Pediatric emergency care
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Identification of injuries of a traumatized patient is a mandate for the emergency department (ED) and the trauma team. Delayed diagnosis of injury in trauma patients leads to increased morbidity, mortality, dissatisfaction, and risk of litigation. Comparing children admitted for blunt trauma, with and without delay, this study examines risk factors for delayed diagnosis. ⋯ Delays occurred in 1% of patients. Trauma team care itself did not protect all patients from delay. Injury severity at presentation alone is not an adequate predictor of delayed diagnosis in the pediatric patient. A combination of variables was identified as negative predictors of delay. Further study is needed to validate these criteria, and determine if earlier diagnosis would effect quality.
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Pediatric emergency care · Feb 2001
Comparative StudyAccuracy of visual determination of neutral position of the immobilized pediatric cervical spine.
The definition of neutral position for the immobilized pediatric cervical spine is not well standardized. In this study, we attempted to determine whether 1) physicians and/or paramedics could accurately assess visually if the cervical spine was in a neutral position, 2) the visual assessments of the observers were in agreement, and 3) a radiographic Cobb angle would correlate with the visual determination. ⋯ Although visual determinations of neutral position of the cervical spine by two observers may correlate, radiographic studies demonstrate that neutral position was not achieved in 37% of the cases.
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Pediatric emergency care · Feb 2001
Case ReportsMucus plugging as a cause of acute lobar overdistension.
Acute lobar overdistension in children is usually indicative of foreign body aspiration, especially when a history of a choking episode is recalled. An unusual presentation of asthma as recurrent overdistension of the left lung in a toddler is described. The child had undergone two consecutive negative bronchoscopies with a presumptive diagnosis of foreign body aspiration; however, it was only the antiasthmatic treatment that resulted in an excellent outcome.
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Pediatric emergency care · Feb 2001
Case ReportsTraumatic posterior dislocation of hip in children.
Traumatic posterior dislocation of the hip joint in children is an uncommon injury. It constitutes a true orthopedic emergency. It makes up over 80% of pediatric hip dislocations. ⋯ Both were reduced within 6 hours of dislocation, and review at 6 months revealed normal examination and no evidence of any post-traumatic changes. Post-reduction treatment remains without a consensus. This review highlights the clinical presentation, management, and time-sensitive complications of the injury.