 Category: Emergency Medicine Authors: Drew Pierce, Kate Louise Mangona, George Bisset, Bindi Naik-Mathuria Source Type: research

Point-Of-Care Ultrasound in Resource-Limited Settings
This article will review existing literature to describe the use of point-of-care ultrasound (POCUS) in the pediatric population in resource-limited settings (RLS). We conducted online searches on the clinical use of POCUS in pediatric and adult care in RLS. Original articles, reviews, opinions, descriptive studies, and case reports in English published between 1992 and 2015 were used. Forty articles were identified relating to POCUS use in pediatrics and adult care in RLS. It is most commonly used for the assessment of dehydration, pneumonia, superficial abscesses, and pericardial effusions as well as in the evaluation of...
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Authors: Nicolaus Glomb, Beth D’Amico, Marideth Rus, Carol Chen Source Type: research

Point-Of-Care Ultrasound in Pediatric Emergency Medicine: What Do Fellows Need to Know?
Pediatric emergency medicine (PEM) physicians are increasingly adopting the use of point-of-care ultrasound (POCUS) to integrate focused bedside ultrasonography with clinical examination to care for pediatric patients. It is expected that PEM fellowship trainees will receive substantive POCUS education, yet there exist wide variations in training experience between institutions based on availability of faculty with expertise in POCUS and the lack of a standard curriculum or national consensus on competency standards. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Authors: Beth M. D’Amico Source Type: research

Pediatric Photo Documentation in the Emergency Department
This brief discussion delves into current and future uses of digital imaging and photo documentation in the emergency department. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Authors: Young H. Shim, Ben Choi, Brent D. Kaziny Source Type: research

A Review of Pediatric Ultrasound-Guided Peripheral Intravenous Access
This article reviews the current literature on pediatric ultrasound-guided peripheral vascular access methods and demonstrates the suitability of point-of-care ultrasound as a safe, effective, patient-centered, timely, efficient, and equitable means of establishing peripheral vascular access in pediatric patients. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Authors: Stephanie Leung Source Type: research

Ocular Ultrasound—Point of Care Imaging of the Eye
Point of care sonography is a useful tool in the evaluation of both medical and traumatic ocular conditions. Traditional ocular evaluation including fundoscopy, computed tomography and magnetic resonance imaging involves significant patient cooperation, radiation exposure, and/or transfer of sometimes critically ill patients. Sonography is safe, does not utilize radiation and is done at the patient's bedside. Imaging is done through the closed eyelids which permit sonographic ocular examination even with significant eyelid edema and limited patient cooperation. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Authors: Russ Horowitz, John Bailitz Source Type: research

Computed Tomography for the Evaluation of Suspected Airway Foreign Bodies
The prompt diagnosis of foreign body aspiration (FBA) in children is essential to avoid complications such as postobstructive pneumonia and bronchiectasis. The conventional approach of diagnosing FBA by clinical history, physical examination, and chest radiography is limited by the modest sensitivity and specificity of these techniques, and diagnostic laryngoscopy and bronchoscopy is limited by operative risks and high costs. Chest computed tomography is highly sensitive and specific for the diagnosis of FBA and for conditions that can mimic the clinical presentation of FBA. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Authors: Carla M. Giannoni, R. Paul Guillerman Source Type: research

Magnetic Resonance Imaging in the Evaluation of Acute Appendicitis
Pediatric appendicitis is one of the most common emergencies presenting in the emergency department. Ultrasonography is a reliable, cost-efficient, and reproducible imaging choice; however, it is highly dependent upon sonographer expertise, body habitus, and underlying bowel gas. When considering imaging using the ALARA (as low as reasonably achievable) principle and the increased availability of magnetic resonance imaging (MRI), the focus has shifted to using MRI as an alternative to computed tomography to diagnose pediatric appendicitis. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Authors: Prakash M. Masand Source Type: research

Table of Contents
(Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Source Type: research

Editorial Board
(Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - December 1, 2015 Category: Emergency Medicine Source Type: research

Evaluation of Pulmonary Emergencies Using Point-Of-Care Ultrasound in the Pediatric Emergency Department: A Review
Point-of-care ultrasound has a wide array of applications in the emergency care of children. Over the past 3 decades, lung ultrasound has evolved and become an asset in evaluating both emergent and critically ill patients. Ultrasound of the lung was once thought to be of little utility because normal lung is aerated and ultrasound cannot directly visualize air. Thus, it was unclear how ultrasound would be beneficial. It is now evident that ultrasound of the chest is extremely useful in evaluating not only normal lung but also pathologic conditions. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - November 27, 2015 Category: Emergency Medicine Authors: Joshua M. Sherman, Alyssa M. Abo Source Type: research

Advances in Pediatric Emergency Imaging
This topic is particularly interesting for those of us who spend every moment deep in the trenches of the pediatric emergency department (ED). Parental expectations that their child be treated with the highest level of care and in the shortest amount of time have spearheaded the attempt to be more efficient while maintaining excellence in patient care. Advances in medicine now allow us to take imaging to new levels. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - November 12, 2015 Category: Emergency Medicine Authors: Kiyetta Alade Tags: Guest Editors' Preface Source Type: research

Airway Management in Patients With Abnormal Anatomy or Challenging Physiology
Most pediatric intubations that occur in the emergency department are in patients without identifiable risk factors for difficulty. Infants and children go through a predictable pattern of development that impacts airway management. A careful, stepwise approach to the identification of the truly difficult pediatric airway is critical to avoid morbidity and mortality. Difficulty can be encountered in cases of challenging anatomy such as congenital airway or midface abnormalities or with acquired conditions such as croup or epiglottitis. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - September 1, 2015 Category: Emergency Medicine Authors: Nathan W. Mick Source Type: research