Pediatric emergency care
-
Pediatric emergency care · Oct 2012
Randomized Controlled Trial Comparative StudyBispectral analysis during procedural sedation in the pediatric emergency department.
Our primary objective was to determine the maximum depth of sedation achieved, as measured by the bispectral (BIS) index monitor, for pediatric patients undergoing procedural sedation in a pediatric emergency department. ⋯ This study suggests that most pediatric procedural sedation patients spend at least a period in a general anesthetic state. During most procedural sedation, the physicians involved are likely underestimating the maximal depth of sedation for their patients.
-
Pediatric emergency care · Oct 2012
Comparative StudyA profile of nonurgent emergency department use in an urban pediatric hospital.
This study was designed to develop a descriptive profile of parents and caregivers who bring their children to the emergency department (ED) for nonurgent issues and to explore the reasons for presenting to an urban hospital pediatric ED for nonurgent conditions. Such work is necessary to develop effective interventions. ⋯ Interventions should focus on health literacy and ensure that parents are provided relevant and accurate education on pediatric illnesses and common safety concerns; by increasing parental education on pediatric health, parents may be better able to assess acuity of their child's health issues.
-
Pediatric emergency care · Oct 2012
Review Case ReportsEarly repair of large infant ventricular septal defect despite respiratory syncytial virus-induced respiratory failure with postrepair chylous pericardial effusion requiring pleuropericardial window: a case report and review of the literature.
The surgical correction of congenital cardiac lesions that are complicated by intercurrent respiratory syncytial virus (RSV) pneumonitis has traditionally been deferred for at least 6 to 8 weeks. The presumption is that using cardiopulmonary bypass will increase the risk of postoperative pulmonary complications. We present an infant who developed acute respiratory failure related to RSV pneumonitis and required urgent mechanical ventilation. ⋯ Two weeks later, he underwent creation of a pleuropericardial window with successful resolution of the chylous effusion. It is of interest to pediatricians to be able to correctly time the repair of congenital heart disease lesions after RSV infection to minimize post-bypass pulmonary complications and yet avoid morbidity from undue delays in repair. In addition, chylopericardium can occur in infants after VSD repair, and dietary modification and catheter drainage may not be adequate.
-
Pediatric emergency care · Oct 2012
Randomized Controlled Trial Comparative StudyProcalcitonin as a marker of bacteremia in children with fever and a central venous catheter presenting to the emergency department.
To evaluate the clinical use of procalcitonin (PCT) as a rapid marker for the identification of bacteremia in the emergency department (ED) population of children with fever and a central venous catheter (CVC). ⋯ The PCT levels are useful in identifying children with fever and a CVC who are bacteremic in the ED.