Pediatric Emergency Services Research Articles

Post-varicella arterial ischemic stroke in children and neurocognitive performance: a 4-year follow-up study.

ABSTRACTObjective To analyze data from children who were previously healthy and presented with post-varicella arterial ischemic stroke upon arrival when admitted to the emergency room, with focus on the clinical/laboratory aspects, and neurocognitive performance after four-year follow-up.Methods Seven children presenting with arterial ischemic stroke after varicella were evaluated at pediatric emergency services in the city of São Paulo (SP), Brazil. Ischemic stroke was determined by magnetic resonance imaging/magnetic resonance angiography in a topography compatible with the areas supplied by the middle cerebral or internal carotid arteries. IgG-class antibodies against varicella zoster virus and varicella-zoster virus DNA by polymerase chain reaction in cerebrospinal fluid were tested. Patients with prothrombotic conditions were excluded. The Pediatric Stroke Outcome Measure was applied upon admission and 4-years after the stroke.Results All patients (age range: 1.3 to 4 years) included presented chickenpox 5.1 (±3.5) months before. All patients had analysis of anti-varicella-zoster-virus-IgG in cerebrospinal fluid, but only three (43%) had a positive result. Of the patients 43% had no vascular lesions identified in magnetic resonance angiography. All patients showed improvement in their sequela scores. After 4 years, five patients displayed good evolution in the Pediatric Stroke Outcome Measure, and only one patient presented with a score of 2 in the sensorimotor and cognition areas. No recurrence of arterial ischemic stroke was observed.Conclusion We reinforced the non-progressive course of post-varicella arterial ischemic stroke after 4-year follow-up. The presence of varicella-zoster-virus-DNA detected by polymerase chain reaction, and/or intrathecal IgG antibody against varicella zoster virus, and angiopathy location in magnetic resonance angiography were not determining for the diagnosis. Invasive tests, with low sensitivity, should be well considered in the diagnosis of post-varicella arterial ischemic stroke.

Evaluation of efficacy and failure of high flow nasal cannula therapy in paediatric emergency service and paediatric intensive care unit

Objective: High-flow nasal cannula oxygen therapy (HFNC) improves gas exchange and decreases work of breathing in patients with acute respiratory distress. We aimed to discuss the indications for HFNC in children of all ages and diagnoses and to evaluate the efficacy and risk factors for failure of HFNC therapy in children with acute respiratory distress and failure in a paediatric emergency service and paediatric intensive care unit (PICU). Material and Methods: A total of 191 patients aged one month to 18 years treated with HFNC between October 1, 2018, and July 1, 2020, in the Paediatric Emergency Service and PICU were included in the study. Demographic and clinical characteristics, underlying chronic diseases, HFNC treatment success, and treatment failure of the cases were recorded. Results: One hundred ninety-one children were included in the study, of whom 70 (36.6%) were female, and the median age was 13 months (1-204). The most common indication of HFNC treatment was bronchopneumonia (n=83, 43,5 %). HFNC treatment succeeded in 81.7 % (n=156) of the patients. It was observed that the two most successful patient groups were acute bronchiolitis and pneumonia. The failure rate was 18.3 % (35 of 191 children). The most common underlying comorbidity was bronchopulmonary dysplasia (BPD) (19, 9.9%). There was a statistically significant difference seen on Glasgow Coma Scale (GCS) and lactate value in blood gas in the first hour of the treatment in the group with unsuccessful results (p<0.05). During the HFNC treatment, 28 patients (14.7%) required invasive mechanical ventilation (IMV), and seven patients (3.7%) required non-invasive mechanical ventilation (NIMV). Conclusion: HFNC is a reliable non-invasive treatment modality that is easily tolerated by children and has effective use in many critical diseases. Our study found that HFNC therapy could be initiated as the first-line therapy for various aetiologies of acute respiratory distress in a paediatric emergency service and PICU and all age groups. It was emphasized that transition to other treatment modalities should not be delayed in the cases predicted to be unsuccessful.

