Pediatric emergency care
-
This study aimed to determine the incidence of missed opportunities to diagnose abuse in a cohort of children with healing abusive fractures and to identify patterns present during previous medical visits, which could lead to an earlier diagnosis of abuse. ⋯ One-third of young children with healing abusive fractures had previous medical visits where the diagnosis of abuse was not recognized. These children most commonly had signs of trauma on physical examination at the previous visits.
-
Pediatric emergency care · Nov 2014
Adult Patients in the Pediatric Emergency Department: Presentation and Disposition.
Pediatric emergency departments (PEDs) are intended to care for acutely ill and injured children. Adult patients sometimes present to these facilities as well. Some of these are young adults still under the care of pediatric specialists, but older adults and those not under the care of specialists may seek care and may challenge pediatric care providers. Understanding the spectrum of adult illness encountered in the PED may help ensure optimum care for this patient population. ⋯ Adult patients in PEDs are rare but have relatively high acuity and often require transfer. Pediatric emergency department clinicians should have adequate, ongoing training to capably assess and stabilize adult patients across a spectrum of illness presentation.
-
Pediatric emergency care · Nov 2014
Case ReportsHemodialysis for near-fatal sodium phosphate toxicity in a child receiving sodium phosphate enemas.
This study aimed to demonstrate the importance of considering hemodialysis as a treatment option in the management of sodium phosphate toxicity. ⋯ Hemodialysis can safely be used as an adjunctive therapy in sodium phosphate toxicity to rapidly reduce serum phosphate levels and increase serum calcium levels in children not responding to conventional management.
-
Pediatric emergency care · Nov 2014
Observational StudyEvaluation of an After-Hours Call Center: Are Pediatric Patients Appropriately Referred to the Emergency Department?
There is concern that after-hours nurse telephone triage systems are overwhelming the emergency department (ED) with nonemergent pediatric referrals. ⋯ Our study identifies that a third of unnecessary pediatric visits to the ED occurred as a result of the nurse triage telephone system in question. We recommend review of the algorithms stated to reduce strain on local ED resources.
-
Pediatric emergency care · Nov 2014
Case ReportsElevated Lidocaine Serum Concentration After Subcutaneous Lidocaine Administration Using a Needle-Free Device in Pediatric Patients.
We report several cases in which pediatric patients at our institution have elevated lidocaine levels in toxicology screens after subcutaneous injection of lidocaine using a needle-free device. The purpose of this article is to report 4 cases in which pediatric patients have elevated lidocaine levels in toxicology screens after J-Tip administration. ⋯ Although the literature has reported the device to be effective with no significant untoward effects in children as young as 3 years, it seems that no information is available for children younger than 3 years. From a quality assurance/safety perspective, a summary is provided as our institutional response to concerns raised over what is typically thought to be a benign and beneficial intervention in children.