Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Aug 2013
ReviewCommon indications for pediatric antibiotic prophylaxis.
Antimicrobial prophylaxis prevents infection and/or complications of infection, and is a routine practice for defined procedures in the hospital. Emergency rooms and pediatric acute care facilities do not have automated procedures for antimicrobial prophylaxis in place. ⋯ Common indications for antimicrobial prophylaxis in the pediatric acute care setting include traumatic wounds, meningococcal exposures, pertussis exposures, and influenza exposures. For each of these indications, the assessment, management and disposition of pediatric patients are reviewed.
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Emerg. Med. Clin. North Am. · Aug 2013
ReviewRisk stratification and management of the febrile young child.
Febrile young children present frequently to the emergency department. While most febrile children recover uneventfully, certain subgroups are at higher risk of serious infection. ⋯ Diagnostic testing can be utilized in older patients to identify children at low risk and high risk for serious infection. This information may assist in determining the treatment and disposition of these febrile children.
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Early recognition of sepsis and septic shock in children relies on obtaining an attentive clinical history, accurate vital signs, and a physical examination focused on mental status, work of breathing, and circulatory status. Laboratory tests may support the diagnosis but are not reliable in isolation. ⋯ Mortality is significantly better among children when managed appropriately. Every physician who cares for children must strive to have a high level of suspicion and keen clinical acumen for recognizing the rare but potentially seriously ill child.
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Child abuse presents commonly to emergency departments. Emergency providers are confronted with medical, social, and legal dilemmas with each case. ⋯ Emergency providers are mandatory reporters of a reasonable suspicion of abuse. The role of the emergency provider is to identify abuse, facilitate a thorough investigation, treat medical needs, protect the patient, provide an unbiased medical consultation to law enforcement, and to provide an ethical testimony if called to court.
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Otolaryngology (ear, nose, and throat) emergencies are a common complaint in the emergency department. These can present as a result of infection, trauma, foreign bodies, or postprocedure complications. The emergency department physician is called on to offer initial if not definitive management of these patients. This article discusses common ear, nose, and throat emergencies presenting to the emergency department.