Pediatric emergency care
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Hereditary angioedema is a disorder characterized by decreased levels or function of complement C1 esterase inhibitor. Symptoms in children generally consist of recurrent episodes of soft tissue swelling. On rare occasion, it can cause airway edema which may lead to airway obstruction. ⋯ Initial management of this rare complication should be directed at establishing an adequate airway and ensuring good oxygenation and ventilation. In addition, prompt administration of C1 esterase inhibitor concentrate is the most effective means of stopping progression of laryngeal edema and other forms of swelling. Commonly used agents for airway edema such as glucocorticoids, antihistamines, H1-blockers, and epinephrine tend not to be effective for reducing swelling related to hereditary angioedema.
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Pediatric emergency care · Jan 2005
Envenomation by the Northern Blacktail Rattlesnake (Crotalus molossus molossus): case report.
The clinical course after a human envenomation by the Northern Blacktail rattlesnake (Crotalus molossus molossus) is not well described in the literature. The present report discusses a 12-year-old girl who was envenomated by C. molossus molossus and treated with antivenom (Crotalidae polyvalent immune Fab). ⋯ Hematologic and coagulation studies were within normal limits at follow up. The clinical effects of C. molossus molossus envenomation are reviewed, and previous reports of bites by C. molossus molossus are discussed and compared with our patient.
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Pediatric emergency care · Jan 2005
Evaluation of pediatric glucose monitoring and hypoglycemic therapy in the field.
As specific indications for glucose monitoring in pediatric patients are not standardized, we sought to evaluate our EMS system regarding the use of this test, so that objective data can be used for prehospital provider education. We performed a 5-year electronic search of prehospital records to assess pediatric patients who had glucose monitoring performed, with subgroup analysis on those requiring therapy. We found that 6018 pediatric patients received glucose monitoring with the most common chief complaints for testing including: seizure, "other medical," trauma head/neck, and OD/poisoning. ⋯ Age breakdowns for therapy were as follows: 0-4 years, 44 (11.9%); 5-9, 36 (9.7%); 10-14, 58 (15.7%); 15-19, 232 (62.7%). In the prehospital setting, the need to treat hypoglycemia in pediatric patients is infrequent. The chief complaints associated with the highest frequencies of hypoglycemia are seizures and altered neurologic status.