Pediatric emergency care
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Primary neurological injury in children can be induced by diverse intrinsic and extrinsic factors including brain trauma, tumors, and intracranial infections. Regardless of etiology, increased intracranial pressure (ICP) as a result of the primary injury or delays in treatment may lead to secondary (preventable) brain injury. Therefore, early diagnosis and aggressive treatment of increased ICP is vital in preventing or limiting secondary brain injury in children with a neurological insult. ⋯ Thus, the emergency physician has a critical role to play in early identification and treatment of increased ICP. This article intends to identify those patients at risk of intracranial hypertension and present a framework for the emergency department investigation and treatment, in keeping with contemporary guidelines. Intensive care management and the treatment of refractory increases in ICP are also outlined.
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Pediatric emergency care · Feb 2012
Bronchiolitis: clinical characteristics associated with hospitalization and length of stay.
Bronchiolitis is a leading cause of infant hospitalization in the United States; the mean length of stay (LOS) is 3.3 days. We sought to identify the initial clinical characteristics of bronchiolitis associated with admission and with longer LOS in a large multicenter clinical trial. ⋯ A model using objective findings had limited accuracy for predicting hospitalization after emergency department evaluation for bronchiolitis. In these infants with moderate to severe bronchiolitis, however, initial SpO(2) was the best predictor of hospital admission and of longer LOS. Efforts to better define and manage hypoxemia in bronchiolitis may be helpful.
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Pediatric emergency care · Feb 2012
Ability of pediatric physicians to judge the likelihood of intussusception.
Intussusception is the most common cause of intestinal obstruction in infants and children. To date, no study has evaluated the ability of physicians to predict the likelihood of intussusception. ⋯ Pediatric physicians can accurately predict the likelihood of intussusception. This ability to properly judge the risk of intussusception can be incorporated into management strategies.
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Pediatric emergency care · Feb 2012
Case ReportsPosttraumatic pulmonary pseudocysts as a manifestation of child abuse.
Posttraumatic pulmonary pseudocysts (PTPPCs) are air-, fluid-, or blood-filled spaces in the lung parenchyma. They are rare findings and are associated with substantial blunt force trauma to the chest. ⋯ There has not been a case of PTPPC reported in the child abuse literature. This case report describes a child with a PTPPC secondary to inflicted abusive injury.
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Pediatric emergency care · Feb 2012
Profile of patients visiting the pediatric emergency service in an Egyptian university hospital.
The emergency department (ED) is an essential component of the medical service offered in any hospital. Yet, the published information about patients' profile and utilization of emergency services in both developing and developed countries is scarce. ⋯ Appropriate and ongoing data collection and analysis could guide more efficient utilization of pediatric emergency services to achieve better outcomes.