Emergency medicine clinics of North America
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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.
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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.