Pediatric emergency care
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Pediatric emergency care · Feb 2000
Pediatric advanced life support training of pediatricians in New Jersey: cause for concern?
The Pediatric Advanced Life Support (PALS) course teaches the fundamental basics for pediatric emergency care, and it is recommended that all physicians, nurses, and paramedics who care for children complete training and refresher courses on a regular basis. The purpose of this study was to determine how many pediatricians in general practice participated in PALS courses in the first 3 years since its introduction in New Jersey. ⋯ The majority of those students who participated in PALS training were not physicians. Pediatricians in general office practice accounted for a small percentage of those who could have participated. Further research should be conducted to determine attitudes toward PALS training and the barriers that exist to the office-based pediatrician participating in PALS training.
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Pediatric emergency care · Feb 2000
Comparative StudyComparison of intubation skills between interfacility transport team members.
To compare intubation skill level and success rate between interfacility transport team members. ⋯ In our experience, RCPs on the interfacility transport team were very successful in performing endotracheal intubations and were more successful than resident physicians. RCPs are established members of not only the transport team, but also the intensive care units and, therefore, should be considered qualified to routinely perform endotracheal intubations in those settings as well.
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Pediatric emergency care · Feb 2000
Review Case ReportsNon-Q wave acute myocardial infarction in acute meningococcemia in a 10-year-old girl.
Children with acute meningococcemia may have impaired myocardial function resulting in low cardiac output despite normal intravascular volume. Severe meningococcal infection has been associated with acute interstitial myocarditis, endocarditis, and pericarditis, but not with myocardial infarction. ⋯ This is the first pediatric case of non-Q wave acute myocardial infarction associated with purpura fulminans in meningococcemia. Similarly, the association of high troponin I levels and meningococcemia has not been described previously. Although, the patient's genetic predisposition for myocardial infarction might have been a potential contributing factor, there was no angiographic evidence of coronary artery disease in this patient. Thereby, other factors related to shock, endotoxin, microthrombi of meningococcemia, and their treatment might have been also contributing. We propose possible mechanisms for this rare but serious complication of meningococcemia and review the literature.
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Pediatric emergency care · Feb 2000
Pediatric emergency department nurses' perspectives on fever in children.
Fever is the most common complaint of children seen in a Pediatric Emergency Department (PED). Since pediatric emergency nurses commonly educate parents on fever management, this study sought to examine their knowledge base regarding fever in children. ⋯ Fever phobia and inconsistent treatment approaches occur among experienced pediatric emergency registered nurses. These phobias and inconsistencies subsequently could be conveyed to parents. In order to assure accurate parental education, PEDs should educate their medical team regarding the management of fever in children.
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Pediatric emergency care · Feb 2000
The safety of etomidate for emergency rapid sequence intubation of pediatric patients.
To determine whether pediatric patients given etomidate for rapid sequence intubation (RSI) in the ED develop clinically important hypotension or adrenal insufficiency. ⋯ We found no evidence of clinically important adrenocorticoid suppression and a low incidence of clinically important hypotension when using etomidate for emergent pediatric RSI. Because other induction agents may also result in hypotension, prospective comparison studies are needed to further evaluate the safety of etomidate in this patient population.