Pediatric emergency care
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Pediatric emergency care · Dec 1998
Review Case ReportsDelayed diagnosis of splenic injury after falls from less than 10 feet.
Splenic injury is the most common abdominal organ injury in children who sustain blunt trauma and may result from apparently minor injuries. We present two cases of delayed diagnosis of splenic injury in children who fell from a moderate height of less than 10 feet. Careful physical examination and close follow-up with reevaluation are necessary to identify children with possible splenic injury after relatively minor blunt trauma.
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Pediatric emergency care · Dec 1998
Comparative StudySedation of pediatric patients for minor laceration repair: effect on length of emergency department stay and patient charges.
Sedating children can facilitate minor laceration repair by minimizing physical and psychic discomfort. However, some clinicians are reluctant to use sedation, in part because of concern about increased patient charges and fear that the emergency department (ED) stay will be prolonged. The purpose of this study was to determine the extent to which sedative use during the repair of simple facial lacerations in children increased the length of ED stay and patient charges. ⋯ The results of this study demonstrate that sedation with ketamine or midazolam increases the length of ED stay compared with using no sedation. However, the increased lengths of stay were modest, particularly for midazolam. Fear of prolonged recovery time should not dissuade clinicians from using either sedative for minor procedures. The patient charges are considerably higher with both midazolam and ketamine, but they may not reflect the actual cost of patient care.
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Pediatric emergency care · Dec 1998
Review Case ReportsPeripherally inserted central venous catheter fracture and embolization to the lung.
We report an adolescent patient with a peripherally inserted central venous catheter fracture and subsequent migration of the catheter fragment through the heart and into the lower lobe of the right lung. Physical findings were unremarkable for indications of this pulmonary embolization. With the increasing use of such devices for prolonged venous access, the practicing pediatric emergency physician should be aware of this potential complication.
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Pediatric emergency care · Dec 1998
Review Randomized Controlled Trial Clinical TrialUse of topical lidocaine in pediatric laceration repair: a review of topical anesthetics.
To determine whether application of topical aqueous lidocaine to a laceration attenuates the pain from the subsequent lidocaine injection in children. ⋯ For children, soaking a simple laceration with 1% lidocaine does not decrease pain from the subsequent lidocaine injection.
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With the increase in popularity of adult methamphetamine abuse in the state of Arizona, there has been an increase in the number of pediatric admissions from inadvertent methamphetamine poisoning. This report describes the signs and symptoms and the hospital course of pediatric patients inadvertently poisoned with methamphetamine. A nine-year retrospective chart review identified 18 pediatric patients poisoned only with methamphetamine. ⋯ Three patients received Centruroides sculpturatus antivenin intravenously. The most common complication of methamphetamine poisoning was rhabdomyolysis (two patients), and the average hospital stay for all patients was three days. This case series demonstrates that pediatric patients who ingest methamphetamine can present with signs and symptoms similar to those of an abdominal or neurologic pediatric emergency.