Pediatric emergency care
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Pediatric emergency care · Jun 2011
Case ReportsRhabdomyolysis without detectable myoglobulinuria due to severe hypophosphatemia in diabetic ketoacidosis.
Clinical signs of hypophosphatemia, even when severe, are rare in diabetic ketoacidosis despite their high frequency in this condition. This article presents a patient with rhabdomyolysis due to severe hypophosphatemia, where the level of serum phosphorus was observed to be as low as 0.42 mg/dL on the 16th hour of ketoacidosis treatment. The patient developed acute tubular necrosis due to rhabdomyolysis, but there was no blood reaction in the urine, and the creatine kinase increased to 1200 U/L. The patient was treated without dialysis and was cured after a polyuria period of 2 months after the oliguric period.
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Pediatric emergency care · Jun 2011
ReviewHospital-based pandemic influenza preparedness and response: strategies to increase surge capacity.
In the spring of 2009, the first patients infected with 2009 H1N1 virus were arriving for care in hospitals in the United States. Anticipating a second wave of infection, our hospital leaders initiated multidisciplinary planning activities to prepare to increase capacity by expansion of emergency department (ED) and inpatient functional space and redeployment of medical personnel. ⋯ Our health center successfully met the challenges posed by the 2009 H1N1 outbreak. The intent in sharing the details of our planning and experience is to allow others to determine which elements of this planning might be adapted for managing a surge of patients in their setting.
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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.
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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
Multicenter Study Comparative Study"Inappropriate" pediatric emergency medical services utilization redefined.
Previous reports on emergency medical services (EMS) transportation of pediatric patients have demonstrated a high rate of overutilization. However, there is also a concern that pediatric patients may underutilize EMS for emergencies that might benefit from EMS. This article compares EMS utilization rate between adult and pediatric patients for high-acuity patients and for the most common reasons for transport. ⋯ As compared with adults, pediatric patients are less likely to utilize EMS for transport to the hospital for both routine and emergent complaints. The definition of inappropriate utilization of EMS for pediatric transport, which has largely focused on inappropriate overutilization, should also incorporate the potential of underutilization for critical patients.