Pediatric emergency care
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Pediatric emergency care · May 2014
Review Case ReportsArachnoid cysts with subdural hematoma or intracystic hemorrhage in children.
Arachnoid cyst (AC) is a common congenital intracranial lesion in children. It may be complicated by subdural hematoma (SDH) and intracystic hemorrhage (ICH) to cause intracranial hypertension after minor head injury or spontaneously. However, because most bleeding after trauma is delayed, it is often overlooked. ⋯ At the same time, we review 41 pediatric patients reported in the last 20 years. We conclude that a child with AC should be regularly followed up after minor head injury, and that therapy for children with complicated ACs should be more aggressive than for adults. The cyst wall should be resected, and communication between cyst and cerebral cistern should be established.
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Pediatric emergency care · May 2014
Review Case ReportsIntra-articular Lidocaine for Reduction of Shoulder Dislocation.
Anterior shoulder dislocation is the most common joint dislocation seen in the emergency department. Although emergency medicine providers use several techniques for reduction, each method is associated with potential discomfort for the patient. ⋯ Intra-articular injection of lidocaine has demonstrated efficacy in reduction of pain and facilitation of shoulder reduction compared with analgesia and sedation. Intra-articular lidocaine may also reduce time to successful reduction of shoulder dislocations.
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Pediatric emergency care · May 2014
Review Observational StudyA Prospective Study of Pediatric Hand Fractures and Review of the Literature.
Hand fractures represent a leading cause of morbidity in children. However, little information exists correlating the mechanisms and environment of injury with outcomes and treatments. We examine the demographics, etiology, anatomic location, mechanism, and management of pediatric hand fractures in our center's hand unit. ⋯ The pattern of pediatric hand fracture in different age groups is highlighted in this article. The observations from this study will hopefully encourage further review with a larger cohort and a focus on preventative measures for pediatric hand fractures.
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Pediatric emergency care · May 2014
Case ReportsRapunzel Syndrome: Diagnosis via Radiograph and History.
Rapunzel syndrome is defined as a gastric trichobezoar with a tail that extends distally into the small intestine. It is extremely rare and found more often in premenarchal girls with psychiatric comorbidities. Symptoms can be vague and linger for years. ⋯ The standard imaging modality of choice to make a presurgical diagnosis is via computed tomography (CT) scan of the abdomen. However, the risk of radiation-induced malignancy associated with a CT scan is an important consideration when managing children. We report a case of Rapunzel syndrome in a 6-year-old girl who was diagnosed presurgically without the use of a CT scan.