Pediatric emergency care
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Pediatric emergency care · Mar 2007
ReviewEmergency department management of the pediatric patient with supraventricular tachycardia.
Supraventricular tachycardia (SVT) is the most common tachyarrhythmia that necessitates treatment in children. It is characterized by a rapid and regular heart rate, which generally exceeds 180 beats per minute in children and 220 beats per minute in adolescents. ⋯ Treatment of a stable patient with SVT includes vagal maneuvers and adenosine, whereas treatment of an unstable patient requires synchronized cardioversion. This article presents an overview of the etiology, pathophysiology, and clinical presentation of SVT and discusses the emergency department management of an infant or child with SVT.
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Pediatric emergency care · Mar 2007
Emergency department evaluation of ventricular shunt malfunction: is the shunt series really necessary?
The malfunction of a ventricular shunt is one of the most common clinical problems encountered in pediatric neurosurgery. Standard emergency department (ED) evaluation of suspected shunt malfunction consists of plain radiographs of the skull, neck, chest, and abdomen (shunt series) to look for mechanical breaks, kinks, and disconnections in the shunt, and a cranial computed tomography (CT) scan to evaluate for signs of increased ventricular size. We hypothesized, however, that in the context of a cranial CT scan that did not demonstrate a shunt malfunction, obtaining the shunt series would not prove to be clinically useful. ⋯ The routine use of the shunt series seems warranted in the evaluation of the child with suspected shunt malfunction as children with shunt malfunction may present with a normal cranial CT scan but an abnormal shunt series.
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Pediatric emergency care · Mar 2007
ReviewUltrasound guidance for central vascular access in the pediatric emergency department.
Central vascular access is sometimes required for hemodynamic monitoring and infusion of fluids and medications in the pediatric emergency department. In many cases, it is attempted after failed peripheral venous and intraosseous access. ⋯ In the pediatric emergency department, the femoral vein is the most practical central venous cannulation site. A sound educational and quality assurance program is necessary for US-guided cannulation in the pediatric emergency department.