Evaluation of the Pediatric Neurology Consultations Requested from the Pediatric Emergency Service: A Single-Center Experience

Evaluation of the Pediatric Neurology Consultations Requested from the Pediatric Emergency Service: A Single-Center Experience

Gastrointestinal fistula due to multiple neodymium magnet ingestions

Foreign body ingestion (FBI) is one of the critical conditions encountered in pediatric emergency services. FBI can lead to high mortality in children. Neodymium magnets are increasingly popular due to children’s great interest in them. In cases of multiple magnet ingestion, the risk of mucosal perforation is higher when compared with other types of FBI. With this case, an attempt to raise awareness of this medical problem was made by sharing the case of a neodymium magnet body in a 24-month-old patient. The magnet was detected incidentally during our fever etiology examination although possible ingestion of a foreign body had previously been reported in her medical history. Our patient presented with abdominal tenderness, agitation, and other symptoms. An abdominal X-ray was taken. A foreign body that resembled a neodymium magnet sphere was observed. During surgery, a gastrocolic fistula in the antrum was observed. Multiple magnets are foreign bodies that present a higher risk of causing intestinal perforation compared to other foreign bodies. It is known that multiple magnet ingestions may cause mucosal ulceration, and it should be emphasized that such ingestion may cause gastrointestinal fistulas. Since pediatric patients in a certain age group tend to put objects in their mouths, each patient with an unclear cause of fever and abdominal sensitivity should be questioned with respect to FBI and then tested radiologically.

Estado actual de recursos generales y funcionamiento de servicios hospitalarios de emergencias pediátricas con gestión pública en Latinoamérica (Estudio Rfsepla)

Introduction: To improve the quality of care in Pediatric Emergency Services (SEP) it is essential to carry out measurements and surveys. Purpose: Describe the resources and operation of the SEPs of public hospitals in Latin America. Methods: Descriptive, quantitative and retrospective study. Survey conducted in SEP of Latin American hospitals with public funding and with PICU (2019). Data processed by REDcap and InfoStat programs. Continuous variables are presented as medians and ranges; categorical variables as percentages; productivity / resource ratios as a ratio. Univariate analysis was performed. Results: Of 371 services in 17 countries, 107 (28.8%) answered the survey; 102 (95.3%) have an observation area and 42 (39.3%) have isolation rooms. The medians of annual visits / observation bed and daily visits / clinic were 4830.6 and 24.4, respectively. The number of beds increased by 74.1% in the seasonal peak, 6.1% of the consultations required hospitalization and 2.0% were assisted in the Resuscitation Sector. 37 (34.6%) SEP have> 80% of 27 items considered essential by the International Emergency Federation, 43 (40.2%) lack complete airway equipment and 74 (69.2%) perform triage. The median number of daily consultations is 38.4 / doctor and 35.3 / nurse. In 72 (67.9%) SEP there is a doctor and a nurse coordinator per shift, in 83 (77.6%) computerized data are handled, in 25 (23.4%) they do not perform diagnostic coding and in 16 (15% ) discharge summary is not prepared. 68 (64.1%) SEP use 5 protocols for critical situations, in 10 (9.4%) the medical personnel have teaching / research hours and in 43 (41%) there is a quality improvement plan. Conclusions:The information obtained regarding resources and operation of public PEDs in Latin America reveals important gaps.

The role of eosinopenia in the diagnosis of bacterial infection in children

Purpose: Number of eosinophils circulating in the blood decreased significantly after acute infections. Our aim in this study is to determine the role of eosinopenia in the diagnosis of bacterial infection in children and to compare it with other acute phase reactants. Material and methods: Patients aged 0-14 years, who applied to İzmir Tepecik Training and Research Hospital Pediatrics Polyclinics and Pediatric Emergency Service between 01.01.2008 and 31.12.2008, whose hemogram and C-reactive protein were studied within the first 24 hours of admission were included in this study. The cases were screened according to the International Classification of diseases (ICD-10) diagnostic codes. Results: Totally 1857 patients were included in the study. The patients were evaluated in 3 groups; 519 cases (28%) with bacterial infection,356 cases (19.2%) with viral infection, and 972 cases (52.6%) in the control groups. The mean absolute eosinophil count in the bacterial infection group was 103.7±76.9/mm³, while it was 192.8±129.3/mm³, in the viral infection group, and this difference was statistically significant (p<0.001). It was determined that the bacterial infection group had the highest C-reactive protein value, the lowest absolute eosinophil count, and the lowest absolute eosinophil count /white blood cell ratio, and this was statistically significant (p<0.001). The parameter with the highest sensitivity was absolute eosinophil count/white blood cell with 73.7%, and highest specificity was absolute eosinophil count with 82.4%. Conclusion: Absolute eosinophil count and absolute eosinophil count / white blood cell ratio as specific and sensitive markers in the diagnosis of bacterial infection in children, can be promising diagnostic parameters by providing ease of use in daily practice.

