Pediatric emergency care
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Pediatric emergency care · Aug 1998
Review Case ReportsAn unusual complication of endotracheal intubation: ingestion of a laryngoscope bulb.
Many well described complications can result from endotracheal intubation in neonates during resuscitation. Ingestion of a laryngoscope bulb is a rare event with potentially serious consequences. We are reporting this unusual complication in a neonate during delivery room resuscitation and point to the importance of checking the integrity of the equipment prior to resuscitative efforts.
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Pediatric emergency care · Aug 1998
Comparative StudyPediatric ambulance utilization in a large American city: a systems analysis approach.
Research on utilization of ambulances by pediatric patients lacks an objective, reproducible tool for the evaluation of patterns of ambulance use by both the providers and the users of this resource. ⋯ The PANE tool compared favorably to admission rates as a measure of the severity of illness of patients arriving by ambulance. Applying the PANE tool, we conclude that the majority of requests for ambulances are appropriate, and that the majority of the time dispatchers were able to dispatch the appropriate level of care. However, there is room for significant improvement in utilization of ambulances, and tools like the PANE will be useful in achieving this goal.
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Pediatric emergency care · Aug 1998
Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant.
The differentiation of severe systemic infection, such as sepsis or meningitis, from a congenital obstructive left heart abnormality presents a unique challenge to clinicians responsible for the care of such infants in the first few weeks of life. Clinical findings are very similar in the two populations. Failure to identify the need for specific intervention, such as prostaglandin administration, by the primary care or emergency physician may result in increased morbidity or death in these infants. ⋯ We conclude that while it is very difficult to differentiate these two groups at presentation, early clinical suspicion of COLHS with attention to key clinical parameters identified in this study may expedite appropriate intervention and enhance outcome. The multivariate model derived may provide a template from which further research can elucidate a more clinically useful tool for the clinician.
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Pediatric emergency care · Aug 1998
Unexpected second foreign bodies in pediatric esophageal coin ingestions.
To determine the frequency of unexpected second foreign bodies in children who present to the pediatric emergency department with esophageal coin impaction. ⋯ Unexpected second foreign bodies in pediatric esophageal coin ingestions with adequate radiographic studies are rare and generally do not cause significant esophageal injury.