Pediatrics
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Many Ethics Committees Are Not Following AAP Guidance
In a survey of ethics consultant leaders at children’s hospitals, researchers found multiple practice gaps, including training needs; informing staff, patients, and family about ethics services; and scope of ethics service. These practice gaps could erode ethics quality and narrow ethics reach.
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New Ethical Guidance on Pediatric Decision-Making
According to the recommendations, ethical decision-making can factor in parents’ consideration of the child’s non-health interests (e.g., a child’s interest in playing football, even if it risks concussions), and also may consider the interests of other family members, provided those do not severely compromise the child’s health.
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Pediatric Hernias: Diagnosis and Management
Hernias are a common condition encountered by emergency providers and can be overlooked if the genitourinary system is not included in the evaluation of every child with vomiting or abdominal pain. Incarcerated hernias that are not identified in a timely fashion can have devastating consequences for a child. The authors provide an anatomical review, along with diagnostic and therapeutic approaches to pediatric hernias.
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CDC Recommends RSV Vaccine for Patients in Third Trimester
The agency says this solution should be administered to patients during weeks 32 through 36 of pregnancy to protect babies against the dangerous virus, both before and shortly after birth.
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Was Child Brought to ED by EMS? Medication Dosages May Be Incorrect
ED personnel should ensure a good handoff report is received from EMS providers, and that the dose of any medications administered by EMS is recorded. ED personnel should be mindful in carrying out weight-based dosing calculations, and should follow recommendations of national guidelines.
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Many Pediatric Patients Leave EDs Without Being Seen
As pediatric patients become more medically complex, inpatient pediatric beds across the country continue to consolidate, and pediatric EDs are expecting to see higher volumes of children. Healthcare leaders must build these considerations into their staffing and patient flow approaches if they hope to prevent more patients from leaving without before they are seen.
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Proton Pump Inhibitors: Too Much of a Good Thing?
Proton pump inhibitor use in infants is associated with a 34% increase in the risk of subsequent infection-related hospitalization. These medications should be used only when the benefits clearly outweigh the risks.
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Pediatric Hematology/Oncology Trainees Want Ethics Expertise
Ethics education would not replace the option or need to obtain a formal ethics consultation. However, such education could lead to fewer cases during which specialists believe they need such assistance.
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Uncommon Diagnoses that Cannot Be Missed: An Update
There are a variety of uncommon pediatric conditions that, if not detected, may result in devastating consequences. The authors review and update the current standard of care for a variety of conditions, including necrotizing fasciitis, DRESS syndrome, Kawasaki disease, MIS-C, Lemierre's, and RPA.
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Pediatric Chest Trauma
Pediatric thoracic trauma is the second highest cause of pediatric trauma mortality. It is critical for emergency care providers to be aware of the anatomic and physiologic differences in children, which result in significantly different injury patterns than adults. The authors highlight the essential steps for diagnosis and management of pediatric thoracic injuries.