Objective This study assessed the efficacy of electrocardiogram (ECG) compared to pulse oximetry (PO) in detecting heart rate (HR) during high-risk newborn resuscitation. Methods A prospective observational study was performed with high-risk delivery cases to measure the time required for HR detection. A conventional PO and a standard ECG monitor were used for HR assessment. Results Forty-one infants were analyzed in the study, and 11 needed resuscitation. The study population was divided according to gestational age (GA): 9 were GA <32 weeks, 28 were GA 32–35 weeks, and 4 were GA ≥36 weeks. Time from ECG placement to HR detection (median, 30 seconds; interquartile range [IQR], 20–43.5 seconds) was significantly faster than that from PO placement (median, 125 seconds; IQR, 100–175 seconds; P<0.001). Time from ECG placement to HR detection was shortest in infants with GA <32 weeks at birth (19 seconds [IQR, 11.5–30.0] for GA <32 weeks vs. 34.5 seconds [IQR, 25.0–44.3] for GA 32–35 weeks vs. 39.5 seconds [IQR, 30.0–64.8] for GA ≥36 weeks; P=0.039). Conclusion ECG effectively evaluated HR during neonatal resuscitation compared to PO. Low- GA infants who require resuscitation may benefit from HR evaluation with nearby standard ECG.
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Results A total of 1,351 patients were included in the analysis, 643 patients from A hospital (derivation set) and 708 patients from B hospital (validation set). In the derivation set, there were more girls and a lower incidence of a past history of UTI, older age, less fever without source, and more family members with upper respiratory symptoms in the viral infection group. The stepwise regression analysis identified sex (uncircumcised male), age (≤12 months), a past history of UTI, and family members with upper respiratory symptoms as significant variables.
Conclusion Young febrile patients in the PED were more likely to have UTIs if they were uncircumcised boys, were younger than 12 months of age, had a past history of UTIs, or did not have families with respiratory infections. This clinical prediction model may help determine whether to perform urinalysis in the PED.
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OBJECTIVE The clavicle is almost always involved in skull X-rays of infants. The objectives of this study were to determine how often the clavicle and clavicle fractures are visible but missed on skull anterior-posterior view (skull AP) of infants and which factors are associated with missing the diagnosis.
MATERIALS AND METHODS: We retrospectively studied about the patients aged 1 year or younger who were taken skull AP for any injury survey at a single urban, academic hospital from April 1999 to July 2012. Outcomes of interest were the numbers and percentage of visible clavicles, clavicle fractures including missed ones on skull AP, and the factors associated with a missing the diagnosis.
RESULTS Both clavicles were visible in 734 patients (89.6%). Of them, 10 cases (1.4%) of clavicle fractures were confirmed and 6 of them (0.8%) were missed at presentation. Although we tried to determine the factors associated to missed diagnoses among age (< 6 months), male sex, blocking by guardian’s hands, associated skull fractures, mechanism of injury, none was significantly associated with clavicle fractures.
CONCLUSION The clavicle was recognizable on skull X-rays in most cases. Therefore one should check the clavicle while reading skull X-rays.
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