Clinical Pediatric Emergency Medicine This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

A male Adolescent with Fever, Headaches, and Body Aches
A 17-year-old African-American male adolescent had recurrent emergency department visits for hypertension resistant to initial treatment, which resulted in multiple hospital admissions. Hypertension was associated with significant weight loss, peripheral neuropathy, and night sweats. An extensive laboratory and imaging workup ruled out renal, cardiac, rheumatologic, and endocrine causes for his symptoms. Ultimately, a more detailed history and toxicology consultation led to the cause of his persistent symptoms: mercury poisoning. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - May 3, 2015 Category: Emergency Medicine Authors: Thomas J. Czolgosz, Nirupama Kannikeswaran, Curt Stankovic Source Type: research

Difficult Conversations in the Emergency Department: Spotlight on the Disclosure of Medical Errors
Despite our best efforts, medical errors remain an unavoidable reality in the field of medicine, and bring with them sensitive and often-challenging communication issues. This is particularly significant in the emergency department (ED), where health care providers must stabilize, diagnose, and treat patients very quickly, all while establishing rapport and developing trust with the patient and family. The patient and family rely on the ED physician not only to provide appropriate treatment but also to alleviate anxiety. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - April 25, 2015 Category: Emergency Medicine Authors: Dana Aronson Schinasi, Irini N. Kolaitis, Frances Nadel Source Type: research

Communicating in the Emergency Department
The pediatric emergency department (ED) can be a complex, fast-paced environment where dedicated providers work to balance the needs of many patients, from those with life-threatening illnesses requiring immediate intervention to those with minor issues that require a thorough history, physical examination, and anticipatory guidance without additional testing or therapeutics. The challenge, of course, is identifying those patients who fall into the latter category, without compromising the care of those who are more acutely ill or injured. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - April 25, 2015 Category: Emergency Medicine Authors: Cynthia J. Mollen Tags: Guest Editor's Preface Source Type: research

A 14-Year-Old Female With Abdominal Pain and Vaginal Bleeding
Determining pregnancy status is vital in the approach to adolescent females with abdominal pain or vaginal bleeding. The prognosis of extrauterine pregnancies and gestational trophoblastic disease depends greatly on the ability to make an early diagnosis. Urine qualitative β human chorionic gonadotropin (β-hCG) tests are routinely used in emergency departments for pregnancy screening. However, point-of-care testing can be misleading in molar or late first-term pregnancies when β-hCG levels are extremely high. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - April 22, 2015 Category: Emergency Medicine Authors: Jonathan Auten Tags: Emergi-Quiz Clinical Puzzler Source Type: research

Emergi-Quiz Clinical Puzzler: A 14-Year-Old Girl With Abdominal Pain and Vaginal Bleeding
Determining pregnancy status is vital in the approach to adolescent females with abdominal pain or vaginal bleeding. The prognosis of extrauterine pregnancies and gestational trophoblastic disease depends greatly on the ability to make an early diagnosis. Urine qualitative β human chorionic gonadotropin (β-hCG) tests are routinely used in emergency departments for pregnancy screening. However, point-of-care testing can be misleading in molar or late first-term pregnancies when β-hCG levels are extremely high. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - April 22, 2015 Category: Emergency Medicine Authors: Jonathan Auten Source Type: research

Communicating With the Adolescent: Consent and Confidentiality Issues
Adolescents frequently use the emergency department (ED) for care; and those who seek access to care in EDs tend to report high rates of substance use, physical or sexual abuse, risky sexual behaviors, and mental health problems. Therefore, the ED functions as a strategic venue for behavioral health screening and interventions. However, to effectively screen for sensitive health conditions, privacy and confidentiality must be optimized, which can be particularly challenging in the ED setting. Given that adolescents in the ED represent a high-risk population, it is imperative that providers develop understanding and compete...
Source: Clinical Pediatric Emergency Medicine - April 18, 2015 Category: Emergency Medicine Authors: Monika K. Goyal Source Type: research

