Pediatric emergency care
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Pediatric emergency care · Dec 2009
Comparative StudyAnalysis of parental and nurse weight estimates of children in the pediatric emergency department.
To evaluate the accuracy of parent and triage nurse estimates of children's weights in the pediatric emergency department. ⋯ Parents were more accurate at estimating children's weights than triage nurses but were within 10% of the children's actual weights only 79% of the time. Nurse estimates were highly inaccurate. Other methods to estimate patient weights should be used when actual patient weights are unobtainable.
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Pediatric emergency care · Dec 2009
Case ReportsHypophosphatemia-induced seizure in a child with diabetic ketoacidosis.
We report an unusual case of hypophosphatemia-related seizure in a child with diabetic ketoacidosis (DKA). A 1-year-old type 1 diabetic boy with hyperglycemia, ketoacidosis, and dehydration was admitted to the pediatric intensive care unit. After having received fluid replacement using isotonic solution with added potassium and continuous intravenous insulin administration according to the protocol for DKA, the patient was conscious, awake, and fed with breast milk. ⋯ He had no neurologic lesions and was discharged. Although hypophosphatemia is a common complication of DKA treatment, phosphate supplementation has not been routinely recommended in the treatment of DKA. Early recognition and treatment of severe hypophosphatemia in the treatment of DKA are important to reduce the risk of neurological complications.
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Pediatric emergency care · Dec 2009
Case ReportsDiscitis and epidural abscess after dental extraction in a pediatric patient: a case report.
Neck pain is a relatively common pediatric complaint. Most is of benign etiology. ⋯ An extensive search of the literature has revealed only 5 cases of epidural abscess secondary to dental sepsis, and to the author's knowledge, this is the first reported case in the pediatric population. We present the case and a brief review of the literature on this subject.
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Pediatric emergency care · Dec 2009
Case ReportsBruising in infants: those with a bruise may be abused.
Bruising in the young infant is rare, and if present, this may be a manifestation of physical child abuse. Early signs of abuse, such as bruising, are often overlooked or their significance goes unrecognized resulting in poor patient outcomes. ⋯ This brief report presents 3 cases of nonmobile infants who presented to health care providers with bruising before a subsequent fatal or near-fatal event. These cases emphasize the importance of including abusive trauma in the differential diagnosis of an infant with a bruise or a history of easy bruising and the importance of initiating a thorough trauma evaluation immediately and concomitantly with any other workup for the causes of bruising in the noncruising infant.
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Pediatric emergency care · Dec 2009
Comparative StudyEvaluation of decision rules for identifying serious consequences of traumatic head injuries in pediatric patients.
We evaluated the existing decision rules and developed our own decision rule for use with pediatric patients having head injuries to see how good they are for identifying serious complications. ⋯ All the 3 existing decision rules tested had high sensitivities for at least complicated head trauma, but rather low specificity. Because the most optimal decision rule based on the present data was not superior to the existing ones, we conclude that it is difficult to develop a rule that would be markedly better than that of NEXUS II. Use of the NEXUS II rule would have resulted in reduced hospitalization and imaging rates in our hospital, where no decision rules are currently used.