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Triage of Children with Diarrhea

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1. Triage of Children with Diarrhea

Triage of Children with Diarrhea Triage of Children with Diarrhea Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Triage of Children (...) with Diarrhea Triage of Children with Diarrhea Aka: Triage of Children with Diarrhea , Pediatric Diarrhea Red Flags From Related Chapters II. Indications: Urgent or emergent evaluation for red flag symptoms and signs Age <3 months: > 100.4 F (38 C) Age >3 months: > 104 F (40 C) Caregiver report of dehydration signs See Decreased tearing (sensitive parent reported marker for dehydration) Decreased fluid intake Decreased Age <1 year old: last urine >8 hours earlier Age >1 year old: last urine >12 hours

2018 FP Notebook

2. Assessing Dehydration Employing End-Tidal Carbon Dioxide in Children With Vomiting and Diarrhea. (PubMed)

and presented for emergency department (ED) care because of vomiting and/or diarrhea. End-tidal carbon dioxide measurements were performed after triage. The diagnostic standard was weight change determined from serial measurements after symptom resolution. A receiver operating characteristic curve was constructed to identify a cut-point to predict 5% or more dehydration.In total, 195 children were enrolled. Among the 169 (87%) with EtCO2 measurements, the median (interquartile range [IQR]) was 30.4 (27.8 (...) Assessing Dehydration Employing End-Tidal Carbon Dioxide in Children With Vomiting and Diarrhea. Serum bicarbonate reflects dehydration severity in children with gastroenteritis. Previous work in children receiving intravenous rehydration has correlated end-tidal carbon dioxide (EtCO2) with serum bicarbonate. We evaluated whether EtCO2 predicts weight change in children with vomiting and/or diarrhea.A prospective cohort study was conducted. Eligible children were 3 months to 10 years old

2017 Pediatric Emergency Care

3. Evaluation of Fecal Calprotectin Screening and a Gastroenterology Questionnaire for Triaging Children With Chronic Abdominal Pain and/or Diarrhea Referred to a Pediatric Gastroenterology Service

Evaluation of Fecal Calprotectin Screening and a Gastroenterology Questionnaire for Triaging Children With Chronic Abdominal Pain and/or Diarrhea Referred to a Pediatric Gastroenterology Service Evaluation of Fecal Calprotectin Screening and a Gastroenterology Questionnaire for Triaging Children With Chronic Abdominal Pain and/or Diarrhea Referred to a Pediatric Gastroenterology Service - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer (...) to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Evaluation of Fecal Calprotectin Screening and a Gastroenterology Questionnaire for Triaging Children With Chronic Abdominal Pain and/or Diarrhea Referred to a Pediatric Gastroenterology Service The safety and scientific validity of this study is the responsibility

2013 Clinical Trials

4. Triage of Children with Diarrhea

Triage of Children with Diarrhea Triage of Children with Diarrhea Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Triage of Children (...) with Diarrhea Triage of Children with Diarrhea Aka: Triage of Children with Diarrhea , Pediatric Diarrhea Red Flags From Related Chapters II. Indications: Urgent or emergent evaluation for red flag symptoms and signs Age <3 months: > 100.4 F (38 C) Age >3 months: > 104 F (40 C) Caregiver report of dehydration signs See Decreased tearing (sensitive parent reported marker for dehydration) Decreased fluid intake Decreased Age <1 year old: last urine >8 hours earlier Age >1 year old: last urine >12 hours

2015 FP Notebook

5. Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings

ethylene propylene’ plastic to which the cosyntropin binds. 12 26 28–30 TREATmEn T There is limited empirical evidence to guide the optimal glucocorticoid stress-dosing of children and adolescents who have AI. While the debate about what constitutes phys- iological stress is unresolved, several situations are gener- ally accepted as significant stress including: fever >38°C (100.4°F), intercurrent illness with emesis, prolonged or voluminous diarrhea, infectious disease requiring antibi- otics, acute (...) Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings Miller BS, et al. J Investig Med 2019;0:1–10. doi:10.1136/jim-2019-000999 1 Review Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings Bradley S Miller, 1 Sandra P Spencer, 2 Mitchell E Geffner, 3 Evgenia Gourgari, 4 Amit Lahoti, 5 Manmohan K Kamboj, 2 Takara L Stanley, 6 Naveen K Uli, 7 Brandy

