Pediatric emergency care
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Pediatric emergency care · Feb 2012
Impact of physicians' characteristics on the admission risk among children visiting a pediatric emergency department.
This study aimed to assess the impact of physicians' gender, work experience, and training on hospitalization among children visiting a pediatric emergency department (ED). ⋯ Individual physician's admissions proportions vary widely. Providers' experience and specialization in pediatric emergency medicine are weak predictors of admission, whereas gender was not associated.
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Pediatric emergency care · Feb 2012
Comparative StudyChanges in community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections presenting to the pediatric emergency department: comparing 2003 to 2008.
This study aimed to compare the differences in the type and location of skin infections, organisms cultured, and antibiotic resistance patterns presenting to the same pediatric emergency department from 2003 to 2008 with specific focus on community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections. ⋯ The prevalence of CA-MRSA skin infections, specifically abscesses, has significantly increased at our institution from 2003 to 2008. The antibiotic resistance patterns have not significantly changed. The most common anatomic location for CA-MRSA abscesses continues to be the buttocks, but more children are presenting with multiple abscesses in a wider variety of anatomic locations.
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The authors created a computer-based, interactive atlas of pediatric chest radiographs to facilitate (1) understanding of normal variants and (2) interpretation of pediatric chest radiographs in the acute setting. ⋯ Improved interpretation of pediatric chest radiographs in the acute setting may be facilitated by a comprehensive, computer-based, pediatric chest atlas.
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Pediatric emergency care · Feb 2012
Case ReportsLoud clicking sounds associated with rapid soft palate muscle contractions.
An 8-year-old boy was seen by his primary care pediatrician with a chief complaint of "intermittent rapid vibrations of the epiglottis" that began several weeks prior. Intraoral examination revealed rapid, symmetrical bilateral contractions of the soft palate muscles (velum), accompanied by clicking sounds audible to physician (objective tinnitus) and patient. The patient was able to volitionally control the initiation and cessation of the palatal movements. ⋯ There are 2 distinct types, and our patient was diagnosed with the essential palatal myoclonus type. This type is characteristically associated with clicking tinnitus, heard by the affected person as well as those in close proximity. The clicking noise is not continuous, ceases during sleep, and is not lifelong.
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Pediatric emergency care · Feb 2012
Case ReportsHeart failure secondary to dilated cardiomyopathy: a role for emergency physician bedside ultrasonography.
Heart failure as a result of cardiomyopathy is an uncommon presentation in the pediatric emergency department (PED). The initial presenting symptoms in these cases are often nonspecific and may be confused with more common pediatric illnesses. ⋯ A bedside ultrasound performed by the emergency physician in the PED allowed for the initiation of appropriate, rapid, goal-directed therapy and expedited timely transport to a facility with pediatric cardiothoracic surgery. We will review dilated cardiomyopathy and the role of emergency physician echocardiography.