Emergency medicine clinics of North America
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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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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
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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Seizures are a commonly encountered condition within the emergency department and, because of this, can engender complacency on the part of the physicians and staff. Unfortunately, there is significant associated morbidity and mortality with seizures, and they should never be regarded as routine. This point is particularly important with respect to seizures in pediatric patients. The aim of this review is to provide a current view of the various issues that make pediatric seizures unique and to help elucidate emergent evaluation and management strategies.