Pediatric emergency care
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Pediatric emergency care · Sep 2004
Comparative StudyParents' beliefs and practices regarding childhood fever: a study of a multiethnic and socioeconomically diverse sample of parents.
To examine childhood fever beliefs and practices in a multiethnic, multiracial, and socioeconomically diverse sample. ⋯ Parents' beliefs and practices regarding childhood fever vary by race, ethnicity, sociodemographics, and the child's insurance coverage. Educating parents about fever, improving access to health insurance and primary care, and ensuring that families have thermometers may enhance appropriate use of health services and improve outcomes for febrile children.
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To describe the circumstances and injuries associated with nonmotorized scooter-related trauma and to assess parental and child awareness and use of safety equipment. ⋯ Scooter-related injuries result in substantial morbidity. Although injured patients and their parents report awareness of scooter safety equipment, few injured children wear their equipment.
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Pediatric emergency care · Sep 2004
Case ReportsAcute, severe bilirubin encephalopathy in a newborn.
In recent years, changes in health care practices including the early discharge of newborns have transformed the management of neonatal jaundice into an outpatient problem. At the same time, there has been a resurgence in the incidence of kernicterus. ⋯ We review the infant's presentation and hospital course, diagnostic and therapeutic interventions, and autopsy findings. In the current era of increased frequency of breast-feeding, shortened hospital stays, and inconsistent follow-up after hospital discharge, emergency department physicians should be alerted to the rare but increasing occurrence of severe hyperbilirubinemia and kernicterus.
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Pulmonary infections due to anaerobic bacteria usually occur in children prone to aspiration. The source of the anaerobic bacteria is the oropharyngeal bacterial flora, where these organisms outnumber aerobic and facultative organisms in a 10:1 ratio. ⋯ The predominant isolated anaerobic bacteria are Peptostreptococcus, Fusobacterium, pigmented Prevotella, and Porphyromonas spp. and Bacteroides fragilis group. Management of these infections includes the administration of antimicrobials effective against the anaerobic as well as the aerobic pathogens.
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Septic shock causes more deaths in children than cancer. However, studies have shown that mortality can be significantly reduced by adhering to the American College of Critical Care Medicine/Pediatric Advanced Life Support guidelines. This article reviews the definitions, pathophysiology, and emergency management of children with septic shock, including the controversial role of steroids.