Pediatric emergency care
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Pediatric emergency care · Jan 2008
Case ReportsThe importance of a multidisciplinary approach in a child with major abdominal penetrating trauma.
We present a case of a 2-year-old girl who had a lawn mower accident with subtotal gut evisceration, multiple ischemic intestinal lesions, hepatic and gastric wounds, amputation of the left forearm, and hypovolemic shock. Prompt and adequate management was carried out in tertiary level institution, based upon quick evaluation of the lesions, fluid resuscitation, surgical repair, and postoperative admission to the pediatric intensive care unit.
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Pediatric emergency care · Jan 2008
Randomized Controlled TrialPilot study of oral montelukast added to standard therapy for acute asthma exacerbations in children aged 6 to 14 years.
We hypothesized that children with moderate acute asthma exacerbations receiving oral montelukast with standard therapy will have at least 12% greater forced expiratory volume in 1 second (FEV1) improvement in 3 hours than those receiving standard therapy alone. ⋯ Based on these results, for children aged 6 to 14 years with moderate acute asthma exacerbations, oral montelukast (5 mg) added to standard therapy as in this design is unlikely to result in additional FEV1 improvements in 3 hours.
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Pediatric emergency care · Jan 2008
Comparative StudyPrescribing errors in a pediatric emergency department.
To determine the frequency, prescriber, and type of prescribing errors in written in-house orders and ambulatory prescriptions in a pediatric emergency department (PED). ⋯ Prescribing errors are common in both written in-house orders and ambulatory prescriptions in a PED. Targeting safety interventions toward groups with less practice in prescribing pediatric doses and reeducating groups on safe medication writing techniques could decrease this error rate.
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The clinical spectrum of infectious causes of upper airway obstruction has changed dramatically in the last few decades, especially after the introduction of vaccines against diphtheria and Haemophilus influenzae. Nevertheless, infectious causes of upper airway obstruction remain an important source of morbidity and potential mortality in the pediatric age group. ⋯ Despite the virtual elimination of invasive H. influenzae type B infection, it is important for physicians caring for children to understand the management issues surrounding patients with supraglottitis to avoid disastrous outcomes. As illustrated in the following case, these children may not always present with classic features of supraglottitis.
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Pediatric emergency care · Jan 2008
Case ReportsA child with abdominal pain and hyperglycemia: is it diabetic ketoacidosis?
Hyperglycemia, abdominal pain, and vomiting are the most common manifestations of diabetic ketoacidosis in pediatric patients. The absence of ketonemia in these patients should prompt a consideration of acute pancreatitis. We report a case of an 11-year-old girl with acute necrotizing pancreatitis, who was initially diagnosed as having new onset diabetes with nonketotic hyperglycemia.