Pediatric emergency care
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Emergency department (ED) overcrowding has been a serious issue on the national agenda for the past 2 decades and is rapidly becoming an increasingly significant problem for children. The goal of this report is to focus on the issues of overcrowding that directly impact children. Our findings reveal that although overcrowding seems to affect children in ways similar to those of adults, there are several important ways in which they differ. ⋯ Children may be at particularly increased risk for medical errors because of their inherent variability in size and the need for age-specific and weight-based dosing. We strongly recommend that pediatric issues be actively included in all future aspects of research and policy planning issues related to ED overcrowding. These include the development of triage protocols, clinical guidelines, research proposals, and computerized data monitoring systems.
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Pediatric emergency care · Jul 2007
ReviewPrevention and treatment of sleep deprivation among emergency physicians.
Emergency physicians commonly experience sleep deprivation because of the need to work shifts during evening and late night hours. The negative effects of this problem are compounded by job stress and traditional methods of scheduling work shifts. ⋯ Sleep-promoting agents may also help treat the problem by helping physicians to sleep during daytime hours. Minimizing sleep deprivation may help prevent job burnout and prolong the length of an emergency physician's career.
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Pediatric emergency care · Jul 2007
Prospective study of sudden-onset asthma exacerbations in children.
Sudden-onset asthma exacerbations among adults have more rapid treatment responses than do slower-onset exacerbations. We hypothesized that a similar pattern would be evident in children presenting to the emergency department (ED) with an asthma exacerbation. ⋯ Patients with sudden-onset exacerbations had similar acute asthma severity as those with slower-onset exacerbations but had shorter ED length of stay and were less likely to be admitted to the hospital, suggesting a more rapid response to treatment.
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Etizolam (ETZ) is an antidepressive thienodiazepine drug that is used worldwide. The most frequent adverse effects in adults are drowsiness and muscle weakness, and this can rarely cause paradoxical excitation; however, no information exists on intoxication in children. ⋯ We present a case of a child who accidentally took a single dose of ETZ, approximately the same as a therapeutic dose for adults, and who showed paradoxical excitation and muscle weakness. The case presented here suggests that pediatricians and emergency physicians should be aware of the possible adverse effects in children and therapeutic approaches in intoxication of ETZ and the necessity of further investigations on a specific therapeutic guideline for overdose management especially in children.
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Pediatric emergency care · Jul 2007
Review Case ReportsInfant botulism presenting with poor feeding and lethargy: a review of 4 cases.
Infant botulism is a rare cause of hypotonia in young infants. It may present with vague symptoms such as poor feeding and lethargy. We present 4 cases of infant botulism presenting to 2 community hospitals in central Maryland. ⋯ Three patients required endotracheal intubation. All were treated with botulism immune globulin, and all eventually made full recoveries. We discuss the differential diagnosis and provide an overview of infant botulism.