Pediatrics – Surgery
Prospective Validation Study: High accuracy of PECARN rules in reducing unnecessary CT scans in pediatric blunt trauma – Lancet Child Adolesc Health
5 May, 2024 | 15:08h | UTCStudy Design and Population:
This multicenter prospective validation study tested the Pediatric Emergency Care Applied Research Network (PECARN) prediction rules aimed at reducing unnecessary CT scans for children presenting with blunt abdominal or minor head trauma. Over a nearly five-year period, children and adolescents under 18 from six U.S. emergency departments in cities including Sacramento, Dallas, and Los Angeles were enrolled. Exclusion criteria included pregnancy, pre-existing neurological disorders, penetrating trauma, injuries older than 24 hours, prior CT or MRI scans, or suspicion of non-accidental trauma.
Main Findings:
A total of 7,542 children with blunt abdominal trauma and 19,999 with minor head trauma were enrolled. The intra-abdominal injury rule demonstrated a sensitivity and negative predictive value (NPV) of 100%, confirming its reliability in detecting injuries requiring acute intervention. For head traumas, the sensitivity varied slightly with age; 100% for children under 2 years and 98.8% for those aged 2 years and older, with an NPV of 100% in both groups. Only two cases in the older cohort were misclassified, neither requiring neurosurgery.
Implications for Practice:
The validation of PECARN rules with high sensitivity and NPV supports their use as a safe guideline to minimize unnecessary CT scans in pediatric trauma cases, thereby promoting efficient use of resources and reducing exposure to radiation in children. These results suggest that implementation of these rules should be considered in emergency pediatric care to improve outcomes and healthcare efficiency.
Reference (link to abstract – $ for full-text):
AAP Policy Statement | Pediatric organ donation and transplantation: across the care continuum
1 Aug, 2023 | 14:26h | UTCPediatric Organ Donation and Transplantation: Across the Care Continuum – Pediatrics
News Release: Policy underscores role of medical home in pediatric organ donation, transplantation – AAP News
AAP Clinical Report | Assessment and management of inguinal hernias in children
10 Jul, 2023 | 13:50h | UTCAssessment and Management of Inguinal Hernias in Children – Pediatrics
News Release: AAP report on managing inguinal hernias addresses common questions, controversies – AAP News
Commentary: AAP issues guidance on inguinal hernias – MDedge
AAP Policy Statement | Child pedestrian safety
10 Jul, 2023 | 13:44h | UTCChild Pedestrian Safety – Pediatrics
Technical Report: Epidemiology and Prevention of Child Pedestrian Injury – Pediatrics
News Release: Speed, technology, road design are key factors in reducing pedestrian injuries – AAP News
Consensus Paper | Transition of patients with esophageal atresia–tracheoesophageal fistula
19 Jun, 2023 | 13:44h | UTCThe International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula – Nature Reviews Gastroenterology & Hepatology (if the link is paywalled, try this one)
Cohort Study | 63.1% of uncomplicated appendicitis in children successfully treated non-operatively at 1 year
15 Jun, 2023 | 14:45h | UTC
Commentary on Twitter
1y outcomes of CASCADE examining💊treatment for uncomp🪱itis in kids ➡️overall success: 63.1%, 21.5% req🔪during hospitalisation, 10.4% recurrence @1y. Overall comp: 7.3%🔪vs. 1.3% in success Non🔪treatment. Thoughts?https://t.co/AuIgSKkU6w#SoMe4Surgery #some4peds #emgensurg pic.twitter.com/9mM5NFOEh1
— BJS Open (@BjsOpen) June 7, 2023
RCT | Ultrasonography noninferior to radiography for pediatric distal forearm fracture diagnosis
