Pediatric emergency care
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Pediatric emergency care · Jun 2011
Case ReportsCholelithiasis in a toddler with sickle cell disease.
Cholelithiasis is rarely seen in toddlers and school-aged children, even in the setting of sickle cell anemia. In addition to more common etiologies, such as gastroenteritis, constipation, and urinary tract infection, the differential diagnoses of acute abdominal pain in young children with sickle cell disease include vaso-occlusive pain crisis and splenic sequestration. We describe a case of a toddler with sickle cell disease initially presenting with abdominal pain who was found to have symptomatic cholelithiasis.
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Pediatric emergency care · Jun 2011
Multicenter Study Comparative StudyIllicit drug exposure in patients evaluated for alleged child abuse and neglect.
Substantiation of drug exposure in cases with alleged maltreatment is important to provide proper treatment and services to these children and their families. A study performed at University of Iowa Hospitals and Clinics showed that 30% of pediatric patients with burn injuries, which were due to child maltreatment, were also exposed to illicit drugs. ⋯ The results of this study showed that an illicit drug screening protocol used in the assessment of children evaluated for child abuse identified almost 15% of the population of allegedly abused and neglected children who were tested according to a protocol being exposed to illicit drugs. Thus, routine drug testing of at least children assessed for neglect and nonaccidental burn and soft tissue injuries, children with a history of either parental drug use or domestic violence is recommended.
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Pediatric emergency care · Jun 2011
Comparative StudyAssessing survey methods and firearm exposure among adolescent emergency department patients.
The objective of the study was to determine the nature of gun exposure in an adolescent population presenting to an urban emergency department (ED) and to ascertain attributes that correlate with the ability to buy a gun or to access a loaded gun within 3 hours. ⋯ The ability to buy a gun and access to a loaded gun within 3 hours are relatively common among ED adolescent patients. Having a gun in the home and witnessing a gun at school were independent predictors of the ability to access a loaded gun within 3 hours. Gang membership and drug use were associated with a self-reported ability to buy a gun.
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Pediatric emergency care · Jun 2011
Case ReportsA case of autonomically mediated pain due to spinal epidural abscess in an adolescent female.
Spinal epidural abscess (SEA) is a rare disease in children without predisposing risk factors. Atypical presentations of SEA without the classic triad of fever, back pain, and neurological signs, have previously been described. We report an atypical presentation of an acute SEA in a previously healthy adolescent female. ⋯ Our experience adds to the literature a case that demonstrates the difficulty in diagnosis of atypical presentations of SEA in previously healthy children. In addition, referred or autonomically mediated pain should be considered in unusual pain presentations. Children with significant extremity or abdominal pain should be considered for the possibility of sympathetically mediated pain syndrome due to a thoracic-level spinal cord lesion such as a SEA.
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Pediatric emergency care · Jun 2011
Randomized Controlled Trial Comparative StudyParental health literacy and asthma education delivery during a visit to a community-based pediatric emergency department: a pilot study.
The objective of the study was to compare change in asthma knowledge among parents with low or adequate health literacy after video or written asthma education delivered during their child's asthma-related emergency department (ED) visit. ⋯ Asthma education materials distributed at the time of an ED visit increase parental knowledge about the disease. Video-based asthma education appears promising as a tool for increasing asthma knowledge in both low- and adequate-health-literacy parents.