Emergency medicine clinics of North America
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In the clinical setting, dehydration implies loss of both water and electrolytes. This is indeed what occurs in diarrhea, which is the most common cause of dehydration in children. The treatment of diarrhea is detailed first, followed by consideration of several less common conditions leading to dehydration in early infancy, including acute adrenal insufficiency and pyloric stenosis.
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Information specific to the rapid resuscitation of pediatric patients is detailed and treatment of injury to specific systems, including the chest, abdomen, urinary tract, and diaphragm and esophagus, is described.
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Acute hematologic-oncologic problems fall into two groups, those that require immediate assessment, diagnosis, and therapy, and those that require attention but are not life threatening if treated appropriately. Both types are considered in this article, which discusses hemorrhagic disorders; anemias, with special emphasis on patients with sickle cell disease; an approach to fever and infection in the immunocompromised child; and oncologic disorders that may be life threatening.
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The suicidal child and adolescent present significant diagnostic and dispositional problems. The diagnosis and treatment of such patients by emergency room physicians are likely and essential. As precise a diagnosis as possible is critical to the appropriate treatment. Consultation with a psychiatric resource should be sought when any uncertainty exists.