2019 Pediatric Endocrine Society

6. Accuracy of Triage for Children With Chronic Illness and Infectious Symptoms. (PubMed)

Accuracy of Triage for Children With Chronic Illness and Infectious Symptoms. This prospective observational study aimed to assess the validity of the Manchester Triage System (MTS) for children with chronic illnesses who presented to the emergency department (ED) with infectious symptoms.Children (<16 years old) presenting to the ED of a university hospital between 2008 and 2011 with dyspnea, diarrhea/vomiting, or fever were included. Chronic illness was classified on the basis (...) of International Classification of Diseases, Ninth Revision, Clinical Modification, codes. The validity of the MTS was assessed by comparing the urgency categories of the MTS with an independent reference standard on the basis of abnormal vital signs, life-threatening working diagnosis, resource utilization, and follow-up. Overtriage, undertriage, and correct triage were calculated for children with and without a chronic illness. The performance was assessed by sensitivity, specificity, and diagnostic odds

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2013 Pediatrics

7. Development and Initial Validation of a Frontline Health Worker mHealth Assessment Platform (MEDSINC<sup>®</sup>) for Children 2-60 Months of Age. (PubMed)

Development and Initial Validation of a Frontline Health Worker mHealth Assessment Platform (MEDSINC®) for Children 2-60 Months of Age. Approximately 3 million children younger than 5 years living in low- and middle-income countries (LMICs) die each year from treatable clinical conditions such as pneumonia, dehydration secondary to diarrhea, and malaria. A majority of these deaths could be prevented with early clinical assessments and appropriate therapeutic intervention (...) . In this study, we describe the development and initial validation testing of a mobile health (mHealth) platform, MEDSINC®, designed for frontline health workers (FLWs) to perform clinical risk assessments of children aged 2-60 months. MEDSINC is a web browser-based clinical severity assessment, triage, treatment, and follow-up recommendation platform developed with physician-based Bayesian pattern recognition logic. Initial validation, usability, and acceptability testing were performed on 861 children aged

2019 American Journal of Tropical Medicine & Hygiene

8. The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age

The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age We use cookies to enhance your experience on our website. By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America (...) | Clinical Infectious Diseases | Oxford Academic Search Account Menu Menu Navbar Search Filter Mobile Microsite Search Term Close search filter search input Article Navigation Close mobile search navigation Article navigation 1 October 2011 Article Contents Article Navigation The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America John S

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2011 Infectious Diseases Society of America

9. Risk factors for death in children during inpatient treatment of severe acute malnutrition: a prospective cohort study. (PubMed)

), and a capillary refill time >2 s (HR: 3.9; 95% CI: 1.4, 11.3). HIV infection was not associated with mortality (HR: 3.0; 95% CI: 0.7, 12.4), which was most likely due to low power. Biochemical risk factors were a plasma C-reactive protein concentration >15 mg/L on admission and low plasma phosphate that was measured on day 2 (HR: 8.7; 95% CI: 2.5, 30.1), particularly in edematous children. The replacement of F-75 with unfortified rice porridge to ameliorate diarrhea was associated with a higher risk of death (...) phosphate. The identified clinical risk factors may potentially improve the triage of children with malnutrition. This trial was registered at www.isrctn.com as ISRCTN55092738.© 2017 American Society for Nutrition.

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2016 American Journal of Clinical Nutrition

10. Emergency Department Revisits in Children With Gastroenteritis: a Retrospective Observational Cohort Study. (PubMed)

home between July 2003 and June 2008. Multivariable regression models were used to determine the associations between the exposures (intravenous rehydration, triage severity score, age) and ED revisits and revisits with intravenous rehydration. Accuracy was assessed using bootstrap analysis.There were 22,125 potentially eligible visits; 3346 were included in our final cohort. A total of 497 children (15%) received intravenous rehydration and 543 (16%) had an unscheduled revisit. Regression analysis (...) included 2874 children with complete data, and identified 5 independent predictors of an ED revisit: intravenous rehydration (odds ratio [OR] 1.76; 95% confidence interval [CI] 1.36-2.26); number of vomiting episodes (1.20; 95% CI 1.04-1.28/5 episode increase); days of diarrhea (OR 0.92; 95% CI 0.88-0.97/day increase); frequency of diarrhea (1.19; 95% CI 1.03-1.38/5 episode increase); and age (OR 0.94; 95% CI 0.91-0.98/year). Bootstrap methodology identified intravenous rehydration, age, number

