How Should We Measure Body Temperature in the Pediatric Emergency Department? Which One Is the Most Accurate?

2019 ◽  
Vol 14 (03) ◽  
pp. 121-126 ◽  
Author(s):  
Abdullah Yazar ◽  
Esra Türe
Keyword(s):  
Predictive Value ◽  
Temporal Artery ◽  
Pediatric Emergency ◽  
Measurement Methods ◽  
Pediatric Emergency Department ◽  
Body Temperatures ◽  
Infrared Thermometer ◽  
Old Patients ◽  
Specificity And Sensitivity

AbstractThe aim of this study is to evaluate temperature measurement methods in children. Body temperatures of 3 to 18 years old patients were measured with a tympanic infrared thermometer, a noncontact infrared skin thermometer and with a temporal artery thermometer. While the specificity of temporal artery and noncontact thermometers were good in determination of temperatures above 37.5°C, their sensitivities were low. Positive predictive value and negative predictive value for both thermometers were sufficient. Both specificity and sensitivity of both thermometers were determined to be good at temperature values above ≥ 38°C. It is thought that noncontact and temporal artery thermometers can be used for screening in pediatric emergency departments.

IMPORTANCE OF ANTIBODIES TO 21-HYDROXYLASE FOR THE DIAGNOSIS, DIFFERENTIAL DIAGNOSIS AND PROGNOSIS OF AUTOIMMUNE CHRONIC PRIMARY ADRENAL INSUFFICIENCY

2021 ◽  
Vol 100 (2) ◽  
pp. 78-86
Author(s):  
L.S. Sozaeva ◽  
◽  
N.V. Makazan ◽  
L.V. Nikankina ◽  
N.M. Malysheva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Adrenal Insufficiency ◽  
Predictive Value ◽  
Primary Adrenal Insufficiency ◽  
Polyglandular Autoimmune Syndrome ◽  
Diagnosis And Prognosis ◽  
Specificity And Sensitivity ◽  
Enzymelinked Immunosorbent Assay

21-hydroxylase (21-OH) is the main antigen of the adrenal cortex, so the determination of antibodies (Ab) to 21-OH can help in the diagnosis and prognosis of chronic primary adrenal insufficiency (CPAI). Purpose of the study: evaluation of the relevance of Ab to 21-OH for the diagnosis and prediction of autoimmune CPAI. Materials and methods of research: the study consisted of three blocks: 1) assessment of the specificity and sensitivity, as well as the prognostic potential of Ab to 21-OH in patients with polyglandular autoimmune syndrome (APS) – individuals with APS type 1 with and without CPAI (n=106); 2) assessment of the dynamics of the level of Ab to 21-OH – patients with autoimmune CPAI were included (n=41); 3) assessment of the significance of Ab data for the differential diagnosis of various forms of CPAI, including patients with CPAI and APS type 1 exclusion (n=30). The study of Ab to 21-hydroxylase was performed using enzymelinked immunosorbent assay (BioVendor kits, Czech Republic). Results: statistically significant differences were obtained in the frequency of detection of Ab to 21-OH in patients with or without PCNI (p<0,001). The sensitivity of the method was 96%, specificity was 75%, a positive predictive value was 90%, and the negative predictive value was 89%. In 83% of patients, the level of Ab decreased with time (median size decreases – 20,4%/year). An inverse relationship was also found between the level of Ab and the duration of the course of CPAI (R=–0,460, p<0,001). In a group of 30 patients with CPAI and with exclusion of APS type 1, 21 were found to have Ab to 21-OH, only one of them had a monogenic non-autoimmune cause of CPAI (a mutation in the MC2R gene). Monogenic forms of CPAI were found in another 7 patients (mutations were found in the DAX1 and ABCD1 genes), among them an increase in Ab to 21-OH was not detected. Conclusion: determination of Ab to 21-OH is a specific and sensitive method for the diagnosis of autoimmune CPAI. An increase in Ab to 21-OH is a risk marker of autoimmune CPAI development.

scholarly journals Determination of plasma salbutamol concentrations after nebulization in a pediatric emergency department

2007 ◽  
Vol 0 (0) ◽  
Author(s):  
Eloni T. Rotta ◽  
Sérgio L. Amantéa ◽  
Pedro E. Froehlich ◽  
Adriana Becker
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department

scholarly journals Validation of a Modified Triage Scale in a Norwegian Pediatric Emergency Department