Talking Back: A Review of Handoffs in Pediatric Emergency Care
Incomplete communication is a critical source of medical error and subsequent patient harm within the health care system. Patient handoffs in health care require the coordinated transfer of information, responsibility, and authority between providers. In pediatric emergency medicine, there are specific cultural and structural factors that contribute to the need for evidenced-based and standardized handoff practices. This review presents an overview of the existing literature on handoffs to inform guidance for the development and implementation of high-efficacy handoff tools in pediatric emergency medicine. (Source: Clinica...
Source: Clinical Pediatric Emergency Medicine - April 18, 2015 Category: Emergency Medicine Authors: Zachary F. Meisel, Robert J. Smith Source Type: research

Motivational Interviewing for Adolescents in the Emergency Department
Motivational interviewing (MI) is defined as a collaborative, patient-centered counseling style used to strengthen motivation for behavioral change by evoking an individual’s own reasons for change. It has been extensively used to address substance use and has shown effectiveness in facilitating a variety of healthy behaviors among a wide range of age groups and in an array of settings. To review the literature involving the use of MI for adolescents in the emergency department (ED), we performed a literature search using PsycINFO, PubMed, and Google-Scholar and identified 16 randomized controlled studies targeting 7 hea...
Source: Clinical Pediatric Emergency Medicine - April 18, 2015 Category: Emergency Medicine Authors: Sofie L. Champassak, Melissa Miller, Kathy Goggin Source Type: research

Adolescent Relationship Abuse: How to Identify and Assist At-Risk Youth in the Emergency Department
Adolescent relationship abuse is common among adolescents seeking care in the emergency department (ED). Adolescent relationship abuse is a health issue; adolescents experiencing relationship abuse are at increased risk for multiple, severe short- and long-term consequences. Adolescents endorse providers screening for adolescent relationship abuse. Although universal screening of all adolescents regarding adolescent relationship abuse is ideal, targeted screening for highest-risk teens may be the most practical. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - April 15, 2015 Category: Emergency Medicine Authors: Jami Jackson, Kimberly A. Randell, Melissa K. Miller Source Type: research

Status Epilepticus in the Pediatric Emergency Department
Status epilepticus is a common pediatric neurologic condition that often presents to the emergency department. Prior neurologic abnormalities or preexisting epilepsy are significant risk factors for the development of status epilepticus, although younger children more commonly present with either an acute symptomatic or febrile etiology. Prolonged seizure duration is associated with the development of resistance to anticonvulsants and the potential for permanent neurologic injury. Treatment strategies should focus on rapid administration of appropriate antiepileptic medications, with benzodiazepines used as the first-line ...
Source: Clinical Pediatric Emergency Medicine - March 1, 2015 Category: Emergency Medicine Authors: Jonathan E. Kurz, Joshua Goldstein Source Type: research

A Confused Child
We present a case of anti–N-methyl-D-aspartate receptor encephalitis that initially presented to our emergency department with acute confusion. With increasing recognition of this form of encephalitis, emergency physicians will benefit from understanding the salient neuropsychiatric features, disease progression, diagnostic options, management, and prognostic outcome of these patients. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - March 1, 2015 Category: Emergency Medicine Authors: Sathyaseelan Subramaniam Tags: Emergi-Quiz Clinical Puzzler Source Type: research

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

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

Sepsis-Associated Neurologic Dysfunction
Sepsis is a leading cause of morbidity and mortality for infants and children in the United States and is associated with peripheral and central nervous system dysfunction including encephalopathy and paresis. Sepsis-associated encephalopathy (SAE) may be underdiagnosed in children, but the exact incidence is not known because of variable criteria for its diagnosis, which require a high index of suspicion and exclusion of other confounding factors. Neuroimaging and cerebrospinal fluid analysis are often normal. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - February 28, 2015 Category: Emergency Medicine Authors: Mashael F. Alqahtani, Mark S. Wainwright Source Type: research

The Child With Acute Weakness
Infants and children are commonly brought to the emergency department (ED) with a complaint of acute weakness. A good history and physical are paramount in determining etiology. Once a diagnosis is suspected, diagnostic tests such as a lumbar puncture and magnetic resonance imaging of the spine will help to further define the etiology and guide therapy. Many causes of acute weakness have the potential for respiratory compromise, and ED practitioners must continually and closely evaluate patients and may choose to electively intubate. (Source: Clinical Pediatric Emergency Medicine)
Source: Clinical Pediatric Emergency Medicine - February 25, 2015 Category: Emergency Medicine Authors: Lindsey Morgan Source Type: research