Pediatric emergency care
-
Pediatric emergency care · Sep 2010
Comparative StudyDelayed repeat enema in the management of intussusception.
To describe the demographic and clinical characteristics of children with intussusception and failed initial air enema reduction who were managed by delayed repeat enema attempts and identify predictors associated with successful reduction. ⋯ With the coordinated care of emergency medicine, surgery, and radiology services, delayed repeat enema seems to be an option to consider in the management of clinically stable children who, on initial air enema, have partial reduction. Our study showed that the success rate of delayed repeat enemas was greatest when the intussusceptum was initially reduced to the ileocecal valve.
-
Pediatric emergency care · Sep 2010
Comparative StudyClinical spectrum of shock in the pediatric emergency department.
The objective of this study was to describe the clinical spectrum of patients presenting with shock or developing shock in a pediatric emergency department (ED) during an 8-year period. ⋯ Pediatric ED patients with shock represent a diverse population with substantial mortality. Of 147 patients, 21 presented without clinical signs of shock and deteriorated to a clinical condition meeting the definition of shock during the ED course.
-
Pediatric emergency care · Sep 2010
Comparative StudyValidation of a clinical score to predict skull fracture in head-injured infants.
To validate a previously derived clinical score that uses clinical signs to determine which head-injured infants are at risk of skull fracture. The clinical score is calculated on the basis of the patient's age, the scalp hematoma size, and the location of the hematoma, with a total value between 0 and 8. ⋯ We have validated our clinical scoring system as an accurate way of determining an infant's risk of skull fracture. Whereas a clinical score of 4 or greater maximizes the trade-off between sensitivity and specificity for identifying skull fracture, a clinical score of 3 or greater may be preferable for detecting intracranial injury.
-
Pediatric emergency care · Sep 2010
Case ReportsProgressive unilateral arm weakness in a 7-year-old boy.
A child with joint or extremity pain is a common presentation to the emergency department. Often, there is some element to the patient's history, whether it is trauma or some other significant history, which leads to a likely diagnosis. When there is a history of fever and progressive arm weakness, an astute emergency physician would have heightened awareness of a possible systemic process. We describe a case of unilateral shoulder pain with associated fever in a 7-year-old boy who presented to the emergency department with progressive arm weakness to the same side.
-
Pediatric emergency care · Sep 2010
Comparative StudyResidents' mental model of bag-mask ventilation.
Our objectives were to characterize resident knowledge of bag-mask ventilation (BMV) and to identify predictors of a well-developed mental model of BMV. ⋯ Emergency medicine residents identified more steps to optimize difficult BMV, although most residents exhibited a poorly developed mental model for difficult BMV compared with the consistent mental model of airway experts. Future research should investigate strategies for improving residents' mental model of BMV and its impact on patient care.