Pediatric emergency care
-
Pediatric emergency care · Jan 2006
Randomized Controlled Trial Multicenter StudyEvaluation of a Web-based education program on reducing medication dosing error: a multicenter, randomized controlled trial.
The Broselow Pediatric Resuscitation Tape has been shown to be effective in reducing medication dosing error among pediatric emergency providers. However, the tape has often been used inappropriately or incorrectly. ⋯ The Web-based education program on the proper use of the Broselow Pediatric Resuscitation Tape could improve dosing accuracy and reduce dosing time.
-
Pediatric emergency care · Jan 2006
Case ReportsNecrotizing fasciitis caused by Aeromonas hydrophilia in an immunocompetent child.
Necrotizing fasciitis is a rapidly progressive and potentially fatal infection. It is characterized by extensive subcutaneous and muscle necrosis. ⋯ Necrotizing fasciitis caused by A. hydrophilia have occurred in children who had underlying systemic diseases or immune dysfunction. We report a 14-year-old boy without underlying systemic diseases or immunodeficiency who developed necrotizing fasciitis secondary to A. hydrophilia and he was successfully treated with extensive surgical debridement and systemic antibiotics.
-
Pediatric emergency care · Jan 2006
Case ReportsPTU-associated vasculitis in a girl with Turner Syndrome and Graves' disease.
Palpable purpura is a concerning clinical finding in pediatric patients and can have many causes, including infectious and autoimmune processes. A rare cause, drug-induced vasculitis, may result from the production of antineutrophil cytoplasmic antibodies (ANCAs) in response to a medication. ⋯ The diagnosis of propylthiouracil (PTU)-associated vasculitis was made by observation of consistent clinical features, the detection of elevated ANA and ANCA in the blood, and the observed clinical resolution of symptoms following withdrawal of PTU. Subsequent treatment of persistent hyperthyroidism with radioablation did not result in an exacerbation of the vasculitis, a complication described in prior case reports.
-
Pediatric emergency care · Jan 2006
Signs and symptoms of cerebrospinal fluid shunt malfunction in the pediatric emergency department.
Pediatric patients with cerebrospinal fluid shunts frequently present to the emergency department for evaluation of possible shunt malfunction. Most shunt studies appear in the neurosurgical literature. To our knowledge, none have reviewed presenting signs and symptoms of shunt malfunction in patients who present to the pediatric emergency department. The study objective was to evaluate the medical record of children with cerebrospinal fluid shunts who presented to a pediatric emergency department to determine if any signs and/or symptoms were predictive of shunt malfunction. ⋯ In this study, lethargy and shunt site swelling were predictive of shunt malfunction. Other signs and symptoms studied did not reach statistical significance; however, one must maintain a high index of suspicion when evaluating children with an intracranial shunt because the presentation of malfunction is widely varied. A missed diagnosis can result in permanent neurological sequelae or even death.
-
Pediatric emergency care · Jan 2006
Analgesia administration for acute abdominal pain in the pediatric emergency department.
To document the use of analgesia for children with acute abdominal pain in the Pediatric Emergency Department (PED) and to compare between children with suspected appendicitis in a high versus low probability. ⋯ Children with abdominal pain receive more analgesia when the physician suspects appendicitis, yet only in half of the cases, and only 15% receive opioids. Opioid underdosing happens in a quarter of times it is given.