Pediatric emergency care
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Pediatric emergency care · Aug 2006
Unscheduled return visits to the pediatric emergency department-one-year experience.
Patients returning to the emergency department (ED) within 72 hours of their visit may contribute to crowding and might indicate failure to give a proper assessment, treatment, or follow-up instructions. The aim of this study was to describe the rate of return visits in a tertiary care pediatric ED (PED) and find characteristics of children who return to the ED. ⋯ Five percent of our PED visits are return visits of children seen in the 72 hours before the visit. Younger children, with high acuity who come to the ED in the late evening hours, are most likely to return to the ED.
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Pediatric emergency care · Aug 2006
Randomized Controlled TrialOral betamethasone versus intramuscular dexamethasone for the treatment of mild to moderate viral croup: a prospective, randomized trial.
Intramuscular dexamethasone is an effective, but painful, treatment for croup. The effectiveness of betamethasone, an oral, palatable, and equally potent glucocorticoid has not been studied. The purpose of this study was to compare the effectiveness of a single oral dose of betamethasone with intramuscular dexamethasone in the outpatient treatment of mild to moderate croup. ⋯ There is no difference between oral betamethasone and intramuscular dexamethasonein the management of mild to moderate viral croup. It is palatable and does not require a nurse for administration, making it a good alternative for ambulatory management.
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Pediatric emergency care · Aug 2006
Poststabilization care for pediatric fractures: a follow-up survey.
Compliance with emergency department instructions regarding patient follow-up is generally poor. Children with Medicaid have been previously shown to have less access to orthopedic care than those with private insurance. Our objectives were to quantify the compliance of pediatric fracture patients with recommended emergency department follow-up and to identify barriers for patients who do not follow-up. ⋯ Over one third of children with nonemergent fractures treated in our emergency department did not receive recommended follow-up. Although our data cannot comment on the outcomes of these specific patients, the orthopedic literature suggests that these children are at higher risk of a poor outcome than those receiving timely follow-up.
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Pediatric emergency care · Aug 2006
Acute rhabdomyolysis complicating status asthmaticus in children: case series and review.
To describe a case series of 4 children who developed acute rhabdomyolysis as a complication of acute respiratory failure secondary to status asthmaticus. ⋯ Acute rhabdomyolysis complicating status asthmaticus may be more common than previously ascertained. We therefore suggest that CPK levels should be followed closely in all children with status asthmaticus and acute respiratory failure. The early presentation of rhabdomyolysis in the current series suggests that factors other than corticosteroids and neuromuscular blockers are potentially involved. Mechanical ventilation and older age seem to be significant risk factors for rhabdomyolysis, perhaps implicating a mechanism similar to the pathogenesis of severe exercise-related rhabdomyolysis. Further clinical study of the incidence and causative factors of rhabdomyolysis in this population is warranted.
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Pediatric emergency care · Aug 2006
Sonography of the hip-joint by the emergency physician: its role in the evaluation of children presenting with acute limp.
To describe a new imaging bedside test called Sonography of the Hip-joint by the Emergency Physician (SHEP) and to examine if its use as a triage tool for the presence of fluid in the hip joint can guide the emergency physician to the right diagnosis. ⋯ The SHEP tests provided additional information that narrowed the differential diagnosis, and minimized unnecessary blood tests and diagnostic imaging studies.