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 “bar-code sign”, 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 “bar-code sign”, the absence of lung sliding and the absence of B lines had a sensitivity of 100% and a specificity of 100%. The “bar-code sign” 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.

Psychopathology and Disability in Children With Unexplained Chest Pain Presenting to the Pediatric Emergency Department

2010 ◽  
Vol 26 (11) ◽  
pp. 830-836 ◽  
Author(s):  
Joshua D. Lipsitz ◽  
Merav Gur ◽  
F. Meredith Sonnet ◽  
Peter S. Dayan ◽  
Steven Z. Miller ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department

Sympathomimetic Drug Use in Adolescents Presenting to a Pediatric Emergency Department with Chest Pain

1998 ◽  
Vol 36 (4) ◽  
pp. 321-328 ◽  
Author(s):  
Laura P. James ◽  
Henry C. Farrar ◽  
Eva M. Komoroski ◽  
W. Rebecca Wood ◽  
C. James Graham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Drug Use ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Sympathomimetic Drug

Use of Troponin as a Screen for Chest Pain in the Pediatric Emergency Department

2011 ◽  
Vol 33 (2) ◽  
pp. 337-342 ◽  
Author(s):  
Jennifer L. Brown ◽  
Daniel A. Hirsh ◽  
William T. Mahle
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department

scholarly journals Σύγκριση της δοκιμασίας σύνδεσης κοβαλτίου - αλβουμίνης και του υπερηχογραφήματος καρδιάς στην διαγνωστική ασθενών με θωρακικό πόνο

2013 ◽  
Author(s):  
Ευαγγελία Κουντάνα
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Unstable Angina ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Stress Test ◽  
Acute Chest Pain ◽  
Developed Countries ◽  
Coronary Syndrome ◽  
Sensitivity Specificity

Cardiovascular disease is the leading cause of mortality in developed countries andplaces a massive burden on healthcare services. Thousands of patients visit every yearthe Emergency Department (ED) with acute chest pain and a considerable proportionhas an acute coronary syndrome (ACS). In most cases, the electrocardiogram and thecommonly used biomarkers are not helpful in the early diagnosis of myocardialischemia.ObjectiveTo assess the role of ischemia modified albumin (IMA), a novel cardiac biomarker, inexcluding unstable angina (UA) in patients visiting the ED with acute chest pain. Thepredictive value of serum IMA concentrations were evaluated in comparison toechocardiogram.MethodsWe studied 33 patients (84.8% males, age 59.8±10.8 years) who presented at theAccident and Emergency Department with acute chest pain lasting < 3 h, normal ornon-diagnostic electrocardiogram and normal serum troponin and CK-MB levels.Serum IMA levels were determined and a comprehensive echocardiographic studywas performed. All patients were admitted to our Department of Cardiology and thediagnosis of UA was established with exercise or thallium stress test or with coronaryangiography.ResultsFive patients were eventually diagnosed with UA. The area under the curve for thediagnosis of unstable angina based on serum IMA levels was 0.193 (95% confidenceinterval 0.047-0.339, p < 0.05). Serum IMA levels ≥ 31,95 IU/ml had a sensitivity,specificity, positive and negative predictive value for the diagnosis of UA of 40.0%,28.6%, 9.1% and 72.7%, respectively. The sensitivity, specificity, positive andnegative predictive value of echocardiography for the diagnosis of UA was 60.0%,89.3%, 50.0% and 92.6%, respectively.Conclusion: Assessment of serum IMA levels in patients presenting with suspectedUA has comparable negative predictive value with echocardiography for excludingthe diagnosis of UA. Therefore, this biomarker appears to be useful in the diagnosisand stratification of risk in patients with ACS.

Adult Chest Pain in the Pediatric Emergency Department

2017 ◽  
Vol 33 (11) ◽  
pp. 740-744
Author(s):  
Jeffrey H. Sacks ◽  
Peter B. Flueckiger ◽  
Philip R. Spandorfer ◽  
William T. Mahle ◽  
Brian E. Costello
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
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 Implementation of a Clinical Pathway for Chest Pain in a Pediatric Emergency Department

2018 ◽  
Vol 34 (11) ◽  
pp. 778-782 ◽  
Author(s):  
Shaun Mohan ◽  
Deipanjan Nandi ◽  
Paul Stephens ◽  
Mirna MʼFarrej ◽  
R. Lee Vogel ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Clinical Pathway ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department
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