Pediatric emergency care
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Pediatric emergency care · Mar 2012
Review Case ReportsPrimary amebic meningoencephalitis: a case report and literature review.
Primary amebic meningoencephalitis (PAM) is a rare but nearly always fatal disease caused by infection with Naegleria fowleri, a thermophilic, free-living ameba found in freshwater environments. Cases of N. fowleri infection have been reported from many of the southern-tier states in the United States, with Florida and Texas disproportionately represented among them. ⋯ Pediatric acute care practitioners in emergency departments, general pediatric wards, and critical care units, especially those practicing in the southern United States, should be familiar with the risk factors for acquisition of PAM, its clinical presentation, and the fact that common empiric treatment of bacterial meningitis will not treat N. fowleri. Herein, we present the case of an adolescent who died of PAM and review the (a) epidemiology, (b) pathophysiology, (c) available diagnostic modalities, (d) treatment options, and (e) outcomes of patients treated for N. fowleri infection of the central nervous system.
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Pediatric emergency care · Mar 2012
Review Case ReportsSalter-harris type 2 fracture of the proximal phalanx of the thumb with a rotational deformity: a case report and review.
Hand fractures are the most common site of injury in the pediatric population. They commonly involve the epiphyseal growth plates, and their standard classification is that of Salter-Harris (SH). Rotational deformities after SH fractures are rarely reported in literature. ⋯ A review of literature is performed. Thus, examination for rotational deformities in SH fractures should be kept in mind. A satisfactory closed reduction under local anesthesia can be obtained.
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Pediatric emergency care · Mar 2012
ReviewDexmedetomidine sedation: uses in pediatric procedural sedation outside the operating room.
As the field of pediatric procedural sedation continues to expand, so does the exploration of medications that have a role in such invasive and noninvasive procedures. One such medication that has emerged during the last decade is dexmedetomidine, a drug approved for use in the adult intensive care setting. Its role in pediatrics has varied in its use from sedation in ventilated children in the intensive care unit to treatment for emergence reactions from general anesthesia and in sedation needed for radiographic imaging studies, electroencephalography, and invasive procedures. This review article presents the pediatric studies that have been published thus far regarding dexmedetomidate in the nonventilated, spontaneously breathing patient and identifies those patients where the use of this agent may not be indicated.