Pediatric emergency care
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To define injuries from short vertical falls (SVF) in infants, and to compare those with minor or no injuries to those with significant injury. ⋯ The most common mechanism of a SVF was rolling off a bed. Most patients sustained minor or no injury. No child sustained an intracranial hemorrhage from a SVF. The child with intracranial injury and/or multiple injuries warrants an investigation. Being dropped appears to be a greater risk for significant injury than rolling off or falling from furniture.
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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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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
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.
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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.