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2013 Journal of Pediatric Gastroenterology and Nutrition

11. Ondansetron Administration to Children With Gastroenteritis, Vomiting and SOME Dehydration in EDs in Pakistan

of nonbilious, nonbloody vomiting within the 4 hours preceding triage The requirement for only 1 vomiting episode is based on prior work which similarly required 1 vomiting episode within 4 hours of triage. The later study reported a 17% absolute reduction in the use of IV rehydration. The vast majority of children seeking care and enrolled in the aforementioned study had a significantly greater number of vomiting episodes in the preceding 24 hour (mean >9 episodes).29 Presence of ≥ 1 episode of diarrhea (...) in children presenting for emergency department care with some dehydration, vomiting and diarrhea in Pakistan. SOME Dehydration is defined as 2 or more of the following signs and symptoms: Restlessness, irritability Sunken Eyes Drinks eagerly, thirsty Skin pinch goes back slowly Condition or disease Intervention/treatment Phase Dehydration Gastroenteritis Vomiting Diarrhea Drug: Ondansetron Drug: Placebo Phase 4 Study Design Go to Layout table for study information Study Type : Interventional (Clinical

2013 Clinical Trials

12. Ondansetron Administration to WELL Children With Gastroenteritis Associated Vomiting in EDs in Pakistan

preceding triage The requirement for only 1 vomiting episode is based on prior work which similarly required 1 vomiting episode within 4 hours of triage. The later study reported a 17% absolute reduction in the use of IV rehydration. The vast majority of children seeking care and enrolled in the aforementioned study had a significantly greater number of vomiting episodes in the preceding 24 hour (mean >9 episodes). Presence of ≥ 1 episode of diarrhea during the illness We require the presence of only 1 (...) diarrheal stool to enhance our probability of enrolling children with enteritis (as opposed to other diagnoses). In fact, of the 8 RCTs performed using antiemetics in children with gastroenteritis in developed countries, only 1 even required the presence of any diarrhea as part of the eligibility criteria (and that study required a single diarrheal stool). Presence of NO dehydration (NO=not enough signs to classify as some or severe dehydration) Exclusion Criteria: Weight <8 kg Vomiting or diarrhea

2013 Clinical Trials

14. Appropriate Use Criteria: Imaging of the Abdomen and Pelvis

for diagnostic surgery or as a triage test to assist in decision making regarding diagnostic surgery. The evaluated modalities included ultrasound, MRI, and CT. While none of the imaging modalities met criteria to replace surgery in making the diagnosis of endometriosis, transvaginal ultrasound did approach the criteria for a triage test for pelvic endometriosis in general. Transvaginal ultrasound met the criteria for a triage test for endometrioma, as well as for deeply infiltrating endometriosis involving (...) modalities may be considered in pediatric patients and pregnant women due to long-term concerns related to ionizing radiation. 8 A meta-analysis of 29 studies evaluating the relative accuracies of ultrasound, CT, and MRI for clinically suspected acute appendicitis in children indicated high diagnostic accuracy for all 3 modalities and no statistically significant difference between them. 9 A systematic review and meta-analysis found that, with an experienced sonographer, point of care ultrasound

2019 AIM Specialty Health

15. 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza

, fatigue/malaise, headache, poor appetite, sore throat, and myalgias/muscle aches, whereas hospitalized patients reported shortness of breath and wheezing [33]. Infants and young children with influenza may not always have fever and may present with a wide range of signs and symptoms [34], making an influenza diagnosis more difficult [29]. Infants and young children may present with fever and suspected sepsis [35, 36]. Diarrhea can occur in up to 28% of infants and young children with influenza [37–39 (...) diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations

2019 Infectious Diseases Society of America

16. Surveillance, Diagnosis and Management of Clostridium Difficile Infection in Ireland

from both the mandatory (notifiable) and voluntary (enhanced) surveillance schemes as summarised in Section 1.3 of this guideline. (5) CDI has been increasingly recognised as an important infection in populations not traditionally considered as at risk including community-acquired infection, patients with no previous exposure to antimicrobials, children, pregnant women and patients with inflammatory bowel disease (IBD). New reservoirs such as soil, water, animals, meats and vegetable sources have (...) accommodation 1 2 3 4 5 Essential elements of CDI • Governance structures • Standard Precautions • Standard operating procedures for a positive C. difficile result • CDI clusters/outbreak review • CDI testing essentials 6 7 8, 9 10 11,12 Prevention of CDI • Antimicrobial stewardship • Proton pump inhibitor use • Education for staff and patients • Management of asymptomatic carriers 13,14 15 16,17 18 Surveillance • Surveillance - when and who • Surveillance in children 90% in a variety of surgical