Prevalence of traumatic dental injuries in emergency dental services: A systematic review and meta-analysis.

This study aimed to perform a systematic review and meta-analysis regarding the prevalence of traumatic dental injuries (TDI) in emergency dental services. Seven electronic and two grey literature databases were searched, up to December 2021, for studies that reported the TDI prevalence among dental emergencies. The Joanna Briggs Institute critical appraisal checklist for prevalence studies, and The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were used to assess the risk of bias and quality of evidence respectively. The R software was used to perform a proportion meta-analysis on a random-effects model to estimate the pooled prevalence and respective 95% CI. From a total of 1476studies identified after excluding duplicates, 38met the inclusion criteria, and another five were identified through hand searching, summing 43 included observational studies with a total sample of 209099 individuals searching for emergency dental care. The overall pooled prevalence of TDI was 15.4% (95% CI: 11%-21%, I²=100%). Paediatric dental emergency services and age group from 0 to 21years presented the highest prevalence, 29% (95% CI: 22%-38%, I²=99.5%) and 24% (95% CI: 15%-35%, I²=98%) respectively. The overall pooled prevalence of TDI in emergency dental services was 15.4%, and 24% in the age group under 21years. Considering the impact of prompt and correct emergency care in the long-term prognosis of TDI, such knowledge is relevant to organize emergency healthcare and support public policies in this area.

Anxiety and healthcare satisfaction of mothers with children hospitalized in the pediatric emergency service

This cross-sectional study was conducted to determine the anxiety and healthcare satisfaction levels of mothers with children hospitalized in the pediatric emergency service and the relationship between them. The study sample comprised mothers (n=316) with children hospitalized in the pediatric emergency service of a tertiary hospital in Turkey. Intsitutional and ethics committee approval was obtained, and data were collected using the Questionnare Form, State Anxiety Inventory (SAI), and PedsQL Healthcare Satisfaction Scale (PHSS). The SAI mean scores of mothers were moderate (45.30 ± 9.29) and their PHSS total mean scores were high (70.74 ± 23.80). In the study, there was a low-level negative correlation between the SAI mean scores of the mothers and the PHSS subscales and total scale mean scores (p < 0.05). We found a relationship between the PHSS mean scores of mothers and the SAI mean scores, maternal age, education level, and waiting time for the examination, explaining 13.5% of the scores on the PHSS scale (p < 0.05). In this study, the mothers had moderate anxiety and high healthcare satisfaction levels. Anxiety, educational level, and the waiting for an examination affected the healthcare satisfaction of mothers. The anxiety of mothers whose children are hospitalized in the pediatric emergency service should be reduced by conducting interventional studies.

COVID-19 Pandemisi kısıtlama sürecinde çocuk akut apandisit bulgularının değerlendirilmesi

Introduction: To evaluate the effect of the COVID-19 pandemic on patients admitted to the pediatric emergency department and operated with the diagnosis of acute appendicitis in the pediatric surgery clinic. Metods: Files of patients who underwent appendectomy in the pediatric surgery clinic of Health Sciences University Adana City Training and Research Hospital between 16 March-16May 2019 and 16 March-16 May 2020 were retrospectively analyzed and divided into two groups respectively. Results: In the study, 95 patients in Group-1 (5.1% 95/1851) and 83 patients in Group-2 (11.5% 83/724) was operated for acute appendicitis. There was a significant difference between the two groups in terms of the number of patients who underwent appendectomy (p=0.001). A statistically significant difference was not found between the two groups when age, gender, duration of admission to hospital, preoperative laboratory values and duration of hospitalizasyon were compared. Perforated appendicitis was detected in 9 (9.5%) of the patients who underwent appendectomy in Group-1 and in 13 (15.7%) of the patients in Group-2 and it was not statistically significant (p=0.007). The mean size of appendix of the surgical pathology specimens was found to be 8.98±3.12 mm in Group-1 and 10.3±3.43 mm in Group-2 (p=0.007). Conclusion: Although the number of applications to pediatric emergency services decreased during the pandemic period, there was no decrease in the number of patients operated on due to appendicitis. In addition, it was found that the rate of perforated appendicitis increased. For this reason, it should be considered that the situations requiring emergency surgery do not decrease with the epidemic.

Characteristics of pediatric emergency patients in a Turkish tertiary-level hospital: A 1-year cross-sectional study.

