Pediatric emergency care
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Pediatric emergency care · Aug 2000
Case ReportsAcute traumatic compartment syndrome of the foot in children.
Acute traumatic compartment syndrome of the foot is a sequelae of serious injury to the foot, which, if unrecognized, may result in significant motor and sensory deficits, pain, stiffness, and deformity. It is nearly always associated with fractures, dislocations, and crush injuries to the foot. Vascular injuries and coagulopathic states are also risk factors for the development of an acute foot compartment syndrome. ⋯ Recognition of the signs and symptoms of compartment syndrome in the emergency room are paramount; the diagnosis is best confirmed by multiple compartment pressure readings. The urgency of diagnosis of a compartment syndrome must be underscored, as the complications of a missed foot compartment syndrome includes contractures, claw toe deformity, sensory loss, stiffness, and chronic pain. Prompt orthopaedic consultation is mandatory; urgent compartment fasciotomies are associated with a good clinical outcome.
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Concussion is the most common head injury occurring in sports participation. Concussions range from a brief period of neural dysfunction to a prolonged period of unconsciousness with retrograde amnesia. It is imperative that the pediatric emergency medicine specialist be familiar with the proper initial assessment of the child or adolescent athlete who has sustained a sports-related concussion, the latest grading scales of concussions, and the current recommendations for returning the athlete to competition. A systematic approach to the athlete who has suffered a concussion will minimize the risk of further injury or mortality.
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Pediatric emergency care · Aug 2000
Comparative StudyA short stay or 23-hour ward in a general and academic children's hospital: are they effective?
We evaluated the usefulness of a short stay or 23-hour ward in a pediatric unit of a large teaching hospital, Westmead Hospital, and an academic Children's hospital, The New Children's Hospital, to determine if they are a useful addition to the emergency service. ⋯ This data demonstrates the robust nature of the short stay ward. At these two very different institutions we have shown improved bed efficient and patient care in a cost-effective way. We have also reported on greater parental satisfaction and early return of the child with their family to the community.
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Pediatric emergency care · Aug 2000
Comparative StudyAppendiceal perforation in children diagnosed in a pediatric emergency department.
To determine the incidence of appendiceal perforation (AP) among children with acute appendicitis (AA) and determine factors associated with AP. ⋯ The rate of AP among pediatric patients with AA is greater among younger children and is associated with vomiting, prolonged illness, and higher body temperatures. Unexpectedly, patients with AP did not have higher total WBC values, more frequent late night arrivals, a longer time interval prior to surgery, or more ED visits prior to diagnosis. These findings suggest that efforts to decrease the rate of AP should be directed toward heightening awareness among primary care physicians regarding the high rate of AP in children, with an emphasis on early ED and surgical referral.
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Pediatric emergency care · Aug 2000
Review Case ReportsPenetrating neck trauma: an unusual presentation.