2019 National Clinical Guidelines (Ireland)

17. Tide Pod Challenge: Managing caustic laundry pod ingestions

Tide Pod Challenge: Managing caustic laundry pod ingestions Tide Pod Challenge: Managing caustic laundry pod ingestions - CanadiEM Tide Pod Challenge: Managing caustic laundry pod ingestions In by Tanishq Suryavanshi January 31, 2018 A Case of Laundry Pod Ingestion You are called to the low-acuity side of your department for a two year old child who was triaged three hours ago. The child was witnessed to eat a laundry pod at home, but was stable on arrival so sent to the back. Now, the child (...) can be severe in some cases, given that the chemicals in pods are in very high concentration. As a result, it is crucial that those on the front line are familiar with how to handle these emergencies. 1 EPIDEMIOLOGY Laundry pod ingestion can present in a variety of populations. These exposures are generally divided into: (1) intentional (in persons with suicidal ideation and more recently the “Tide Pod Challenge”), (2) accidental (in children or adults with dementia), and (3) incidental (due

2018 CandiEM

18. CRACKCast E191 – Weapons of Mass Destruction

, are heavier than air, so they tend to accumulate at the level where children are more likely to inhale them. Children have a greater surface area–to–volume ratio and their skin is thinner. This makes them more susceptible to agents that act on or through the skin. They have smaller fluid reserves and higher metabolic rates. Therefore, they are more vulnerable to dehydration from vomiting and diarrhea and suffer increased toxicity from a given exposure, such as to radioactive iodine. [2] What (...) if the unthinkable should happen. Shownotes – Key concepts Emergency department (ED) preparedness for a radiation incident should address decontamination (an external freestanding decontamination unit is best), triage, staff safety, personal protective equipment (PPE), and diagnostic procedures that emphasize radiation monitoring. It is important that emergency personnel know their radiation safety officer. Management of acute life-threatening conditions takes priority over radiation-associated issues. Aerosol

2018 CandiEM

19. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology

, Children’s Healthcare of Atlanta, Georgia Search for other works by this author on: Robert C Jerris Department of Pathology, Children’s Healthcare of Atlanta, Georgia Search for other works by this author on: Sue C Kehl Medical College of Wisconsin, Milwaukee Search for other works by this author on: Robin Patel Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota Search for other works by this author on: Bobbi S Pritt Division of Clinical (...) Acinetobacter spp HACEK a bacteria Brucella spp Anaerobic bacteria Adults: 2–4 blood culture sets per septic episode 20–30 mL of blood per culture set in adults injected into at least 2 blood culture bottles b Inoculated culture vials should be transported to the Laboratory ASAP at RT, organisms will usually survive in inoculated culture vials even if not incubated immediately Infants & children: ≥2 blood culture sets Blood volume depends on the child’s weight (see Table 3) c Bartonella spp ≥2 lysis

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2018 Infectious Diseases Society of America

20. CRACKCast E173 – Infectious Diarrheal Disease and Dehydration

test because it may support a diagnosis of invasive disease. This test should be considered in children with diarrhea who are febrile or have mucus or blood in the stool. If the test result is positive, stool culture is indicated to further guide management. Oral Rehydration Most patients with mild to moderate dehydration can be treated with oral rehydration therapy (ORT). Resumption of feeding with age-appropriate diets should begin as soon as vomiting subsides. Note: Routine fasting (...) other conditions, such as septic shock, hemorrhage, capillary leak with third-space fluid sequestration, and heart failure. Rosen’s In Perspective Diarrhea = Second leading cause of death in children <5 yrs worldwide! Acute diarrhea is defined as the abrupt onset of abnormally high fluid content in the stool with increased volume or frequency. As supported by the World Health Organization (WHO), “acute” diarrhea has a sudden onset and lasts no longer than 14 days; “chronic” or “persistent” diarrhea

2018 CandiEM

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