Pediatric emergency care
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Pediatric emergency care · Apr 2006
Case ReportsRecurrent episodes of intractable laryngospasm during dissociative sedation with intramuscular ketamine.
We report 2 cases of dissociative sedation with intramuscular ketamine with recurrent episodes of laryngospasm that we were unable to ventilate with bag-mask ventilation, in 1 case leading to endotracheal intubation to protect the airway. Supplemental oxygen was given throughout the sedations, and ventilatory status was noninvasively monitored on a continuous basis, providing detailed and objective documentation of the patients' clinical status throughout the sedations. We were, therefore, able to rapidly assess and confirm apnea, laryngospasm, and airway dysfunction.
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Pediatric emergency care · Apr 2006
Cardiac troponin I as a predictor of mortality for pediatric submersion injuries requiring out-of-hospital cardiopulmonary resuscitation.
It is difficult to predict ultimate survivors to hospital discharge in children who are successfully resuscitated after a cardiorespiratory arrest associated with a submersion injury. Serum measurements of organ injury or dysfunction may serve as a surrogate marker of the degree of hypoxic injury. We designed a prospective study whose purpose was to assess the predictive value for outcome of serum cardiac troponin I measurements after submersion injury and cardiorespiratory arrest. ⋯ Nine patients were admitted, and 2 patients (22%) survived to hospital discharge. The area under the receiver operating characteristic curve is 0.786 (95% confidence interval, 0.481-1.0). This suggests that cardiac troponin I has a moderate degree of discriminatory power in selecting children who did not survive to hospital discharge.
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Pediatric emergency care · Apr 2006
Case ReportsCase report: esophageal foreign body mistaken for impacted button battery.
Foreign body ingestion is a common complaint in the pediatric emergency department. Here, we report an interesting case of a coin ingestion in which the radiographic findings were alarming and inconsistent with the history provided by our patient. A brief review of the diagnosis and management of gastrointestinal foreign bodies is presented, with particular focus on ingested coins and button batteries.