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Mette Engan ◽  
Asle Hirth ◽  
Håvard Trønnes
Keyword(s):  
Emergency Department ◽  
Negative Predictive Value ◽  
Resource Utilization ◽  
Predictive Value ◽  
Intraclass Correlation ◽  
Tertiary Hospital ◽  
Pediatric Emergency ◽  
Interrater Agreement ◽  
Pediatric Emergency Department ◽  
Sensitivity Specificity

Objective. Triage is a tool developed to identify patients who need immediate care and those who can safely wait. The aim of this study was to assess the validity and interrater reliability of a modified version of the pediatric South African triage scale (pSATS) in a single-center tertiary pediatric emergency department in Norway. Methods. This prospective, observational study included all patients with medical conditions, referred to the pediatric emergency department of a tertiary hospital in Norway from September 1, 2015, to November 17, 2015. Their assigned triage priority was compared with rate of hospitalization and resource utilization. Validity parameters were sensitivity, specificity, positive and negative predictive value, and percentage of over- and undertriage. Interrater agreement and accuracy of the triage ratings were calculated from triage performed by nurses on written case scenarios. Results. During the study period, 1171 patients arrived at the hospital for emergency assessment. A total of 790 patients (67 %) were triaged and included in the study. The percentage of hospital admission increased with increasing level of urgency, from 30 % of the patients triaged to priority green to 81 % of those triaged to priority red. The sensitivity was 74 %, the specificity was 48 %, the positive predictive value was 52 %, and the negative predictive value was 70 % for predicting hospitalization. The level of over- and undertriage was 52 % and 26 %, respectively. Resource utilization correlated with higher triage priority. The interrater agreement had an intraclass correlation coefficient of 0.99 by Cronbach’s alpha, and the accuracy was 92 %. Conclusions. The modified pSATS had a moderate sensitivity and specificity but showed good correlation with resource utilization. The nurses demonstrated excellent interrater agreement and accuracy when triaging written case scenarios.

scholarly journals Lung Ultrasound to Detect Pneumothorax in Children Evaluated for Acute Chest Pain in the Emergency Department: An Observational Pilot Study

2021 ◽  
Author(s):  
Barbara Scialanga ◽  
Danilo Buonsenso ◽  
Mqariachiara Supino ◽  
Simona Scateni ◽  
Piero Valentini ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Predictive Value ◽  
Acute Chest Pain ◽  
Final Diagnosis ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Bar Code ◽  
B Lines ◽  
Lung Sliding

Objectives- We prospectively analyzed children with acute chest pain and clinical suspicion of pneumothorax (PNX) evaluated at the pediatric Emergency Department. Methods- After clinical examination and before Chest X-Ray, children underwent LUS to evaluate the presence of PNX. We enrolled 70 children, 13 (18,57%) received a final diagnosis of PNX. Results- In all 13 (100%) patients LUS showed the &ldquo;bar-code sign&rdquo;, the absence of lung sliding and the absence of B lines while in 12 (92,3%) there was the lung point, giving a diagnosis of PNX. All cases had PNX features on CXR. The &ldquo;bar-code sign&rdquo;, the absence of lung sliding and the absence of B lines had a sensitivity of 100% and a specificity of 100%. The &ldquo;bar-code sign&rdquo; had a positive predictive value of 100% and a negative predictive value of 100% for the detection of PNX. Conclusions- LUS is highly accurate in detecting or excluding pneumothorax in children with acute chest pain evaluated in the pediatric emergency department.

Comparison of Temporal Artery Thermometry and Rectal Thermometry in Febrile Pediatric Emergency Department Patients

2013 ◽  
Vol 29 (3) ◽  
pp. 301-304 ◽  
Author(s):  
Robert J. Hoffman ◽  
Kumarie Etwaru ◽  
Naomi Dreisinger ◽  
Aditi Khokhar ◽  
Gregg Husk
Keyword(s):  
Emergency Department ◽  
Temporal Artery ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Emergency Department Patients

Assessing Somatization and Psychosocial Impairment in the Pediatric Emergency Department

2010 ◽  
Author(s):  
Zorash Montano ◽  
Neda Safvati ◽  
Angela Li ◽  
Ilene Claudius ◽  
Jeffrey I. Gold
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Psychosocial Impairment
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