| Effect of bedside ultrasound on management of pediatric soft-tissue infection. | |
| | |
MedLine Citation:
|
PMID: 19665335 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
BACKGROUND: Superficial soft-tissue infections (SSTI) are frequently managed in the emergency department (ED). Soft-tissue bedside ultrasound (BUS) for SSTI has not been specifically studied in the pediatric ED setting. OBJECTIVE: To evaluate the effect of a soft-tissue BUS evaluation on the clinical diagnosis and management of pediatric superficial soft-tissue infection. METHODS: We conducted a prospective observational study in two urban academic pediatric EDs. Eligible patients were aged < 18 years presenting with suspected SSTI. Before BUS, treating physicians were asked to assess the likelihood of subcutaneous fluid collection and whether further treatment would require medical management or invasive management. A trained emergency physician then performed a BUS of the lesion(s). A post-test questionnaire assessed whether the physician changed the initial management plan based on the results of the BUS. RESULTS: BUS changed management in 11/50 cases. After initial clinical assessment, 20 patients were designated to receive invasive management, whereas the remaining 30 patients were designated to receive medical management. Management changed in 6/20 in the invasive group. In the medical group, 5/30 patients changed management. BUS had a sensitivity of 90% (95% confidence interval [CI] 77-100%) and specificity of 83% (05% CI 70-97%), whereas clinical suspicion had a sensitivity of 75% (95% CI 56-94%) and specificity of 80% (95% CI 66-94%) in detecting fluid collections requiring drainage. CONCLUSIONS: BUS evaluation of pediatric SSTI may be a useful clinical adjunct for the emergency physician. It changed management in 22% of cases by detecting subclinical abscesses or avoiding unnecessary invasive procedures. |
| | |
Authors:
|
Adam B Sivitz; Samuel H F Lam; Daniela Ramirez-Schrempp; Jonathan H Valente; Arun D Nagdev |
Related Documents
:
|
8142095 - Management of tracheobronchial and esophageal foreign bodies in children: a survey study. 16381445 - Practice management for the fee-for-service pediatric dentist. 9310535 - The university of massachusetts medical center office-based continuity experience: are ... 19059095 - Pediatric airway management. 8142095 - Management of tracheobronchial and esophageal foreign bodies in children: a survey study. 8517815 - The uncertainties of clinical practice. |
Publication Detail:
|
Type: Journal Article Date: 2009-08-08 |
Journal Detail:
|
Title: The Journal of emergency medicine Volume: 39 ISSN: 0736-4679 ISO Abbreviation: J Emerg Med Publication Date: 2010 Nov |
Date Detail:
|
Created Date: 2010-10-25 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: United States |
Other Details:
|
Languages: eng Pagination: 637-43 Citation Subset: IM |
Copyright Information:
|
Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Emergency Medicine, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Construction of identification system for non-invasive analysis of macrolides tablets using near inf...
Next Document: Development and preliminary evaluation of a cognitive behavioural approach to fatigue management in ...