Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Aug 2013
ReviewPediatric ultrasound: applications in the emergency department.
Bedside ultrasound (US) was introduced to the emergency department more than 20 years ago. Since this time, many new applications have evolved to aid the emergency physician in diagnostic, procedural, and therapeutic interventions and the scope of bedside ultrasound continues to grow. ⋯ Consequently, US has been adopted by many pediatric emergency providers. This article reviews the use of bedside ultrasound in pediatric emergency medicine.
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Sedation and analgesia are vital components of pediatric emergency care. When children present to the emergency department injured, it may be difficult to administer care secondary to the child's anxiety, pain, lack of cooperation, and pressure by the parents to alleviate the child's discomfort. There is much in the emergency physician armamentarium to address these circumstances and provide excellent care, safely.
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Emerg. Med. Clin. North Am. · Aug 2013
ReviewDiabetic ketoacidosis in the pediatric emergency department.
Despite many advances, the incidence of pediatric-onset diabetes and diabetic ketoacidosis (DKA) is increasing. Diabetes mellitus is 1 of the most common chronic pediatric illnesses and, along with DKA, is associated with significant cost and morbidity. ⋯ When DKA is recognized and treated immediately, the prognosis is excellent. However, when a patient has prolonged or multiple courses of DKA or if DKA is complicated by cerebral edema, the results can be devastating.
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The diagnosis and management of pediatric cardiac emergencies can be challenging and complicated. Early presentations are usually the result of ductal-dependent lesions and appear with cyanosis and shock. Later presentations are the result of volume overload or pump failure and present with signs of congestive heart failure. Acquired diseases also present as congestive heart failure or arrhythmias.
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Pediatric trauma evaluation mimics adult stabilization in that it is best accomplished with a focused and systematic approach. Attention to developmental differences, anatomic and physiologic nuances, and patterns of injury equip emergency physicians to stabilize and manage pediatric injury.