Pediatric emergency care
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Pediatric emergency care · Jun 2014
Treating Psychiatric Emergencies in Incarcerated Minors in the Emergency Department: What Is the Cost and What Is Their Disposition?
Although mental health disorders are common among incarcerated minors, psychiatric urgencies and emergencies often cannot be treated in juvenile detention facilities, necessitating emergency department (ED) transfers. The cost of this ED care has not been well studied. ⋯ We describe the magnitude and cost associated with addressing psychiatric emergencies in a juvenile correctional system relying on transport of patients to an ED for acute psychiatric evaluation and treatment. Further research is needed to determine if costs could be decreased by increasing psychiatric resources in juvenile detention centers.
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Pediatric emergency care · Jun 2014
Case ReportsCrural amputation of a newborn as a consequence of intraosseous needle insertion and calcium infusion.
Intraosseous needle insertion and infusion is considered an easy and reliable method of achieving a vascular access in acute circulatory collapse where other methods have not been successful within reasonable time. Complications are considered few but may be serious. ⋯ Despite following most standard recommendations, the treatment resulted in transtibial amputation due to necrosis. We suspect that the necrosis was a consequence of extravasation of tissue-toxic calcium infusion.
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Pediatric emergency care · Jun 2014
Case ReportsHemoperitoneum: an unusual presentation of chronic granulocytic leukemia in a pediatric patient.
Chronic granulocytic leukemia (CGL) is a rare hematologic disease in pediatric patients. It usually presents with insidious symptoms. However, some cases may have an atypical presentation. ⋯ Pathology revealed a CGL-infiltrated ovary. The patient is currently stable, has finished adjuvant chemotherapy, and is at 24 months of follow-up. To our knowledge, this is the first report of such a case.
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Pediatric emergency care · Jun 2014
Sepsis and Meningitis in Hospitalized Children: Performance of Clinical Signs and Their Prediction Rules in a Case-Control Study.
Feverish illness is a common presentation to acute pediatric services. Clinical staff faces the challenge of differentiating the few children with meningitis or sepsis from the majority with self-limiting illness. We aimed to determine the diagnostic value of clinical features and their prediction rules (CPR) for identifying children with sepsis or meningitis among those children admitted to a District General Hospital with acute febrile illness. ⋯ The pediatrician's overall illness assessment was the most useful feature to rule in sepsis or meningitis in these hospitalized children. Clinical prediction rules did not effectively rule in sepsis or meningitis. The modified Yale Observation Scale should be used with caution. Single clinical signs could complement these scores to rule in sepsis or meningitis. Further research is needed to validate these CPRs.
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Pediatric emergency care · Jun 2014
Risky Behaviors Associated With Pediatric Pedestrians and Bicyclists Struck by Motor Vehicles.
Road safety constitutes a crisis with important health and economic impacts. In 2010, 11,000 pedestrians and 3500 bicyclists were injured by motor vehicles in New York City (NYC). Motor vehicle injuries represent the second leading cause of injury-related deaths in NYC children aged 5 to 14 years. To better target injury prevention strategies, we evaluated demographics, behaviors, environmental factors, injuries, and outcomes of pediatric pedestrians and bicyclists struck by motor vehicles in NYC. ⋯ Risky behaviors are common among pediatric pedestrians and bicyclists injured by motor vehicles. Road safety education and prevention strategies must stress compliance with traffic laws, readdress the importance of supervision, and reinforce avoidance of common distractors including electronic devices.