Overcrowding in pediatric emergency departments negatively affects the quality of care. Investigating the characteristics of the patients admitted to PEDs will provide valuable information to increase the satisfaction of patients and healthcare staff. This research aimed to investigate the characteristics of pediatric emergency patients in a foundation university hospital in Ankara. This is a retrospective, descriptive, single-center, cross-sectional study, which was conducted with 6550 patients who were admitted to the pediatric emergency department of a foundation university hospital in Ankara, and got diagnosed with one of the 15 most common diseases between 1 August 2017 and 31 July 2018. The associations between the demographics and clinical features of the patients and their diagnoses were evaluated. For comparisons, frequencies, percentages, crosstabs, and chi-square tests were used. While none of the patients had a red triage level, 19% had a yellow triage level, and 81% had a green triage level. The three most common diagnoses were fever of unknown origin, cough, and nausea and vomiting. Despite the 0-28 days of age group having the lowest admission rate of 5%, they had the highest usage rate of yellow triage level (66.5%). However, it was the opposite for the 19 months to 5 years of age group with the highest rate of admissions of 49% and the lowest usage rate of yellow triage level (12.8%). The reasons for admitting to pediatric emergency department differ according to some contextual variables. Being aware of the current situation is the first step in planning for better pediatric emergency service.

Indoor concentrations of particulate matter 2.5 in a pediatric emergency service.

Objective:To evaluate air quality in the waiting room of a pediatric emergency service considering the serial concentrations of particulate matter (PM2.5), and to determine if the number of people present in the room can have an influence on the pollutant concentrations.Methods:Cross-sectional study, carried out in the waiting room of a reference pediatric hospital in the city of Porto Alegre, conducted in a one-year period, in a continuous-time sample including all of the four seasons of the year. The monitoring of PM2.5 was performed using a real-time aerosol monitor (DustTrak II). The number of people in the room was determined every hour and the climatic characteristics per daily mean. The concentration of PM2.5 and the number of people were expressed by mean and standard deviation. The means were compared by Analysis of Variance and Pearson's correlation coefficient.Results:There was a significant increase in the concentration of PM2.5 in the autumn, when compared to other seasons (p<0.001). The pollutant increase, in this season, was accompanied by the higher number of people in the emergency room (p=0.026). The association between PM2.5 and the number of people is confirmed by the positive correlation between these two variables (r=0.738; p<0.001).Conclusions:The pediatric emergency waiting room showed elevated PM2.5 in all seasons. The number of people in the room had a positive correlation with the concentration of the pollutant in the environment.

The characterization of a hospitalized population at the pediatric emergency service of Mother and Child Hospital, Marrakech, Morocco.

the pediatric emergency department is the first contact between the population and the hospital. Consequently, its dysfunction influences the quality of the general health care system. However, any successful policy must first be based on convincing results hence the need to better explore this service, diagnose the various dysfunctions, and survey disease trends to identify the needs of the local population. In this perspective, we propose to describe the epidemiological profile of children hospitalized at the emergency service of the Mother-Child hospital, University Hospital Centre Marrakech, and establish the prevalence table for childhood pathologies. a retrospective study was carried out in pediatric emergency services for 1658 hospitalized patients between March 2015 and December 2018. The collected data concerns mainly the socio-demographic, clinical profile, evolution status, mode of admission, and medical history. the characterization of the studied population by sex and age showed a predominance of male with a sex ratio of 1.36, infants with 625 patients. Concerning the final diagnosis, the most frequent pathologies affected the respiratory system in 28% of cases, then the digestive system (11.3%), while infectious pathologies represented 10.7% of admissions. The death rate in the emergency department was 7.4%. Multivariate analysis of the data showed a statistically significant relationship between the final diagnosis (16 diseases by a system according to The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)) and age, season, and weight. Thus, for the association between the digestive system diseases and weight (aOR=1.052, 95% CI= 1.019-1.086, p=0.02). While for the skin and subcutaneous tissue diseases and the autumn season (aOR=11.37, 95% CI= 1.272-101.777, p=0.03) and age has a negative significance for most diseases. the epidemiological profile study will allow knowledge of patient´s pathologies typology for a well-supported and better definition of needs.

