Pediatric emergency care
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Pediatric emergency care · Aug 2014
Case ReportsAnother Angry Adolescent: Another Boxer's Fracture?
Hand injuries are a common chief complaint in the pediatric population presenting for emergency care. Adolescents, in particular, often present with trauma to their hands after punching objects. The most frequent result of this action is a fracture to one or more of their metacarpals, also known as a boxer's fracture. However, we present a case with this common mechanism that resulted in an uncommon injury, carpometacarpal joint dislocations.
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Pediatric emergency care · Aug 2014
Review Case ReportsA 6-year-old girl with undiagnosed hemophagocytic lymphohistiocytosis and takotsubo cardiomyopathy: a case report and review of the literature.
Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder of highly stimulated immune responses to antigens that leads to life-threatening inflammation and multiple organ dysfunction. At presentation, HLH may uncommonly mimic septic shock. In this case, we present a 6-year-old girl presenting to the pediatric emergency department with a febrile illness and anemia that subsequently developed decompensated shock, initially thought to be septic. ⋯ During initial HLH treatment, this patient also developed takotsubo cardiomyopathy, a unique pattern of reversible left ventricular dysfunction characterized by transient apical ballooning and hypokenesis of the left ventricle that spontaneously resolves. There are very few case reports of HLH-associated takotsubo cardiomyopathy. We believe that this is the first case of takotsubo cardiomyopathy in a child with HLH.
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Pediatric emergency care · Aug 2014
Comparative StudyShould Pediatric Emergency Physicians Be Decentralized in the Medical Community?
Pediatric emergency physicians (PEPs) are well established as primary emergency department (ED) providers in dedicated pediatric centers and university settings. However, the optimum role of these subspecialists is less well defined in the community hospital environment. This study examined the impact on the ED care of children after the introduction of 10 PEPs into a simulated medical community. ⋯ The greatest impact of PEPs on an ED population of children is produced when the PEPs distribute themselves throughout a medical community rather than create individual pediatric EDs in a small number of hospitals.
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Pediatric emergency care · Aug 2014
Rate of and Risk Factors for Early Recurrence in Patients With Febrile Seizures.
Patients with febrile seizures (FSs) are observed in emergency departments or admitted to hospitals because of the possibility of recurrence. There are no guidelines regarding the observation time for recurring FS. The aim of this study was to identify the rate, time, risk factors, and cumulative probability of early recurrence. ⋯ The majority of recurrent FSs occurred in the first 24 hours. The type and duration of seizures were significant risk factors for early recurrence.