Pediatric emergency care
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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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Pediatric emergency care · Jul 2007
Issues associated with dog bite injuries in children and adolescents assessed at the emergency department.
The aim of this study was to determine the pattern of dog bites seen at the emergency department of a university hospital. The information will be used to plan prevention and enhance management strategies. ⋯ In mammalian attacks, canines are most commonly involved. Most injuries are trivial, and the limbs are usually involved. However, younger children are at higher risk of facial injuries. Extent of pain and adverse psychological impacts are typically not documented in the emergency assessment.
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Pediatric emergency care · Jul 2007
The predictive value and appropriate ranges of prehospital physiological parameters for high-risk injured children.
To assess: (1) the relative importance of prehospital physiological measures in identifying high-risk children; (2) whether different age-based criteria should be used for each prehospital physiological measure; and (3) outcome-based appropriate ranges of physiological measures in injured children. ⋯ Prehospital GCS and respiratory compromise were the most important physiological measures in identifying high-risk injured children. Age-specific criteria should be considered for RR, heart rate, and SBP.
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Pediatric emergency care · Jul 2007
Case ReportsAn unusual case of a central nervous system tumor presenting as a chief complaint of depression.
Patients presenting to the emergency department with a psychiatric chief complaint often undergo a medical clearance examination. There is much debate in the literature as to the value of routine laboratory and other diagnostic studies in the initial evaluation of these patients. We report on a patient presenting to the pediatric emergency department with a chief complaint of depression who ultimately was found to have diabetes insipidus and a primary intracranial germ cell tumor. Although a rare outcome to a relatively common scenario in the emergency department, this case underscores the value of a detailed history, careful physical examination, and consideration of laboratory and other diagnostic studies in patients presenting to the emergency department for psychiatric evaluation.
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Spontaneous esophageal rupture (Boerhaave syndrome) is uncommon in children. Delayed or missed diagnosis can lead to poor outcomes in terms of morbidity and mortality. To highlight the importance of early recognition and management of spontaneous esophageal rupture in children, we report a case of a 16-year-old boy who presented in the emergency department with acute chest pain after episodes of vomiting.