Pediatric emergency care
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Pediatric emergency care · Feb 2010
Anaphylaxis management in the pediatric emergency department: opportunities for improvement.
To determine the rate, immediate treatment, and outpatient management for anaphylaxis in patients receiving care in a pediatric emergency department (ED). ⋯ This study is the first to describe the management of anaphylaxis in a pediatric ED. The results revealed opportunities for improvement. Although our ED treatment and outpatient management of patients with anaphylaxis did not meet the recommended standards of care with regard to administration of intramuscular epinephrine, prescribing autoinjection epinephrine, or referral to an allergist for all patients who had a diagnosis of anaphylaxis, we do report a higher concordance with published recommendations than those reported in previous studies performed in adults.
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Pediatric emergency care · Feb 2010
Case ReportsPneumomediastinum and subcutaneous emphysema in a child with ulcerative colitis.
We discuss the case of a young adolescent boy with ulcerative colitis who developed pneumomediastinum and subcutaneous emphysema in the neck and surrounding cervical soft tissues secondary to a probable retroperitoneal perforation of the colon. To our knowledge, this is the first reported case of this complication in the pediatric literature. Our experience provides insight into this unusual complication, how it may present, and its clinical significance in young patients with ulcerative colitis. The literature on this complication is also discussed.
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Pediatric emergency care · Feb 2010
Case ReportsA 7-year-old boy with acute onset of breathing difficulty.
Group A streptococcus (GAS) is a major bacterial pathogen affecting children globally. Approximately 15% of school-age children experience a symptomatic episode of GAS culture-positive pharyngitis each year. Although the incidence of invasive GAS disease under these circumstances is low (0.5%-2%), an increasing number of invasive GAS cases have been reported over the last 2 decades. This report describes a 7-year-old boy who, after being treated for GAS pharyngitis, developed a fatal streptococcal toxic shock syndrome.