Pediatric emergency care
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Pediatric emergency care · Apr 2013
Race, ethnicity, and analgesia provision at discharge among children with long-bone fractures requiring emergency care.
Inadequate treatment of painful conditions in children is a significant and complex problem. The objective of this study was to examine the effect of race/ethnicity on the provision of analgesic medicines at discharge in children treated emergently for a long-bone fracture. ⋯ Race/ethnicity is associated with different analgesic prescription patterns in children treated in the emergency department for a long-bone fracture.
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Pneumomediastinum is a relatively uncommon occurrence in pediatric patients. After mediastinal air leak, air may dissect through a variety of tissue planes within the chest, neck, and abdomen. We report the case of a 16-year-old adolescent boy who presented with spontaneous pneumomediastinum accompanied by the presence of air within the spinal canal. We suggest use of the term "spontaneous pneumorrhachis" to distinguish this type of presentation from other potential causes.
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Pediatric emergency care · Apr 2013
Early identification of children at risk for critical care: standardizing communication for inter-emergency department transfers.
Interfacility transfers occur frequently and often involve critically ill patients. Clear communication at the time of patient referral is essential for patient safety. ⋯ A standardized communication template for inter-ED transfers can identify children with respiratory complaints who require ICU admission. Next steps include real-time application to judge screening performance compared with current nonstandardized intake protocols.
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Pediatric emergency care · Apr 2013
Knowledge, attitudes, and beliefs about emergency contraception: a survey of female adolescents seeking care in the emergency department.
This study aimed to assess urban adolescents' knowledge of and attitudes about emergency contraception (EC) and to assess the intention to use EC in particular hypothetical situations. We hypothesized that knowledge about EC would be limited, but that adolescents would support using EC in certain situations. ⋯ Participants indicated that although they would support EC use in several situations, they have concerns about EC use and access. Awareness of these factors and potential influences of EC use can guide providers toward effective counseling and interventions aimed to increase adolescents' use of EC in appropriate settings.
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Pediatric emergency care · Apr 2013
Electrolyte profile of pediatric patients with hypertrophic pyloric stenosis.
Recent investigations have demonstrated that the classic hypochloremic, hypokalemic, metabolic alkalosis of hypertrophic pyloric stenosis (HPS) is not a common finding.Some have suggested a trend over time, but none has investigated factors contributing to laboratory derangement, such as duration of vomiting or patient age at presentation. We sought to determine the proportion of patients with HPS with normal and abnormal laboratory findings as a function of year of presentation, duration of vomiting, and patient age. ⋯ We observed that normal laboratory values are the most common finding in HPS and that metabolic alkalosis was found more commonly in the latter part of the decade and in older infants.