14 Jun, 2023 | 14:45h | UTCUltrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Ultrasound breaks new ground for forearm fractures in children – Griffith University
M-A | Inhaled nitrous oxide for painful procedures in children and youth
22 May, 2023 | 13:29h | UTC
Review | Management of gastrointestinal foreign bodies with brief review of the guidelines
24 Feb, 2023 | 13:36h | UTC
Consensus Paper | Pediatric traumatic hemorrhagic shock
17 Feb, 2023 | 13:15h | UTCPreface: Pediatric traumatic hemorrhagic shock consensus conference
Other articles in the supplement:
Pediatric traumatic hemorrhagic shock consensus conference research priorities
Building an optimal pediatric trauma program
Time is tissue: Barriers to timely transfusion after pediatric injury
Resuscitative practices and the use of low-titer group O whole blood in pediatric trauma
Tranexamic acid in pediatric hemorrhagic trauma
Blood banking considerations in pediatric trauma
Detecting traumatic brain injury–induced coagulopathy: What we are testing and what we are not
RCT | Tissue adhesive, adhesive tape, and sutures for skin closure of pediatric surgical wounds
9 Feb, 2023 | 13:35h | UTC
M-A | Enhanced recovery after surgery in children undergoing abdominal surgery
23 Jan, 2023 | 13:12h | UTCEnhanced recovery after surgery in children undergoing abdominal surgery: meta-analysis – BJS Open
AAP Clinical Report | Use of point-of-care ultrasonography in the NICU for diagnostic and procedural purposes
17 Jan, 2023 | 13:32h | UTCUse of Point-of-Care Ultrasonography in the NICU for Diagnostic and Procedural Purposes – Pediatrics
Technical Report: Use of Point-of-Care Ultrasonography in the NICU for Diagnostic and Procedural Purposes – Pediatrics
News Release: AAP Issues Reports on Point-of-care Ultrasonography Applications in the NICU – American Academy of Pediatrics
Commentary on Twitter
https://twitter.com/aap_peds/status/1597612750804598787
Opinion | The American Academy of Pediatrics is pushing drugs and surgery for obesity
17 Jan, 2023 | 13:27h | UTCThe American Academy of Pediatrics is Pushing Drugs & Surgery for Obesity – Sensible Medicine
Original article and commentaries: AAP Guideline | Evaluation and treatment of children and adolescents with obesity
WHO report urges more effective prevention of injuries and violence causing 1 in 12 deaths worldwide.
30 Nov, 2022 | 13:55h | UTCNews Release: WHO urges more effective prevention of injuries and violence causing 1 in 12 deaths worldwide – World Health Organization
Report: Preventing injuries and violence: an overview – World Health Organization
Commentary on Twitter
12,000.
🚗 12,000 people.
🔪 12,000 people die from injuries & violence.
🌊 12,000 people die from injuries & violence around the world.
☠️ 12,000 people die from injuries & violence around the world every day.These deaths can be prevented https://t.co/TRbCFKUcdu pic.twitter.com/DtIyLBat3y
— World Health Organization (WHO) (@WHO) November 29, 2022
Retrospective Cohort Study | Comparative analysis of all-terrain vehicles, motorcycle and automobile-related trauma in a rural community.
25 Nov, 2022 | 12:27h | UTCCommentaries:
Children very vulnerable to severe injury from quad bike use – BMJ Open
More Male, Pediatric Patients Suffer ATV-Related Injury – HealthDay
Related: AAP Recommendations | Prevention of pediatric all-terrain vehicles related deaths and injuries.
Commentary on Twitter
Children are very vulnerable to severe injury from the use of quad bikes, also known as ATVs, finds new research published in the open access journal @BMJ_Open. https://t.co/kjFKRiVgbZ#ATVs #quadbikes pic.twitter.com/njEFhEKgYZ
— BMJ Group (@bmj_company) October 28, 2022
AAP Recommendations | Prevention of pediatric all-terrain vehicles related deaths and injuries.
