Pediatric emergency care
-
Pediatric emergency care · Jul 2004
Physician satisfaction with a pediatric observation unit administered by pediatric emergency medicine physicians.
Observation units (OUs) are widely used to care for adults, but little is published about their use in pediatrics. During the planning stages of our pediatric OU, community primary medical doctors (PMDs) expressed concerns about not admitting and managing their own patients in this unit controlled by pediatric emergency physicians. This study surveyed PMDs to determine their satisfaction with the pediatric OU two and a half years after opening. ⋯ The model of an ED-controlled pediatric observation unit received high satisfaction ratings in all areas by community and subspecialty physicians two and a half years after opening. The initial reservations voiced by community physicians have not resurfaced.
-
Pediatric emergency care · Jul 2004
Trauma stat and trauma minor: are we making the call appropriately?
Trauma accounts for a significant number of pediatric emergency room visits and is the leading cause of death in pediatric patients over 1 year of age. To provide quality care, protocols are used to mobilize personnel to treat injured patients. We reviewed our experience at a level 1 pediatric trauma center, where a 2-tiered trauma activation protocol is used in treating children with significant injuries. ⋯ Trauma activations result in heavy resource utilization and must be appropriate. The 2 trauma activation levels were associated with differences in injury severity, medical resource utilization, and outcome. With no deaths in the Trauma Minor group and a 20% mortality rate in the Trauma Stat group, we conclude that the protocol used was neither too conservative, nor too liberal.
-
Pediatric emergency care · Jul 2004
Case ReportsSevere hyperphosphatemia and hypocalcemia following the rectal administration of a phosphate-containing Fleet pediatric enema.
Toxicity secondary to rectally administered hypertonic phosphate solution in patients with normal renal function is rarely reported in the literature. We report a case of electrolyte disturbance and seizure secondary to the rectal administration of 2 Fleet pediatric enemas. ⋯ Osmotically acting hypertonic phosphate enemas can result in severe toxicity if retained. This is true even in patients without predisposing risk factors.
-
Pediatric emergency care · Jul 2004
Case ReportsHypoglycemia after albuterol overdose in a pediatric patient.
Albuterol overdose can lead to tachycardia, hypotension, tremor, hypokalemia, and hyperglycemia in children. Hypoglycemia had been previously reported in only one child. We describe a 3-year-old boy who ingested high-dose albuterol in this report. ⋯ Hypoglycemia (45 mg/dL) was identified 4 hours after admission. The child recovered uneventfully within 24 hours with glucose replacement. This case suggests that hypoglycemia could be a late complication of acute albuterol overdose; thus, the period of observation should be extended in these cases.