Pediatric emergency care
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The management of dog bite wounds is controversial, and current data on risk of infection are variable and inconsistent. Furthermore, the use of prophylactic or empiric antibiotics for the treatment of these wounds is debatable. We investigate the rate of wound infections and other complications after primary repair of pediatric facial dog bite injuries. ⋯ Intuitively, younger patients and patients with greater severity injuries are more likely to undergo repair in the OR, and this was supported by our data. Overall, we found that primary repair of pediatric facial dog bite injuries, including complex soft-tissue injuries, is safe when performed in conjunction with antibiotic administration; however, further cross-specialty studies are needed to fully characterize these end points in a larger population.
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Pediatric emergency care · Sep 2011
Case ReportsUnintentional fatal phosphine gas poisoning of a family.
The objective of the study was to report the toxicity of phosphine gas after a residential fumigation that resulted in fatal poisoning of a 15-month-old toddler and her 4-year-old sibling. ⋯ Unintentional phosphine gas exposure is rare but has a toxic profile that results in a high fatality rate with no known antidote.
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Pediatric emergency care · Sep 2011
Case ReportsCutaneous gonococcal abscess of the abdomen in a child.
Virtually all pediatric cases of Neisseria gonorrhoeae originate from contact with an infected adult. A cutaneous abscess caused by N. gonorrhoeae in a child is extremely rare, especially outside the genital area. We report a case of a 22-month-old boy with a gonococcal cutaneous abscess on the abdominal wall and suggest that N. gonorrhoeae should be included in the differential diagnosis of skin and soft tissue infections in children.
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Pediatric emergency care · Sep 2011
Children admitted to the hospital after returning to the emergency department within 72 hours.
Children returning to the emergency department (ED) within 72 hours of their visit may increase overcrowding and health care costs. Identifying the characteristics of returning children who need admission may help distinguish who might need admission on their first visit. The objective of this study was to compare the characteristics of children who returned to the ED and needed admission to the characteristics of those discharged. ⋯ More than 4% of our pediatric ED visits are for children returning within 72 hours. Progression of illness resulting in higher acuity, not age, sex, time from previous visit, or change in chief complaint category, was associated directly with admission on the second visit.