Pediatric emergency care
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Pediatric emergency care · Oct 2012
Multicenter Study Comparative StudyAdolescent synthetic cannabinoid exposures reported to Texas poison centers.
This study describes the pattern of adolescent synthetic cannabinoid exposures reported to a large statewide poison center system. ⋯ Adolescent synthetic cannabinoid exposures reported to Texas poison centers were more likely to involve inhalation. The adolescents were more likely to be male. The exposures more often occurred at the patient's own residence and managed at a health care facility with a serious outcome. This pattern of exposures was similar to that observed among adults.
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Pediatric emergency care · Oct 2012
Comparative StudyLow rates of follow-up with primary care providers after pediatric emergency department visits for respiratory tract illnesses.
We sought to determine diagnosis-specific rates of follow-up with primary care providers (PCPs) after emergency department (ED) visits for respiratory tract illnesses. We hypothesized that follow-up rates would be higher among patients with acute infectious illnesses than among those with asthma. ⋯ Rates of PCP follow-up were globally low but significantly higher for patients with acute infectious illnesses, for younger patients, and for those receiving explicit ED discharge instructions.
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Pediatric emergency care · Oct 2012
Case ReportsGastric volvulus complication in an infant with undiagnosed congenital diaphragmatic hernia presenting with acute respiratory distress.
Congenital diaphragmatic hernia is an embryologic defect that creates a passage for herniation of abdominal structures into the thoracic cavity. This can lead to a variety of complications, including gastric volvulus that can present acutely with epigastric distention and vomiting. In cases of late-onset congenital diaphragmatic hernia, symptoms may be vague and often necessitate further investigation. ⋯ This patient's presentation highlights one of the complications that may occur owing to congenital diaphragmatic hernia. Computed tomographic scan is the confirmatory test for diaphragmatic hernia and, in this case, also uncovered a concomitant gastric volvulus. Treatment includes early resuscitation, a definitive airway, and emergent surgery to prevent ischemic necrosis of the stomach owing to strangulation, gastric perforation, and serious cardiorespiratory decompensation.
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Pediatric emergency care · Oct 2012
Comparative StudyWho should be reading chest radiographs in the pediatric emergency department?
Pediatric emergency department chest radiographs are frequently interpreted by the pediatrician, and patient management is based on this interpretation. ⋯ Although the clinically significant discordant rate was relatively low, daily chest radiograph reassessment by pediatric radiologists in a joint meeting with pediatricians has an added value for patient safety, quality assurance, and mutual training.
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Pediatric emergency care · Oct 2012
Comparative StudyDoes a prehospital Glasgow Coma Scale score predict pediatric outcomes?
Although the Glasgow Coma Scale (GCS) score is widely used by medical professionals to evaluate and predict neurological outcomes, studies using the prehospital (P) GCS score to predict neurological outcomes in children are few. ⋯ Our data showed strong agreement between P and ED GCS scores. Also, there was strong association between P GCS scores and short-term outcomes in children with TBI. The results support the use of GCS in prehospital transport destination guidelines for children with TBI.