Pediatric emergency care
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Pediatric emergency care · Nov 2005
Case ReportsCongenital lobar emphysema: tube thoracostomy not the treatment.
A 23-month-old boy was transferred to our facility after being diagnosed with a right-sided pneumothorax in an outlying hospital emergency department. The patient's primary complaint was a nonproductive cough and runny nose. Vital signs were stable with 98% oxygen saturation by pulse oximetry. ⋯ Chest x-ray revealed a large lucency over the right lung field, yet an intact vascular pattern. Computed tomography scan of the chest revealed congenital lobar emphysema of the right upper lobe. The pathophysiology, clinical presentation, diagnostic evaluation, and management of congenital lobar emphysema are reviewed.
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Pediatric emergency care · Nov 2005
Emergency department pediatric all-terrain vehicle injuries in West Central Illinois.
This study was prepared to evaluate pediatric all-terrain vehicle-related injuries treated in a tertiary care emergency department in West Central Illinois. ⋯ Overall, the incidence of all-terrain vehicle-related injuries in West Central Illinois in the emergency department is increasing, and local injury patterns correlate well with those reported on a national level.
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Pediatric patients with dilated cardiomyopathy can initially be present for medical attention with non-specific and misleading signs and symptoms. We present the case of a 7-year-old girl with vague complaints of fever, vomiting, and abdominal pain and cardiac murmur on physical exam who progressed to congestive heart failure before her dilated cardiomyopathy was diagnosed. Clinicians should maintain a high index of suspicion for dilated cardiomyopathy in any patient with cardiac murmur and systematic symptoms.
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Pediatric emergency care · Nov 2005
Case ReportsTracheoinnominate artery fistula: a rare and often fatal complication of indwelling tracheostomy tubes.
Fistula formation between the innominate artery and the trachea is a rare but potentially catastrophic complication after tracheostomy. Although surgery is the definitive treatment of tracheoinnominate artery fistula, the responsibility for making the proper diagnosis and stabilizing the patient before surgery often falls on the personnel in the emergency department. We describe the emergency department management of a 14-year-old girl with a tracheoinnominate artery fistula. A discussion of the risk factors, diagnostic considerations, and emergency department management strategies of tracheoinnominate artery fistula is presented.