Perceptions of telemedicine at a pediatric otolaryngology-head and neck surgery program

Objective With few studies investigating the effectiveness of telemedicine(TM)in pediatric otolaryngology(ear,nose,and throat;ENT),its role in clinical practice is unclear.The objective of this study was to investigate provider perspectives regarding utility of TM in pediatric ENT practice.Methods A survey gauging the relative merits of TM visits for common pediatric ENT chief complaints and postoperative visits was distributed to all pediatric ENT providers at a tertiary care,free-standing children’s hospital.Respondents were asked to assess the effectiveness of TM visits compared with in-person visits for completing the following tasks:history collection,physical examination,medical decision-making,and patient counseling.Results Providers rated TM visits as less useful than in-person visits for completing the most predefined tasks but did identify advantages in history taking via TM for the majority of complaints.Compared with providers with≥10 years of experience,those with<10 years of experience found TM to be more effective than the in-person appointment for making clinical decisions for patients presenting with recurrent/chronic pharyngitis,neck masses,and stridor/noisy breathing.Opinions regarding the utility of TM for postoperative visits were mixed,with adenoidectomy,tonsillectomy and superficial procedures being most frequently deemed appropriate for TM.Conclusions The introduction of TM to pediatric ENT faces limitations in detailed examination of areas not accessible without specialized instrumentation.Due to its strength in history taking,results suggest an asynchronous,‘store and forward’encounter followed by an in-person physical examination to confirm the diagnosis and treatment plan could be beneficial.

Pediatric dog bite injuries in the USA: a systematic review

Introduction Dog bites are one of the leading causes of non-fatal emergency room visits in children.These injuries not only cause physical harm but can lead to long-term psychological stress.This study evaluated the current literature related to pediatric dog bite injuries to identify research gaps which should be prioritized to improve a major public health concern.Methods We performed a keyword search of PubMed,Scopus,and OVID Medline databases(January 1980-March 2020)for all published studies focused on dog bite injuries in the pediatric population(≤18 years of age)using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Results Out of 1859 abstracts screened,43 studies involving 86880 patients were included.Twenty-nine studies were retrospective chart reviews characterizing the epidemiology of dog bites and their associated treatment outcomes;six were prospective cohort studies;two were cross-sectional studies;and six were experimental studies.Synthesized results demonstrate that children<9 years of age suffer the greatest burden of injuries,with children<6 years of age at higher risk of more severe injuries involving the head,neck,and face.Conclusion Studies analyzing the prevention or psychosocial consequences of dog bites injuries are needed.