Pediatric emergency care
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Pediatric emergency care · Dec 2013
Case ReportsPositive lidocaine toxicology screen after j-tip for venipuncture.
Venipuncture is common in children, and topical anesthetics are often used to alleviate the pain of the procedure. The J-Tip (National Medical Products, Inc, Irvine, Calif) device has become popular as a rapid and effective means of delivering lidocaine noninvasively. ⋯ A repeat toxicology screen obtained 1 hour later by venipuncture without J-Tip use was negative. This report serves to remind clinicians that topical anesthetics may interfere with toxicology assays, leading to unreliable toxicology results.
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Pediatric emergency care · Dec 2013
Development and Evaluation of a Program for the Use of Ultrasound for Central Venous Catheter Placement in a Pediatric Emergency Department.
A growing body of literature supports the use of ultrasound (US) to assist central venous catheter (CVC) placement, and in many settings, this has become the standard of care. However, this remains a relatively new and uncommonly performed procedure for pediatric emergency medicine physicians. ⋯ The development of an emergency US program was associated with significantly increased physician use of US for CVC placement.
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Pediatric emergency care · Dec 2013
Review Case ReportsNeuroblastoma presenting as persistent postprandial emesis in a neonate.
Early identification and treatment of neuroblastoma, the most common malignant solid tumor in infants, (Atkinson et al. AJR Am J Roentgenol. 1986;146:113-117; Nuchtern. Semin Pediatr Surg. 2006;15:10-16; Lanzkowsky. ⋯ A diagnosis of nonresectable stage IV thoracoabdominal neuroblastoma with invasion to the spine was made. We concluded that oncological processes, such as neuroblastoma, should be included in the differential diagnosis of persistent emesis in the neonatal period. Emergency physicians may have the opportunity to detect neuroblastoma earlier by contemplating a broader differential diagnosis of a vomiting infant and initiating the appropriate workup in the emergency department.
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Pediatric emergency care · Dec 2013
Experiences of Pediatric Emergency Physicians in Providing Alcohol-Related Care to Adolescents in the Emergency Department.
The emergency department (ED) is a key clinical care setting for identifying and managing patients with alcohol-related presentations. We explored the experiences of emergency physicians in providing alcohol-related care to adolescents. ⋯ Pediatric ED physicians struggled during the caring experience and were skeptical that broader, more chronic social issues that are often associated with adolescent alcohol misuse can be effectively managed in a clinical setting where they feel primarily responsible for providing medical stabilization. Physicians did believe the ED was an appropriate place to ensure medical stability of a patient and then initiate a conversation regarding alcohol use and its harmful effects.