Pediatric emergency care
-
Pediatric emergency care · Sep 2009
Case ReportsTraumatic posterior dislocation of the hip in a 3-year-old child.
We report the case of a traumatic posterior dislocation of the hip in a 3-year-old boy. After a fall in the garden, the boy was brought to our emergency department where an x-ray confirmed a posterior dislocation of his right hip. A successful prompt reduction was performed in the operating room under general anesthesia. This uncommon injury represents an orthopedic emergency and requires prompt reduction to lessen the risk of complications including avascular necrosis of the femoral head.
-
Pediatric emergency care · Sep 2009
Comparative StudyIntravenous contrast agents and associated changes in serum osmolality.
Anecdotal data suggest that intravenous contrast agents given to enhance the sensitivity of computed tomography (CT) can produce increases in serum osmolality, producing an osmolal gap. An unexplained osmolal gap often prompts extensive evaluation for the presence of unidentified toxins, particularly the toxic alcohols (methanol, ethanol, isopropyl alcohol, and ethylene glycol). The ability of intravenous contrast media to raise serum osmolality with a resulting osmolal gap has not been systematically investigated. ⋯ These data suggest that intravenous contrast agents, when administered at conventional doses, do not significantly increase serum osmolality or produce an osmolal gap. Patients who are found to have an osmolal gap after the performance of a contrast-enhanced CT scan should undergo thorough evaluation to identify its etiology rather than attributing the gap to contrast administration.
-
Pediatric emergency care · Sep 2009
Letter Case ReportsRecognition of "plastic bronchitis" in the emergency department.