To report a case of Noonan syndrome with multiple lentigines with unusual ocular features.

The authors describe a case of a Seven-year-old girl with Noonan syndrome with multiple lentigines and anomalous optic discs.

A Seven-year-old girl with genetically proven Noonan syndrome with multiple lentigines (PTPN11 gene mutation) and anomalous optic discs was referred for treatment of persistent macular detachment after 1 year of conservative follow up. The right eye demonstrated an optic disc coloboma with best-corrected visual acuity of 20/32, the left eye demonstrated an optic disc pit with serous macular detachment (best-corrected visual acuity 20/50 – 20/80). Optical coherence tomography demonstrated a neurosensory detachment. 25 gauge pars plana vitrectomy was performed with posterior hyaloid detachment, drainage over disc pit area and SF6 20% gas tamponade. Surgery resulted in subretinal fluid reduction and improvement of visual acuity to 20/32.

A case of Noonan syndrome with multiple lentigines with optic disc coloboma in the right eye and optic disc pit with related maculopathy in the left eye. To the authors’ knowledge, this is the first reported case describing the association of Noonan syndrome with multiple lentigines and congenital optic disc anomalies. Optic disc pit maculopathy was managed surgically due to its longstanding nature with deteriorating visual acuity.

A case of Noonan syndrome with multiple lentigines with optic disc coloboma in the right eye and optic disc pit with related maculopathy in the left eye. To the authors’ knowledge, this is the first reported case describing the association of Noonan syndrome with multiple lentigines and congenital optic disc anomalies. Optic disc pit maculopathy was managed surgically due to its longstanding nature with deteriorating visual acuity.

The SARS-CoV-2 coronavirus (COVID-19) pandemic is impacting post-acute inpatient rehabilitation nursing practice from preadmission assessment to inpatient care delivery and transition planning. Saracatinib in vitro Patients with disability following COVID-19 require interventions to address respiratory, cardiovascular, neurological, musculoskeletal, and psychosocial issues. The pandemic has resulted in changes to program structures and how inpatient rehabilitation facilities approach family caregiver engagement amidst visitation restrictions. Technology solutions can be utilized to reduce the patient and their family’s feelings of isolation and support caregiver preparation for discharge. Nurse leaders are essential in supporting staff during this crisis through authentic presence and providing resources and training. Rehabilitation nurses are key in helping patients and families manage rehabilitation and the aftermath of COVID-19 to restore optimal functioning. In this clinical consultation, we synthesize insights learned fromn nurses are key in helping patients and families manage rehabilitation and the aftermath of COVID-19 to restore optimal functioning. In this clinical consultation, we synthesize insights learned from the COVID-19 responses at three inpatient rehabilitation facilities. We describe the impact of rehabilitation nursing interventions to improve outcomes for patients with COVID-19 and their caregivers.

Fractures of the radius and ulna are very common in pediatric patients. Procedural sedation or general anesthesia is typically required to perform orthopedic reductions. There are several studies in the adult literature that conclude that point-of-care ultrasound-guided hematoma blocks are faster and just as efficacious as procedural sedation for reducing fractures in the emergency department. There is currently no literature examining point-of-care ultrasound-guided hematoma blocks in pediatric patients. This case describes a pediatric patient with a distal radius fracture who underwent a hematoma block under ultrasound guidance and had a successful bedside reduction without the need for sedation.

Fractures of the radius and ulna are very common in pediatric patients. Procedural sedation or general anesthesia is typically required to perform orthopedic reductions. There are several studies in the adult literature that conclude that point-of-care ultrasound-guided hematoma blocks are faster and just as efficacious as procedural sedation for reducing fractures in the emergency department. There is currently no literature examining point-of-care ultrasound-guided hematoma blocks in pediatric patients. This case describes a pediatric patient with a distal radius fracture who underwent a hematoma block under ultrasound guidance and had a successful bedside reduction without the need for sedation.

This study aimed to evaluate the impact of adding video conferencing to dispatcher-assisted telephone cardiopulmonary resuscitation (CPR) on pediatric bystander CPR quality.

We conducted a prospective, randomized manikin study among volunteers with no CPR training and among bachelor nurses. Volunteers randomly received either video or audio assistance in a 6-minute pediatric cardiac arrest scenario. The main outcome measures were the results of the Cardiff Test to assess compression and ventilation performance.

Of 255 candidates assessed for eligibility, 120 subjects were randomly assigned to 1 of the 4 following groups untrained telephone-guided (U-T; n = 30) or video-guided (U-V; n = 30) groups and trained telephone-guided (T-T; n = 30) or video-guided (T-V; n = 30) groups. Cardiac arrest was appropriately identified in 86.7% of the U-T group and in 100% in the other groups (P = 0.0061). Hand positioning was adequate in 76.7% of T-T, 80% of T-V, and 60% of U-V, as compared with 23.4% of the U-T group ation quality and its effectiveness.The number of psychiatric encounters is steadily increasing across all pediatric emergency departments. Based on this growing national crisis, we hypothesized there is a lack of robust education in behavioral/mental health emergencies during pediatric emergency medicine (PEM) fellowship.

This was a cross-sectional survey of PEM fellowship directors. The survey was submitted to the Pediatric Emergency Medicine Program Director Survey Committee via REDCap to all 83 fellowship directors.

Fifty-five (66%) PEM fellowship directors completed the survey from September 2019 to December 2019. Forty-three (78%) programs provide some type of didactic teaching, although only 7 (13%) programs offer more than 5 hours of didactics over 3 years of fellowship. Six (11%) programs offer electronic resources, 13 (24%) offer simulations in psychiatry, and only 4 (7%) programs require any type of psychiatry rotation. Forty-six (84%) programs do not currently use psychiatric emergencies as a competency for evaluating PEM fellows.