Emergency medicine clinics of North America
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The success rate for cardiopulmonary resuscitation (CPR) in children is dismal. This review discusses the physiology of CPR, the basis for pharmacologic therapy, and the rationale for advanced interventions. It focuses attention on those areas in which research indicates hope for improved outcomes.
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Providing sedation and analgesia is an integral part of emergency care for children. To become facile at pediatric pain control and sedation, clinicians must develop expertise regarding proper monitoring, drugs and doses, potential side effects, and strategies to select the best agent for a given procedure and clinical setting. Currently available agents, methods, and monitoring guidelines are reviewed with an emphasis on conscious sedation.
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Although laryngotracheobronchitis is the most common upper respiratory tract disorder in pediatrics, several other diseases are potentially life-threatening. The emergency physician must recognize both the obvious and subtle distinctions among upper airway diseases. The status of the patient's airway remains the primary concern regardless of the suspected disorder, but further definitive care depends on the specific disease entity. The prompt recognition and action of both the prehospital care provider and the ED physician in maintaining a critical airway and supporting ventilation until definitive pediatric critical or surgical care can be delivered is essential in ensuring optimal outcome for children suffering from a life-threatening upper airway illness.
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Emerg. Med. Clin. North Am. · May 1995
Historical ArticlePediatric emergency medicine. The history of a growing discipline.
Pediatric emergency medicine is evolving into a more clearly described area of medical care. The historical development and future challenges of this subspecialty are discussed. In addition, emergency care for children is reviewed closely, citing differences in the pediatric populations seen in pediatric emergency departments and general emergency departments.
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Trauma care for children is examined from a demographic perspective. Critical issues, such as "who should care for acutely injured children" and "where should they receive care" are addressed. Specific issues regarding blunt trauma and indications for and outcome of emergency department thoracotomy are discussed also. A strategy for injury prevention is reviewed.