Pediatric emergency care
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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
Case ReportsEmergency Department Bedside Ultrasound Diagnosis of Retinoblastoma in a Child.
A 30-month-old boy presented to a Haitian emergency department with proptosis, periorbital edema, and progressive blindness. Bedside ultrasound examination revealed bilateral ocular masses with dense calcifications pathognomonic for retinoblastoma. This case illustrates the diagnostic utility of bedside ultrasound for an advanced case of retinoblastoma in a resource-poor setting. Ocular ultrasound technique is also reviewed.
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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.