Pediatric Otolaryngology Emergency Management

2020 ◽  
pp. 443-456
Author(s):  
Ryan H. Belcher ◽  
Patrick Munson
Keyword(s):  
Emergency Department ◽  
American Academy ◽  
Emergency Management ◽  
Neck Surgery ◽  
Pediatric Otolaryngology ◽  
Neck Masses ◽  
American Academy Of Pediatrics ◽  
High Acuity ◽  
Very High ◽  
Nose And Throat

Pediatric otolaryngology-related diagnoses are commonly encountered in the emergency department setting. The symptoms within the ear, nose, and throat encompass a wide variety and can often have a very high acuity, so accurate recognition and treatment are paramount. Some of the more commonly encountered pediatric otolaryngology issues in the emergency department include otitis media, otitis externa, mastoiditis, neck masses, sinusitis, epistaxis, and laryngotracheal airway obstruction. The American Academy of Otolaryngology—Head and Neck Surgery and the American Academy of Pediatrics have published several consensus guidelines on these topics, which are helpful for standardizing the care of patients and decreasing their variances in treatment.

Accuracy of Parental Perception of Nighttime Breathing in Children with Down Syndrome

2017 ◽  
Vol 158 (2) ◽  
pp. 364-367 ◽  
Author(s):  
Norman R. Friedman ◽  
Amanda G. Ruiz ◽  
Dexiang Gao ◽  
David G. Ingram
Keyword(s):  
Down Syndrome ◽  
American Academy ◽  
Tertiary Care ◽  
Case Series ◽  
Neck Surgery ◽  
Parental Perception ◽  
Breathing Patterns ◽  
Children With Down Syndrome ◽  
American Academy Of Pediatrics ◽  
Obstructive Sleep

Objective In 2011, the American Academy of Pediatrics published a guideline for children with Down syndrome (DS), recommending a polysomnogram (PSG) by age 4 years regardless of symptoms. Their rationale was based on 2 publications with small cohorts, where at least 50% of the children had no obstructive sleep apnea (OSA) symptoms but their PSG results were abnormal. The American Academy of Otolaryngology—Head and Neck Surgery Foundation published a clinical practice guideline recommending PSG prior to adenotonsillectomy for these children. This study aimed to assess parents’ accuracy of their children’s breathing patterns as compared with PSGs in a larger cohort of children with DS. Study Design Case series with chart review. Setting Tertiary care academic pediatric hospital. Subjects and Methods Sleep intake forms assessing frequency of parent-observed apnea, snoring, and restless sleep were analyzed. None of the children had a previous tonsillectomy. Two groups were analyzed according to symptoms: infrequent (<3 nights per week on all questions answered) and frequent (≥6 nights per week on at least 1 question). OSA severity was categorized as follows: normal, <2 events per hour; mild, 2 to 4.9; moderate, 5 to 9.9; and severe, ≥10. Results A total of 113 children met inclusion criteria: 34% (n = 38) had infrequent symptoms, and 66% (n = 75) had frequent symptoms. Parents were unable to predict the presence or absence of OSA by nighttime symptoms ( P = .60). The risk of OSA for children with frequent symptoms versus those with infrequent symptoms was 1.04 (95% CI, 0.89-1.3). Conclusion Parents of DS children are unable to predict the presence or absence of OSA by nighttime symptoms, nor are they able to determine its severity.

Joint Committee on Infant Hearing 1994 Position Statement

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 152-156 ◽  
Author(s):  
Keyword(s):  
Risk Factors ◽  
Hearing Loss ◽  
American Academy ◽  
Committee Member ◽  
Neck Surgery ◽  
Position Statement ◽  
American Academy Of Pediatrics ◽  
Screening Protocol ◽  
Children With Hearing Loss ◽  
Universal Detection

