Pediatric emergency care
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Pediatric emergency care · Mar 2014
Case ReportsGiant omental hemorrhagic cyst presenting as acute hemorrhagic anemia in a 21-month-old infant.
An omental cyst is a very rare pathology, especially in small infants. Children generally present with abdominal distention with or without a palpable mass. The mass may be huge, simulating ascites. ⋯ The differential diagnosis includes intestinal duplication cyst, ovarian, choledochal, pancreatic, splenic, or renal cysts, hydronephrosis, cystic teratoma, hydatid cyst, and ascites. We describe the clinical presentation, imaging features, surgical treatment, and postoperative course of a 21-month-old female infant with a congenital giant omental cyst. This entity is extremely rare but should be included in the differential diagnosis in similar cases.
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Pediatric emergency care · Mar 2014
Case ReportsStatus epilepticus, cardiac resuscitation, and posterior reversible encephalopathy syndrome after ingestion of viscous lidocaine: a plea for more childproof packaging of pharmaceuticals.
Ingestion of viscous lidocaine in children can lead to potentially lethal neurologic and cardiac effects. We report the case of a 2-year-old boy who developed posterior reversible encephalopathy syndrome 2 days after unobserved ingestion of about 500 mg viscous lidocaine (40 mg/kg of bodyweight). Initially, the child presented with convulsive status epilepticus and subsequent cardiac arrest necessitating cardiopulmonary resuscitation for eight minutes. ⋯ Despite the potential hazardousness of the drug, packaging of viscous lidocaine is not childproof. Therefore, physicians have to instruct the parents carefully to minimize the risk of overuse or accidental ingestion. In general, the use of viscous lidocaine should be limited.
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Pediatric emergency care · Mar 2014
Review Case ReportsAlternative airways for the pediatric emergency department.
Securing the pediatric airway in the emergency setting is an uncommon event that is complicated by anatomic, physiologic, and environmental factors. Even more uncommonly, practitioners are faced with the added complication of a difficult airway, and the question of what alternatives to traditional endotracheal intubation are available and most useful may arise. Timely and effective intervention determines the patient's clinical outcome. The purpose of this review was to detail specific alternative airway management strategies and tools for use in the pediatric emergency department.
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Pediatric emergency care · Mar 2014
Randomized Controlled TrialHypertonic saline as a therapy for pediatric concussive pain: a randomized controlled trial of symptom treatment in the emergency department.
Three-percent hypertonic saline (HTS) is a hyperosmotic therapy used in pediatric traumatic brain injury to treat increased intracranial pressure and cerebral edema. It also promotes plasma volume expansion and cerebral perfusion pressure, immunomodulation, and anti-inflammatory response. We hypothesized that HTS will improve concussive symptoms of mild traumatic brain injury. ⋯ Three-percent HTS is more effective than NS in acutely reducing concussion pain in children.
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Pediatric emergency care · Mar 2014
Development of a survey of teamwork and task load among medical providers: a measure of provider perceptions of teamwork when caring for critical pediatric patients.
Teamwork training focuses on improving patient outcomes through better communication. Scales exist to assess providers' perceptions of teamwork; however, they are not designed for use immediately after the care of critically ill patients. ⋯ The Survey of Teamwork and Task Load among Medical Providers was developed to evaluate providers' perceptions of teamwork immediately after care of critically ill patients in a pediatric emergency department. Items reflect 2 constructs, with good internal consistency. Responses did not vary by professional training, suggesting that it is useful for all providers. Both factors predicted the overall smoothness. Each was useful in predicting the perception that the resuscitation went smoothly.