Pediatric emergency care
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Pediatric emergency care · Aug 1996
Prediction of childhood drowning and near-drowning morbidity and mortality.
(a) Evaluate the presenting hemodynamic status and neurologic function of a series of warm water submersion injuries. (b) To ascertain the importance of the timing of the neurologic examination. (c) To identify risk factors that predict which patients will not return to presubmersion status. ⋯ Hemodynamic status in the ED and neurologic status in the PICU are highly predictive of outcome. On arrival to the ED, the cardiovascular status is more predictive of abnormal outcome than neurologic status. Poor neurologic outcome appears inevitable for warm water submersion victims who are asystolic at ED arrival and remain comatose for more than 200 minutes.
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This case report of camphor ingestion in a 15-month-old child illustrates the potential toxicity of a common household product. Details of the patient presentation are reported along with a review of the literature. ⋯ Readily available medicated ointments containing camphor have potential for serious or fatal consequences when ingested by children.
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Pediatric emergency care · Aug 1996
Comparative StudyInitial end-tidal CO2 is markedly elevated during cardiopulmonary resuscitation after asphyxial cardiac arrest.
To compare the initial end-tidal CO2 (PetCO2) during cardiopulmonary resuscitation in asphyxial versus ventricular fibrillatory cardiac arrest. ⋯ End-tidal CO2 during the first five breaths of CPR is much higher after an asphyxial cardiac arrest than VF. In each case, the initial PetCO2 appears to reflect alveolar CO2 prior to CPR. After one minute of CPR, PetCO2 is useful in monitoring the effectiveness of CPR.
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Pediatric emergency care · Aug 1996
Review Case ReportsStaphylococcal tracheitis, pneumonia, and adult respiratory distress syndrome.
A child initially seen in the emergency department with respiratory distress was diagnosed with viral laryngotracheitis and discharged home on oral steroids. She returned the following day without abatement of her symptoms and was admitted with upper airway obstruction and pneumonia. ⋯ Hemodynamic instability and severe parenchymal lung disease ensued from septic shock and adult respiratory distress syndrome requiring inotropic support and assisted ventilation. Oscillatory ventilation was instituted when the patient failed conventional ventilation.
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Pediatric emergency care · Aug 1996
Randomized Controlled Trial Clinical TrialDelivery of albuterol in a pediatric emergency department.
To determine if albuterol delivery by the combination of a metered-dose inhaler (MDI) with a spacer is equal in effectiveness to nebulization in a pediatric emergency department setting. ⋯ In a pediatric emergency department setting, aerosolized albuterol delivered by MDI-spacer was equal in effectiveness to nebulization in the acute asthma management of children > or = six years of age.