Pediatric emergency care
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Pediatric emergency care · Oct 2008
ReviewAnticonvulsant medications in the pediatric emergency room and intensive care unit.
Seizures are common in pediatric emergency care units, either as the main medical issue or in association with an additional neurological problem. Rapid treatment prolonged and repetitive seizures or status epilepticus is important. ⋯ A status epilepticus treatment algorithm is suggested, incorporating changes from traditional algorithms based on these new data. Treatment issues specific to complex medical patients, including patients with brain tumors, renal dysfunction, hepatic dysfunction, transplant, congenital heart disease, and anticoagulation, are also discussed.
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Pediatric emergency care · Oct 2008
Review Case ReportsThe edematous toddler: a case of pediatric Ménétrier disease.
Ménétrier disease is a protein-losing gastroenteropathy, characterized clinically by nonspecific gastrointestinal symptoms and generalized edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. Distinct from its adult counterpart, Ménétrier disease of childhood usually remits spontaneously and has a very good prognosis. We present a case report of Ménétrier disease in an edematous toddler and a brief review.
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Pediatric emergency care · Oct 2008
Randomized Controlled Trial Comparative StudyA prospective randomized controlled study of two fluid regimens in the initial management of septic shock in the emergency department.
To compare the impact of 40 mL/kg of fluid over 15 minutes followed by dopamine and further titration of therapy to achieve therapeutic goals (study protocol) versus 20 mL/kg over 20 minutes up to a maximum of 60 mL/kg over 1 hour followed by dopamine (control protocol) in septic shock. ⋯ There was no difference in the overall mortality, rapidity of shock resolution, or incidence of complications between the groups. The occurrence of hepatomegaly at 20 minutes following 40 mL/kg is of concern in settings with limited access to post-resuscitation ventilator care.
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Pediatric emergency care · Oct 2008
Randomized Controlled TrialParental factors influence teen alcohol use after an emergency department visit.
To determine if parental factors are significant predictors of short-term adolescent drinking after an alcohol-related emergency department (ED) visit. ⋯ Parental factors may significantly influence subsequent adolescent drinking after an ED visit. These factors should be assessed when treating alcohol-positive teens, and parents should be advised to closely monitor their teens.
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Pediatric emergency care · Oct 2008
Comparative StudyBronchiolitis management in pediatric emergency departments in Australia and New Zealand: a PREDICT study.
Bronchiolitis is the most frequent reason for admission in infants. We set out to compare clinical practice guideline (CPG) recommendations and physician management of bronchiolitis at Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites in Australia and New Zealand as a baseline for prospective trials. ⋯ Management of bronchiolitis was similar across PREDICT sites. Practice is equally split between i.v. and n.g. rehydration. This reflects a lack of evidence which should be addressed through a multicenter comparative trial.