Pediatric emergency care
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Pediatric emergency care · Jan 2014
Noninvasive Bedside Assessment of Acute Asthma Severity Using Single-Breath Counting.
The single-breath counting (SBC) method for assessment of asthma exacerbation severity has been evaluated in adults during exacerbations and in pediatric patients during routine settings. Single-breath counting has not been evaluated in children during exacerbations. We sought to assess criterion validity and responsiveness of SBC with percent-predicted FEV1 (%FEV1) and the Pediatric Respiratory Assessment Measure (PRAM), a validated acute asthma severity score. ⋯ Single-breath counting demonstrates modest criterion validity for predicting the pretreatment PRAM score and a trend for predicting %FEV1. Single-breath counting does not appear to be responsive to change of these measures in response to treatment and has limited validity as a measure of acute asthma severity.
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Pediatric emergency care · Jan 2014
Multicenter StudyInterhospital Pediatric Patient Transfers-Factors Influencing Rapid Disposition After Transfer.
The objective of this study was to determine the incidence, demographics, and clinical course of pediatric patients rapidly discharged after transfer from outlying emergency departments (EDs) to a tertiary care pediatric ED (PED) with no additional diagnostic or therapeutic actions. ⋯ Pediatric patients transferred from outlying community EDs to a PED frequently required little or no additional care. Referring hospital ED type and physician training type are associated with the need for additional workup at the pediatric emergency room.
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Pediatric emergency care · Jan 2014
Multicenter Study Observational StudyPharmacological Sedation for Cranial Computed Tomography in Children After Minor Blunt Head Trauma.
Children evaluated in emergency departments for blunt head trauma (BHT) frequently undergo computed tomography (CT), with some requiring pharmacological sedation. Cranial CT sedation complications are understudied. The objective of this study was to document the frequency, type, and complications of pharmacological sedation for cranial CT in children. ⋯ Pharmacological sedation is infrequently used for children with minor BHT undergoing CT, and complications are uncommon. The variability in sedation medications and frequency suggests a need for evidence-based guidelines.
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Pediatric emergency care · Jan 2014
Multicenter StudySynovial Fluid Findings in Children With Knee Monoarthritis in Lyme Disease Endemic Areas.
Although Lyme and septic arthritis of the knee may have similar clinical presentations, septic arthritis requires prompt identification and treatment to avoid joint destruction. We sought to determine whether synovial fluid cell counts alone can discriminate between Lyme, septic, and other inflammatory arthritis. ⋯ In Lyme endemic areas, synovial fluid results alone do not differentiate septic from Lyme arthritis. Therefore, other clinical or laboratory indicators are needed to direct the care of patients with knee monoarthritis.
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Novel classes of synthetic drugs, including synthetic cathinones ("bath salts") and synthetic cannabinoids ("spice" or "K2"), have recently emerged as popular drugs of abuse. Salvia divinorum, a naturally occurring herb, has gained popularity in the last decade as a hallucinogenic as well. ⋯ We present an up-to-date information about the legality of these substances. We also discuss the historical background, chemical composition, patterns of abuse, clinical presentations, laboratory analysis, and management strategies for these drugs, with an emphasis on synthetic cathinones.