Pediatric emergency care
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New onset wheezing in the young child can present an interesting differential diagnostic challenge, especially when there is an atypical presentation of a foreign body lodged in the airway. A thorough history and physical examination helps, but one must remember that a foreign body in the trachea or esophagus can masquerade as a respiratory illness. The chest x-ray is a useful part of the evaluation process. A high degree of suspicion is necessary on the part of the physician to remember that "all that wheezes is not asthma," even in the absence of a history of aspiration of a foreign body.
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Pediatric emergency care · Jun 1990
Critical care interhospital transports: predictability of the need for a pediatrician.
The Children's Hospital of Alabama Critical Care Transport System provides a mobile intensive care unit for interhospital transfer of critically ill pediatric patients. The transport team consists of a pediatrician, a pediatric emergency nurse, and a respiratory therapist. We studied whether it was possible to determine in advance whether it was always necessary for a physician to be on the team. ⋯ Therefore, an accurate prediction of need for a physician was possible in advance. Of the remaining transports in which the determination was significantly changed, 37 (25%) indicated a decrease in actual need for a physician after completion of the transport. There was a significant increase over the prediction in the actual need for a physician in only three cases (2%).
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Pediatric emergency care · Jun 1990
Conscious sedation of the pediatric patient for suturing: a survey.
No single drug or combination of drugs was used routinely in pediatric emergency departments to sedate children for suturing. A meperidine-promethazine-chlorpromazine "cocktail" was chosen most frequently. ⋯ The American Academy of Pediatrics (AAP) guidelines for the elective use of conscious sedation, specifically, those regarding monitoring during sedation and discharge post sedation, were not adhered to uniformly. Further study of conscious sedation in children is needed.
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Hypothermia in infancy is not uncommon among the low socioeconomic population in various parts of the world. It is prevalent in Israel and is associated with severe morbidity and mortality. We tried to identify neonates at risk among the population of the Negev district of Israel. ⋯ The neonates belonged to two distinct ethnic groups, Bedouins and Jews, and were compared with 120 healthy controls of similar background. Our data show that premature infants and babies with low birth weight born during the cold season to young (inexperienced) mothers of lower socioeconomic strata and who sustained perinatal morbidity are at risk for IH. It is suggested that parents of infants at risk should be approached while the baby is till in the nursery, be advised about the possibility of hypothermia, and institute the appropriate preventive measures.