Assuntos
Mordeduras e Picadas/epidemiologia , Infecções por Coronavirus/epidemiologia , Cães , Pneumonia Viral/epidemiologia , Animais , Betacoronavirus , Mordeduras e Picadas/prevenção & controle , COVID-19 , Criança , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Pandemias , SARS-CoV-2 , Estresse PsicológicoRESUMO
OBJECTIVE: To determine if troponin I is more often elevated in children with suspected nonaccidental trauma (NAT) compared with uninjured children of similar age, and describe associations between troponin I elevation and NAT injuries. STUDY DESIGN: Prospective 2-group study of children less than 2 years of age presenting to the emergency department with nonaccidental abdominal, thoracic, or intracranial injuries, and similarly aged uninjured children. Primary outcome was serum troponin I (≥ 0.04 ng/mL) using frozen blood samples from the 2 groups. Secondary outcomes included descriptive analyses of age, injury characteristics, and clinical appearance. RESULTS: There were 129 subjects; 60 injured patients and 69 uninjured patients. Groups had similar age and sex. Troponin I was elevated in 38% of injured children compared with 17% of uninjured children (P = .008). No uninjured patient over 3 months of age had elevated troponin I. Abdominal trauma, acute rib fractures, or the child's ill-appearance in the emergency department were associated with having elevated troponin I. CONCLUSIONS: Troponin I is more often elevated in children with suspected NAT than uninjured children. Elevation of troponin I in children greater than 3 months of age with suspected NAT is concerning for trauma. Occult cardiac injury is more likely to occur in children with inflicted abdominal trauma, acute rib fractures, or ill appearance.
Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Troponina I/sangue , Ferimentos e Lesões/sangue , Biomarcadores/sangue , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Humanos , Lactente , Masculino , Estudos ProspectivosRESUMO
OBJECTIVES: To determine what children know about preventing dog bites and to identify parental desires for dog bite prevention education. STUDY DESIGN: This cross-sectional study sampled 5- to 15-year-olds and their parents/guardians presenting to a pediatric emergency department with nonurgent complaints or dog bites. The parent/guardian-child pairs completed surveys and knowledge-based simulated scenario tests developed on the basis of American Academy of Pediatrics and Centers for Disease Control and Prevention dog bite prevention recommendations. Regression analyses modeled knowledge test scores and probability of passing; a passing score was ≥11 of 14 questions. RESULTS: Of 300 parent/guardian-child pairs, 43% of children failed the knowledge test. Older children had higher odds of passing the knowledge test than younger children, as did children with white parents vs those with nonwhite parents. No associations were found between knowledge scores and other sociodemographic or experiential factors. More than 70% of children had never received dog bite prevention education, although 88% of parents desired it. CONCLUSIONS: Dog bites are preventable injures that disproportionately affect children. Dog bite prevention knowledge in our sample was poor, particularly among younger children and children with nonwhite parents. Formal dog bite prevention education is warranted and welcomed by a majority of parents.