Effectiveness of Salbutamol Administered through a Metered-Dose Inhaler with Nebuliser amongst Children for Acute Asthma Treatment

Administration of salbutamol by metered-dose inhaler (MDI) with spacer is as effective as nebuliser in terms of clinical response and patient outcome. In addition, fewer side effects and lesser hospital admission rates are recorded with this method. Changing the practice of using nebuliser to MDI with spacer as the preferred mode of treatment for mild-to-moderate asthma has been studied. In this study, 68 children between the age groups of 5 and 18 years with mild-to-moderate severity of asthma admitted in the paediatric emergency service and the child health outpatient department were studied to compare the effect of salbutamol delivered via MDI with salbutamol through nebuliser for acute asthma treatment. In this study, 70 children with asthma were randomly allocated to the MDI and nebuliser groups. The standardised Modified Pulmonary Index Score was assessed by the clinical assessor before and 10 min after the intervention. The findings revealed that the clinical outcome was highly significant in both the groups. However, the feasibility of using MDI with spacer in comparison to nebuliser was found to be highly significant in relation to the effectiveness, utilisation of hospital resources (treatment preparation, delivery time and cost) and acceptability to patients. Results of the study carried out in the paediatric population indicate that MDI with spacer is as effective as nebuliser in the treatment of children with mild and moderate acute asthma exacerbations in the hospital setting. However, MDI with spacer has more additional benefits such as fewer side effects, less time consumed to administer the treatment, cost-effective, portable and easier to use than nebulisers.

Does breastfeeding protect children from COVID-19? An observational study from pediatric services in Majorca, Spain

BackgroundIt has been demonstrated that children who had been breastfed remain better protected against various infections, and notably respiratory tract infections, well beyond infancy. Since the role of breastfeeding to explain why children are less affected by COVID-19 has not been studied until now, the aim of this study was to determine whether any history of breastfeeding reduces the incidence rate of COVID-19 in children.MethodsThis was a secondary analysis of an observational study on clinical and epidemiological characteristics of pediatric COVID-19 in Majorca. A total of 691 children were recruited during the 5 months of August–December 2020. Eligible participants were children under 14 who were tested for SARS-CoV-2 in pediatric emergency services. The independent explanatory variable was any breastfeeding. Bivariate analyses were conducted through the Chi-square test, the Fisher’s Exact test or the Student’s T test.All children had the same demographic, epidemiological and clinical data collected through a study team member interview and via the participants medical records.ResultsWithin the sample of children who visited emergency services with symptoms of potential COVID-19, we found higher prevalence of positive SARS-CoV-2 RT-PCR test results among those who were exclusively formula fed compared with those who were ever breastfed (OR 2.48; 95% CI 1.45, 3.51; P = 0.036).ConclusionsThe present study suggests that ever breastfeeding reduces the risk of COVID-19 among children, as documented for other infections.

PSYCHOTHERAPY WITH MEDICALLY ILL CHILDREN: EARLY CHILDHOOD TO TRANSITIONAL-AGE YOUTH IN 2021

This session aims to equip attendees with selected psychotherapeutic tools for the mental health assessment and treatment of medically ill children and adolescents situated in a developmental framework. Participants will have an opportunity to discuss the effects of medical illness on development from early childhood through adolescent and young adult (AYA) age groups. They will learn about therapeutic interventions with young medically ill children aged 0-6 years and their families. Presenters will share experiences on establishing remote services on the pediatric unit and emergency service with medically ill children during the pandemic and discuss bedside psychotherapy strategies. Participants will also have an opportunity to learn about psychotherapeutic strategies regarding chronic illness themes in the AYA age group, leading up to and including end-of-life care. Participants will gain a new understanding of the effects of medical illness on development from early childhood through AYA age groups. Methods of psychotherapeutic engagement are evolving, whether due to forced adaptations during the COVID-19 pandemic or through recently developed psychotherapeutic tools from parent-child interaction, dignity, and meaning-centered psychotherapies for patients and families. Effective psychotherapeutic applications across the pediatric continuum of care are essential for optimal implementation and outcomes. Children and adolescents remain subject to chronic and terminal medical illnesses with comorbid mental health conditions and considerations. Even as medical advances have extended life expectancies, the need for relevant, practical, and effective delivery of psychotherapeutic interventions—both in person and virtual—has also increased. Child and adolescent psychiatrists are advised to be current with helpful treatment modalities in their roles as psychotherapists and multidisciplinary treatment team leaders working in settings with medically ill youth.

Case report: Role of SCN9A the sodium channel in genetic epilepsy

Childhood seizures are a frequent cause of pediatric emergency service admission. Genetic epilepsy is commonly related to multiple gene alterations. We report a case of childhood epilepsy associated with alteration in the sodium channel SCN9A gene sequence.

From Lockdown to Slow Release: Pediatric Dental Services during COVID-19 Pandemic-Emergency Preparedness and Impact on Future.

