scholarly journals Gaps in Drug Dosing for Obese Children: A Systematic Review of Commonly Prescribed Emergency Care Medications

2015 ◽  
Vol 37 (9) ◽  
pp. 1924-1932 ◽  
Author(s):  
Stevie Rowe ◽  
David Siegel ◽  
Daniel K. Benjamin
Keyword(s):  
Systematic Review ◽  
Emergency Care ◽  
Obese Children ◽  
Drug Dosing

The Role of Obesity in Motor Vehicle Injuries and Fatalities in the Pediatric Population: A Systematic Review

2021 ◽  
pp. 088506662199273
Author(s):  
Zana Alattar ◽  
Shelby Hoebee ◽  
Eyal Ron ◽  
Paul Kang ◽  
Eric vanSonnenberg
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Extremity Injury ◽  
Obese Children ◽  
Patients Âgés ◽  
Vehicle Accidents ◽  
Increased Risk ◽  
Extremity Injuries

Purpose: A systematic review done to evaluate obesity as a risk factor for injuries and mortality in motor vehicle accidents (MVAs) in the pediatric population, as there has not been a systematic review done in over 10 years. This study aims to update the literature regarding obesity as a risk factor for injuries in MVAs in the pediatric population. Materials and Methods: A systematic review was conducted according to the PRISMA guidelines with strict inclusion and exclusion criteria, resulting in the use of 3 total articles to analyze obesity as a risk factor for overall injury and mortality in the pediatric population. Results: Zaveri et al demonstrated a statistically significant, but weak, decrease in the odds of extremity injury in overweight patients ages 2 to 17 years old (odds ratio [OR] = 0.6, 95% confidence interval [CI] = 0.4-1.0, P ≤ 0.05). On the other hand, Pollack et al and Haricharan et al found an increase in extremity injury in the obese population, in ages 9 to 15 years (OR = 2.54, 95% CI = 1.15-5.59, P ≤ 0.05), and 10 to 17 years (Age 10-13: OR = 6.06, 95% CI = 2.23-16.44, P ≤ 0.05, Age 14-17 OR = 1.44, 95% CI = 1.04-2.00, P ≤ 0.05), respectively. Haricharan et al also found an increase in thoracic injuries in obese children, ages 2 to 13 and increased risk of head/face/neck injury in obese children ages 2 to 5 (OR = 3.67, 95% CI = 1.03-13.08, P ≤ 0.05), but a decreased risk of head injury in obese children ages 14 to 17 (OR = 0.33, 95% CI = 0.18-0.60, P ≤ 0.05). Conclusions: There are sparse data that are conflicting, regarding the effect of obesity on extremity injuries in the pediatric population. Obesity is not protective against thoracic, head, or abdominal injuries. However, it was found to be a risk factor for trunk injuries in ages 2 to 13, as well as head/face/neck injuries for ages 2 to 5. Since the literature is so sparse, further research is warranted in these areas.

Validity of triage systems for paediatric emergency care: a systematic review

2017 ◽  
Vol 34 (11) ◽  
pp. 711-719 ◽  
Author(s):  
Maria Clara de Magalhães-Barbosa ◽  
Jaqueline Rodrigues Robaina ◽  
Arnaldo Prata-Barbosa ◽  
Claudia de Souza Lopes
Keyword(s):  
Systematic Review ◽  
Emergency Care ◽  
Paediatric Emergency ◽  
Paediatric Emergency Care

Telemedicine in paediatric emergency care: A systematic review

2021 ◽  
pp. 1357633X2110101
Author(s):  
Aditi Mitra ◽  
Rubina Veerakone ◽  
Kathleen Li ◽  
Tyler Nix ◽  
Andrew Hashikawa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Emergency Care ◽  
Cost Savings ◽  
Process Measures ◽  
Paediatric Emergency ◽  
Paediatric Emergency Care ◽  
Therapeutic Decision Making ◽  
The Impact

