Pediatric emergency care
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Pediatric emergency care · Feb 1999
Case ReportsRecognition and management of Tillaux fractures in adolescents.
Tillaux fractures are relatively uncommon Salter Harris III fractures of the tibia. The importance of recognizing this fracture is that a residual deformity in the joint surface can lead to premature degenerative arthritis. For this reason, it is important that accurate imaging to assess the congruity of the joint, as well as adequate reduction, is obtained. ⋯ The fracture is of great importance because it involves a major weight-bearing articular surface. A residual deformity of the joint surface can lead to premature degenerative arthritis. We present a patient with a Tillaux fracture to elaborate on the mechanism of injury and to summarize the importance of its recognition and imaging and treatment options.
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Pediatric emergency care · Feb 1999
ReviewPriorities for research in emergency medical services for children: results of a consensus conference.
To arrive at a consensus on the priorities for future research in emergency medical services for children. ⋯ The panel was able to develop a list of important topics for future research in emergency medical services for children that can be used by foundations, governmental agencies, and others in setting research agenda for such services.
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Pediatric emergency care · Feb 1999
Comparative StudyParental estimates of their child's weight: accurate for resuscitation drug doses.
The aim of this study was to assess parental reliability in estimating child body weight in emergency situations, when weighing the child is often impossible. ⋯ Parents, especially mothers, can estimate their child's body weight within clinically acceptable limits. These estimations can reliably be used to calculate drug doses in prehospital and emergency department situations, when children's weight is not known and cannot be measured.
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To initiate investigation into the medication errors that occur in a pediatric emergency department. These errors have the potential for significant morbidity and mortality, as well as costly litigation. ⋯ Incorrect recording of patient weights leading to an incorrect medication dose and failure to note drug allergy are common causes for medication errors in the pediatric emergency department. Incorrect drugs and i.v. fluids are given because of similar names and packaging. Many of the errors in the ED seem to be preventable.
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Traumatic torticollis is an uncommon complaint in the emergency department (ED). One important cause in children is atlantoaxial rotary subluxation. Most children present with pain, torticollis ("cock-robin" position), and diminished range of motion. ⋯ For minor and acute cases, a soft cervical collar, rest, and analgesics may be sufficient. For more severe cases, the child may be placed on head halter traction, and for long-standing cases, halo traction or even surgical interventions may be indicated. We describe two patients with atlantoaxial rotary subluxation, who presented with torticollis, to illustrate recognition and management in the ED.