Pediatric emergency care
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Pediatric emergency care · Dec 1997
Comparative StudyBoomerang babies: emergency department utilization by early discharge neonates.
Since 1987 the average length of stay for infants following hospital delivery has decreased 1.8 days. This study was undertaken to evaluate the null hypothesis that early discharge of newborns from nurseries does not result in increased emergency department (ED) utilization during the first 10 days of life. SITE: Thirty community EDs, one university ED. ⋯ The null hypothesis is rejected. Early discharge of neonates does result in increased ED utilization. No increase in admission rates for these infants was documented, indicating that patient severity did not increase with ED utilization. There is a need for improved predischarge education and greater access for episodic ambulatory complaints.
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Pediatric emergency care · Dec 1997
Review Case ReportsExertional rhabdomyolysis in an adolescent athlete.
Exertional rhabdomyolysis has been previously reported in adult patients following such strenuous activities as military basic training, weight lifting, and marathon running. Exertional rhabdomyolysis in previously healthy pediatric athletes, however, is rarely encountered. ⋯ Thus, the emergency physician must have a high index of suspicion for this entity based on the appropriate clinical setting. We report a classic case of exercise-induced rhabdomyolysis complicated by acute renal failure in a previously healthy adolescent athlete, whose initial presentation was nonspecific, prompting the diagnosis of overexertion.
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Acute pediatric elbow trauma is commonly seen in the emergency department (ED). Reports confirm that, compared to other fractures, children's elbow fractures are commonly misdiagnosed in the ED. In addition, missed orthopedic injuries are one of the leading causes of malpractice claims in emergency medicine. ⋯ Acute neurovascular injury is frequently associated with these injuries, but is often difficult to assess in an apprehensive child. Immediate orthopedic consultation is indicated for any child with an elbow injury in whom neurologic or vascular compromise is suspected. Consultation should be strongly considered for children with displaced supracondylar fractures and/or significant echymosis and swelling about the cubital fossa.
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Pediatric emergency care · Dec 1997
Long-term functional outcome of inpatient pediatric cardiopulmonary resuscitation.
There is limited information published regarding the long-term outcome of pediatric survivors of inpatient cardiopulmonary resuscitation (CPR). The purpose of this study was to document the long-term (i.e., > or = 1 year after the arrest) functional outcome of children surviving inpatient CPR. ⋯ Survival of inpatient pediatric CPR is small. Children surviving inpatient advanced CPR may have little or no change from prearrest function. The survival of hospitalized children with sepsis syndrome requiring CPR or receiving greater than > 30 min of advanced CPR is extremely low.
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Pediatric emergency care · Dec 1997
Case ReportsNeonatal transphyseal supracondylar fracture detected by ultrasound.
Fractures in young infants are often difficult to detect on plain radiographs when they involve the cartilaginous growth plate. We report a case of a neonatal transphyseal fracture which was detected by the use of ultrasound and magnetic resonance imaging. With shortened postnatal hospitalization becoming increasingly common, these and other birth injuries are more likely to present for the first time in the emergency department. The authors recommend the use of ultrasound as the screening modality of choice in the emergency department.