Pediatric emergency care
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Pediatric emergency care · Dec 2008
Case ReportsEmergency department waiting room stress: can music or aromatherapy improve anxiety scores?
The aim of this study was to determine the effect of music alone, aromatherapy alone, and music in addition to aromatherapy on anxiety levels of adults accompanying children to a pediatricemergency department waiting area. ⋯ Music is an easy and useful way to decrease the anxiety of visitors in an emergency department waiting area. Although no difference was detected for the aromatherapy group, this could be because of environmental conditions or imprecise application of the aromatherapy; further study is needed to either prove or disprove its effectiveness in this setting.
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Pediatric emergency care · Dec 2008
Review Comparative StudyUrgency classification methods for emergency department visits: do they measure up?
Across the United States, emergency departments (EDs) are plagued by overcrowding and its deleterious effects. Consequently, investigators have attempted to identify a subset of nonurgent patients who could potentially be managed in alternative settings to help alleviate the burden of overcrowding. ⋯ Accurate identification of nonurgent ED visits is necessary to compare nonurgent populations across health care settings and design safe, effective interventions aimed at reducing ED overcrowding. In this paper, we review the currently used methods for the classification of ED visit urgency, discuss the implications of measurement of ED urgency for health care stakeholders, and suggest future directions for the feasible, practical measurement of ED urgency.
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Pediatric emergency care · Dec 2008
ReviewSearching for the Holy Grail: a review of markers of tissue perfusion in pediatric critical care.
Goal-directed therapy has become the key to resuscitating critically ill patients since 2001. However, the ideal marker to guide pediatric resuscitation has remained elusive. The ideal marker is specific, sensitive, easy to use, safe, validated, and cost-effective. ⋯ Sublingual capnometry may also prove to be useful, but no pediatric research has been published related to this device. Finally, near-infrared spectroscopy monitoring may be useful in highlighting changes in patient conditions, but its use in goal-directed therapy is limited by the wide interpatient variability. In summary, the search for the ideal marker of tissue perfusion continues, but there is promise on the horizon.
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Pediatric emergency care · Dec 2008
Case ReportsEsophageal foreign body: a case of a neonate with stridor.
We present a case of a 7-week-old female with a 3-week history of progressively worsening stridor who was admitted to rule out a congenital anomaly in the airway or vasculature. After 3 different imaging modalities, we discovered an esophageal foreign body causing esophagitis and proximal airway compression. Young infants with symptoms of stridor, wheezing, or retractions will often have a common diagnosis such as a viral infectious etiology, or in rarer cases an anatomic anomaly. This case illustrates that the presence of a foreign body must still remain on the differential, even in this age group.
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Pediatric emergency care · Dec 2008
Review Case ReportsAtlantoaxial rotary subluxation after minor trauma.
We present a case of atlantoaxial rotary subluxation after a minor injury managed by manual reduction under sedation. Atlantoaxial rotary subluxation should be considered in a child with inability or unwillingness to turn their head when history and physical examination do not suggest torticollis of benign etiology. In our discussion, we review etiology, diagnosis, as well as pre- and in-hospital management.