Pediatric emergency care
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Pediatric emergency care · Nov 2007
Case ReportsSerotonin syndrome in dextromethorphan ingestion responsive to propofol therapy.
An 18-year-old male developed a severe serotonin syndrome after recreational ingestion of Coricidin HBP (chlorpheniramine 4 mg and dextromethorphan hydrobromide 30 mg). Propofol infusion rapidly normalized his agitation, neuromuscular hyperactivity, and autonomic instability. Confirmatory analysis demonstrated a dextromethorphan serum concentration of 930 ng/mL. Dextromethorphan can produce serotonin syndrome in the absence of another serotonergic drug.
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Pediatric emergency care · Nov 2007
Multicenter StudySimulated pediatric trauma team management: assessment of an educational intervention.
Trauma is the leading cause of death in children. The quality of initial medical care received by injured children contributes to outcomes. Our objective was to assess effectiveness of an educational intervention on performance of emergency department (ED) teams during simulated pediatric trauma resuscitations. ⋯ This study demonstrated that an on-site educational intervention was effective in improving the performance of ED teams during simulated pediatric trauma resuscitations. Postintervention performance was more consistent with the Pediatric Advanced Life Support and Advanced Trauma Life Support guidelines. Further studies are needed to determine if improved performance in a simulated scenario leads to improved performance and better clinical outcomes of critically injured children.
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The study was undertaken to describe the presenting features of children with physeal separation of the distal humerus and review the radiographic features of the diagnosis. ⋯ Physeal separation of the distal humerus is an unusual injury but accounts for a significant number of elbow fractures in children 3 or younger. Attention to the radiographic relationship of the ulna and humerus and an appropriate index of suspicion are keys to diagnosis. Nonaccidental injury should be considered as an etiology.
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Atrial fibrillation is a rare diagnosis in children and adolescents. We report a case of a 17-year-old previously healthy boy who presented to the emergency department with a 3-week history of shortness of breath, chest pain, and 1 episode of hemoptysis. ⋯ An extensive workup led to the diagnosis of pulmonary embolism. This case highlights the importance of evaluating for thromboembolic events in pediatric patients presenting with new-onset atrial fibrillation and typical electrocardiogram pattern of cor pulmonale with or without respiratory symptoms.
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Pediatric emergency care · Nov 2007
Test characteristics of the 3-view abdominal radiograph series in the diagnosis of intussusception.
To determine the test characteristics of the 3-view abdominal radiograph series to exclude intussusception in children presenting to the pediatric emergency department. ⋯ Using specific criteria, the presence of air in the ascending colon on 2 or 3 abdominal radiograph views has the potential to substantially decrease the likelihood of or exclude intussusception.