IntroductionThe emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has led to global pandemic raising significant challenges to the healthcare professionals due to its high transmission rate via droplet spread or direct contact. Pediatric dentists play an important role in the healthcare system by managing dental emergencies in children while taking special measures to practice universal infection control in this COVID-19 pandemic. However, data are limited pertaining to the prevalence, etiology, and treatment provided to children at pediatric dental emergency services during the COVID-19 lockdown period.Aim and objectiveTo assess the effect of the COVID-19 pandemic lockdown period on Pediatric Dental Emergency Services.Materials and methodsA retrospective study was conducted using data of patients aged 0–14 years who visited the Pediatric Dental Emergency Services, during the COVID-19 lockdown period from March 23, 2020, to August 31, 2020. Information regarding age, gender, time of presentation, chief complaint, and treatment were collected and analyzed.ResultsThis study revealed that dental emergencies in the pediatric dental services were predominantly related to dental pain (54.49%) followed by an abscess (12.35%), traumatic dental injuries (8.42%), and swelling (8.42%). A 5-year-old was the most prevalent age-group who reported dental emergencies.ConclusionDental pain was the most common chief complaint of patients reporting during the COVID-19 pandemic. However, the recent state of affairs obligates the need to strike a balance between the safety of the healthcare professionals and providing optimum dental care to the patients requiring emergency intervention. While dental emergencies are unforeseeable, increasing community awareness about proper at-home care routines and utilizing regular dental preventive measures can potentially reduce the number of emergency visits.How to cite this articleGoswami M, Gogia M, Bhardwaj S. From Lockdown to Slow Release: Pediatric Dental Services during COVID-19 Pandemic—Emergency Preparedness and Impact on Future. Int J Clin Pediatr Dent 2021;14(3):398–402.

Epidemiological Study of Violence against Children and Its Increase during the COVID-19 Pandemic.

The aim of this study was to identify the epidemiological profiles of violence against children, victims, and their aggressors, and their correlations between socioeconomic and demographic factors analyzed before and during the COVID-19 pandemic. This was a cross-sectional, retrospective observational study based on a review of Individual Notification Forms from the Information System for Notifiable Diseases, including child victims of violence, under 18 years, assisted by a pediatric emergency service in Brazil, from 2016–2020. Data were stratified, then statistical analysis was performed using the two-proportion equality test and the Chi-square test, with p < 0.05 and a 95% confidence interval. A total of 609 notifications were analyzed and a prevalence of sexual violence (63.2%) was reported. The prevalent profile of victim was female (76.7%), aged between 2–9 years (38.1%) and 14–18 years (35.6%). The violence occurs in the victim’s home (58.9%). The prevalent profile of perpetrator was male (82.4%), young adolescent (59.2%), living as family (64%), mainly the parents (18.4%). No correlation was found between the classified socioeconomic and demographic variables and violence. There was an increase in notifications during the COVID-19 pandemic, compared to the same period in the previous year; self-harm was reported in 59.7% of physical violence in 2020. Prevalence of sexual violence was higher for females, aged between 2–9 and 14–18 years, victimized in their homes, by male offenders, living as family, mainly by their parents. No association was found between child violence and the socioeconomic and demographic.

The Evaluation of Patients Admitted due to Minor Head Trauma with Clinical Decision Rules

Aim: We aimed to identify patients admitted to pediatric emergency service due to head trauma using clinical decision-making rules.&#x0D; Methods: This is a prospective cohort study involving who referred to a tertiary university hospital pediatric emergency service due to minor head trauma. Evaluations were made with PECARN, CATCH and CHALICE clinical decision rules.&#x0D; Results: 326 cases were included in the study. 63.5% (207) of the cases were male, and their ages were 52±52 months (min: 1 day - max: 214 months). 61.9% (202) of the cases were admitted due to a fall. 15.3% (49) cases presenting with minör head trauma had a (computize tomography)CT performed. In cases under the age of three months the CT scan rate was 66.6%, while it was 11% in cases over three months. 50% of the cases who had a CT scan satisfied the clinical decision rules. However, two cases who had traumatic brain injury(TBI) in the CT could not be determined with clinical decision rules. There was a statistically significant correlation between the presence of severe mechanism of injury and TBI findings in the CT(p

Assessment of pediatric patients presenting to the pediatric emergency service due to electrical injury: a single center experience

article: Assessment of pediatric patients presenting to the pediatric emergency service due to electrical injury: a single center experience - Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2021 June;180(6):274-9 - Minerva Medica - Journals