Pediatric emergency care
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Pediatric emergency care · Oct 2013
Emergency Department Crowding and Younger Age Are Associated With Delayed Corticosteroid Administration to Children With Acute Asthma.
This study aimed to identify factors associated with delayed or omission of indicated steroids for children seen in the emergency department (ED) for moderate-to-severe asthma exacerbation. ⋯ In this ED, steroids were underprescribed and frequently delayed for pediatric ED patients with moderate-to-severe asthma exacerbation. Greater ED volume and younger age are associated with delays. Interventions are needed to expedite steroid administration, improving adherence to National Institutes of Health asthma guidelines.
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Pediatric emergency care · Oct 2013
Observational StudyEmergency Department Conditions Associated With the Number of Patients Who Leave a Pediatric Emergency Department Before Physician Assessment.
As emergency department (ED) waiting times and volumes increase, substantial numbers of patients leave without being seen (LWBS) by a physician. The objective of this study was to identify ED conditions reflecting patient input, throughput, and output associated with the number of patients who LWBS in a pediatric setting. ⋯ In the study ED, throughput variables played a more important role than input or output variables on the number of patients who LWBS. This finding, which contrasts with a work done previously in an ED serving primarily adults, highlights the importance of pediatric specific research on the impacts of increasing ED waiting times and volumes.
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Pediatric emergency care · Oct 2013
Case ReportsSurvival With 98% Methemoglobin Levels in a School-Aged Child During the "Festival of Colors"
Methemoglobin levels more than 70% have almost always been reported to have been fatal. The case of a 4-year-old boy who survived with methemoglobin levels of 98% is presented here. ⋯ A possibility of toxic methemoglobinemia was considered and confirmed by finding of elevated methemoglobin levels of 98%. The child survived with definitive therapy with methylene blue and aggressive goal-directed approach.
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Pediatric emergency care · Oct 2013
Evaluation of a Novel Pediatric Appendicitis Pathway Using High- and Low-Risk Scoring Systems.
This study aimed to determine the test characteristics of a pathway for pediatric appendicitis and its effects on emergency department (ED) length of stay, imaging, and admissions. ⋯ The low-risk criteria had good sensitivity in ruling out appendicitis. The high-risk criteria could be used to guide referral or admission. Neither outperformed the a priori judgment of experienced providers.
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Neonatal seizures are a potentially life-threatening pediatric problem with a variety of causes, such as birth trauma, asphyxia, congenital anomalies, metabolic disturbances, infections, and drug withdrawal or intoxication. Thorough and timely evaluations of such patients are necessary to identify and treat the underlying etiology, therefore reducing potential morbidity and mortality. ⋯ The etiology of these abnormalities was found to be maternal ingestion of extremely high doses of calcium carbonate during the third trimester of her pregnancy, an occurrence that has been reported only once in the literature. Education pertaining to the dangers of excessive calcium carbonate intake during pregnancy may be an important piece of anticipatory guidance for pregnant mothers with symptoms of gastroesophageal reflux, and questioning the mother of a neonate presenting with seizures about such over-the-counter medications may help to elucidate the diagnosis.