Pediatric emergency care
-
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.
-
Pediatric emergency care · Feb 1999
Incidence of bacteremia, urinary tract infections, and unsuspected bacterial meningitis in children with febrile seizures.
To determine the incidence of bacteremia, urinary tract infections, and unsuspected bacterial meningitis in a cohort of children diagnosed with febrile seizures. ⋯ Patients presenting for evaluation of febrile seizures are not at increased risk for bacteremia or urinary tract infections. Bacterial meningitis in the absence of initial laboratory evidence of meningoencephalitis is very uncommon in children diagnosed with febrile seizures.
-
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.
-
Pediatric emergency care · Feb 1999
Case ReportsEmergency cardiopulmonary bypass for cardiac arrest refractory to pediatric advanced life support.
We report the application of emergent cardiopulmonary bypass (CPB) for three pediatric patients in the cardiac catheterization laboratory with cardiac arrest who did not respond to conventional resuscitation efforts. All three patients had return of baseline prearrest rhythms within minutes of the initiation of artificial cardiopulmonary support and the return of spontaneous circulation upon weaning CPB. Two patients had normal neurologic outcomes despite an interval of over 30 minutes from arrest to CPB. The continued judicious application and study of this technology in a small subpopulation of pediatric cardiac arrest patients is warranted.
-
To describe a series of patients seen in a pediatric emergency department with adverse effects following an ingestion of a caterpillar. ⋯ Previously not described, significant adverse effects can occur following ingestion of a caterpillar. In addition, although not previously reported, the caterpillar of the Hickory Tussock moth can cause adverse effects in humans.