This 1994 Position Statement was developed by the Joint Committee on Infant Hearing. Joint committee member organizations that approved this statement and their respective representatives who prepared this statement include the American Speech-Language-Hearing Association (Allan O. Diefendorf, PhD, Chair; Deborah Hayes, PhD; and Evelyn Cherow, MA, ex officio); the American Academy of Otolaryngology—Head and Neck Surgery (Patrick E. Brookhouser, MD, and Stephen Epstein, MD); the American Academy of Audiology (Terese Finitzo, PhD, and Jerry Northern, PhD); the American Academy of Pediatrics (Allen Erenberg, MD, and Nancy Roizen, MD); and the Directors of Speech and Hearing Programs in State Health and Welfare Agencies (Thomas Mahoney, PhD, and Kathie J. Mense, MS). The Joint Committee on Infant Hearing endorses the goal of universal detection of infants with hearing loss as early as possible. All infants with hearing loss should be identified before 3 months of age, and receive intervention by 6 months of age. I. BACKGROUND In 1982, the Joint Committee on Infant Hearing recommended identification of infants at risk for hearing loss in terms of specific risk factors and suggested a follow-up audiologic evaluation until an accurate assessment of hearing could be made (Joint Committee on Infant Hearing, 1982; American Academy of Pediatrics, 1982). In 1990, the Position Statement was modified to expand the list of risk factors and recommend a specific hearing screening protocol. In concert with the national initiative Healthy People 2000 (US Department of Health and Human Services, Public Health Service, 1990), which promotes early identification of children with hearing loss, this 1994 Position Statement addresses the need to identify all infants with hearing loss.

Death in the Emergency Department

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 321-321
Author(s):  
Larrie W. Greenberg
Keyword(s):  
Emergency Department ◽  
American Academy ◽  
Critical Issue ◽  
Pediatric Emergency ◽  
Crisis Counseling ◽  
Residency Programs ◽  
Pediatric Residency ◽  
American Academy Of Pediatrics ◽  
Death Of A Child

The American Academy of Pediatrics Committee on Pediatric Emergency Medicine's position on the death of a child in the emergency department that appeared in the May 1994 issue of Pediatrics omitted a critical issue, in my opinion.1 The paper did not address what pediatric residency programs are or should be doing to train physicians to be more effective in crisis counseling. Unfortunately, the most inexperienced physicians are often expected to inform parents that their child has died and then counsel them.

Postsurgical Follow-Up of Children with Tympanostomy Tubes: Results of the American Academy of Otolaryngology-Head and Neck Surgery Pediatric Otolaryngology Committee National Survey

2000 ◽  
Vol 122 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Craig S. Derkay ◽  
Jeffrey D. Carron ◽  
Brian J. Wiatrak ◽  
Sukgi S. Choi ◽  
Jacqueline E. Jones
Keyword(s):  
Primary Care ◽  
American Academy ◽  
Head And Neck ◽  
Neck Surgery ◽  
Primary Care Providers ◽  
Head And Neck Surgery ◽  
Care Providers ◽  
Pediatric Otolaryngology ◽  
Tympanostomy Tubes

Postsurgical follow-up of children with tympanostomy tubes is becoming a contentious issue in this era of managed care. Primary care providers believe themselves to be capable of evaluating these children. Otolaryngologists, on the other hand, have more specialized equipment available to them (suction apparatus, otomicroscopes, audiology devices, etc) for treating suppurative infections and monitoring the tympanic membrane for structural changes. In addition, the otolaryngologist is placed in an uncomfortable legal and ethical position if access to the patient with a tube-related complication is denied by the primary care provider. Attempts to develop an American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) policy statement have been hampered by a lack of data on the incidence and severity of tube-related complications and the role that otolaryngologists can play in reducing these sequelae. A survey designed by the AAO-HNS Pediatric Otolaryngology Committee was distributed to 1000 board-certified otolaryngologists and all members of the American Society of Pediatric Otolaryngologists and the American Academy of Pediatrics-Otolaryngology Section regarding current practice patterns and practitioners' experiences with tympanostomy tube complications. Specific information regarding complications that could have been avoided with earlier otolaryngology referral was also obtained. The results of the survey and its implications for AAO-HNS policy are presented.

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