3 Oct, 2022 | 14:05h | UTCTechnical Report: A Comprehensive Report on All-Terrain Vehicles and Youth: Continuing Challenges for Injury Prevention – Pediatrics
Commentaries:
ATVs Are Not Safe for Children: AAP Policy Explained – Health Children
AAP Calls for Prevention of Pediatric ATV-Linked Deaths, Injuries – HealthDay
Pediatric battery-related emergency department visits in the US: 2010–2019.
21 Sep, 2022 | 13:13h | UTCPediatric Battery-Related Emergency Department Visits in the United States: 2010–2019 – Pediatrics
News Release: New study finds battery-related injuries in children more than doubled in recent decade – Nationwide Children’s Hospital
Commentary: Young Children are Ingesting Dangerous Batteries at an Alarming Rate – Science-Based Medicine
Related:
Position Paper: Diagnosis, management, and prevention of button battery ingestion in childhood.
Airway Complications Resulting From Pediatric Esophageal Button Battery Impaction: A Systematic Review – JAMA Otolaryngology-Head & Neck Surgery (link to abstract – $ for full-text)
Research: Honey May Reduce Injury and Improve Outcomes After Accidental Button Battery Ingestion
Systematic Reviews | Vascular complications in children following button battery ingestions.
21 Sep, 2022 | 13:12h | UTCRelated:
Pediatric Battery-Related Emergency Department Visits in the United States: 2010–2019 – Pediatrics
Position Paper: Diagnosis, management, and prevention of button battery ingestion in childhood.
Airway Complications Resulting From Pediatric Esophageal Button Battery Impaction: A Systematic Review – JAMA Otolaryngology-Head & Neck Surgery (link to abstract – $ for full-text)
Research: Honey May Reduce Injury and Improve Outcomes After Accidental Button Battery Ingestion
Consensus Paper | Pediatric robotic surgery: issues in management.
20 Sep, 2022 | 13:28h | UTC
AAP Policy Statement | Helmet use in preventing head injuries in bicycling, snow sports, and other recreational activities and sports.
19 Sep, 2022 | 12:43h | UTCTechnical Report: Helmet Use in Preventing Head Injuries in Bicycling, Snow Sports, and Other Recreational Activities and Sports – Pediatrics
Commentary: Multifaceted Approach Urged for Promoting Helmet Use for Children – HealthDay
M-A | Evidence on indications and techniques to increase the future liver remnant in children undergoing extended hepatectomy.
22 Jul, 2022 | 11:33h | UTC
RCT | Immobilization of torus fractures of the wrist in children.
4 Jul, 2022 | 12:46h | UTC
Commentary from the author on Twitter (thread – click for more)
The FORCE study is in @TheLancet – https://t.co/oyYvMMxjln has awesome stuff to implement result – ED pathway, animations & patient info leaflets (multiple languages).
Thanks to @PERUKItweep and everyone who made it possible. https://t.co/Wq67MgcQhB pic.twitter.com/mrA03tGzCs
— Dan Perry (@MrDanPerry) July 1, 2022
Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019.
30 Jun, 2022 | 11:28h | UTC
Commentaries on Twitter
(Thread – click for more)
NEW—#GBDstudy Improving road safety measures (helmets, seatbelts, obeying speed limits, and avoiding drunk driving) could save half a million lives every year WORLDWIDE. @TheLancet @LancetPH #RoadSafety#InvestInYouthhttps://t.co/E2RdjazHDF
— Institute for Health Metrics and Evaluation (IHME) (@IHME_UW) June 30, 2022
(Thread – click for more)
Our new research published in @TheLancetPH “highlights the neglect and chronic underinvestment by the global health community to prevent injury-related harms in adolescents.” @UNSW @UNSWMedicine @CforAH @MCRI_for_kids @IHME_UW @georgeinstitute https://t.co/gjbndubxGE
— Dr Amy Peden (@amyepeden) June 29, 2022
Systematic Review: Interventions for treating supracondylar elbow fractures in children.
10 Jun, 2022 | 11:07h | UTCInterventions for treating supracondylar elbow fractures in children – Cochrane Library