Introduction The impact of telemedicine on the access and quality of paediatric emergency care remains largely unexplored because most studies to date are focused on adult emergency care. We performed a systematic review of the literature to determine if telemedicine is effective in improving quality of paediatric emergency care with regards to access, process measures of care, appropriate disposition, patient-centred outcomes and cost-related outcomes. Methods We developed a systematic review protocol in accordance with PRISMA (Preferred Reporting Items for Systematic Review) guidelines. We included studies that evaluated the impact of synchronous and asynchronous forms of telemedicine on patient outcomes and process measures in the paediatric emergency care setting. Inclusion criteria were study setting, study design, intervention type, age, outcome measures, publication year and language. Results Overall, 1.9% (28/1434) studies met study inclusion and exclusion criteria. These studies revealed that telemedicine increased accuracy of patient assessment in the pre-clinical setting, improved time-to disposition, guided referring emergency department (ED) physicians in performing appropriate life-saving procedures and led to cost savings when compared to regular care. Studies focused on telepsychiatry demonstrated decreased length of stay (LOS), transfer rates and improved patient satisfaction scores. Discussion Our comprehensive review revealed that telemedicine enhances paediatric emergency care, enhances therapeutic decision-making and improves diagnostic accuracy, and reduces costs. Specifically, telemedicine has its most significant impact on LOS, access to specialized care, cost savings and patient satisfaction. However, there was a relative lack of randomized control trials, and more studies are needed to substantiate its impact on morbidity and mortality.

scholarly journals Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

BMJ Open ◽  
2016 ◽  
Vol 6 (5) ◽  
pp. e010609 ◽  
Author(s):  
Aaron M Orkin ◽  
Jeffrey D Curran ◽  
Melanie K Fortune ◽  
Allison McArthur ◽  
Emma J Mew ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Effects ◽  
Emergency Care ◽  
Systematic Review Protocol ◽  
Review Protocol

scholarly journals Using machine-learning risk prediction models to triage the acuity of undifferentiated patients entering the emergency care system: a systematic review

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Jamie Miles ◽  
Janette Turner ◽  
Richard Jacques ◽  
Julia Williams ◽  
Suzanne Mason
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Neural Networks ◽  
Logistic Regression ◽  
Emergency Care ◽  
Model Performance ◽  
Machine Learning Methods ◽  
C Statistic ◽  
Emergency Care System ◽  
Care System

Abstract Background The primary objective of this review is to assess the accuracy of machine learning methods in their application of triaging the acuity of patients presenting in the Emergency Care System (ECS). The population are patients that have contacted the ambulance service or turned up at the Emergency Department. The index test is a machine-learning algorithm that aims to stratify the acuity of incoming patients at initial triage. This is in comparison to either an existing decision support tool, clinical opinion or in the absence of these, no comparator. The outcome of this review is the calibration, discrimination and classification statistics. Methods Only derivation studies (with or without internal validation) were included. MEDLINE, CINAHL, PubMed and the grey literature were searched on the 14th December 2019. Risk of bias was assessed using the PROBAST tool and data was extracted using the CHARMS checklist. Discrimination (C-statistic) was a commonly reported model performance measure and therefore these statistics were represented as a range within each machine learning method. The majority of studies had poorly reported outcomes and thus a narrative synthesis of results was performed. Results There was a total of 92 models (from 25 studies) included in the review. There were two main triage outcomes: hospitalisation (56 models), and critical care need (25 models). For hospitalisation, neural networks and tree-based methods both had a median C-statistic of 0.81 (IQR 0.80-0.84, 0.79-0.82). Logistic regression had a median C-statistic of 0.80 (0.74-0.83). For critical care need, neural networks had a median C-statistic of 0.89 (0.86-0.91), tree based 0.85 (0.84-0.88), and logistic regression 0.83 (0.79-0.84). Conclusions Machine-learning methods appear accurate in triaging undifferentiated patients entering the Emergency Care System. There was no clear benefit of using one technique over another; however, models derived by logistic regression were more transparent in reporting model performance. Future studies should adhere to reporting guidelines and use these at the protocol design stage. Registration and funding This systematic review is registered on the International prospective register of systematic reviews (PROSPERO) and can be accessed online at the following URL: https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42020168696 This study was funded by the NIHR as part of a Clinical Doctoral Research Fellowship.

scholarly journals What do we really know about the appropriateness of radiation emitting imaging for low back pain in primary and emergency care? A systematic review and meta-analysis of medical record reviews

PLoS ONE ◽  
2019 ◽  
Vol 14 (12) ◽  
pp. e0225414 ◽  
Author(s):  
Gabrielle S. Logan ◽  
Andrea Pike ◽  
Bethan Copsey ◽  
Patrick Parfrey ◽  
Holly Etchegary ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Medical Record ◽  
Emergency Care ◽  
Meta Analysis ◽  
Low Back
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