Pediatric emergency care
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Pediatric emergency care · Apr 2015
Case ReportsIntranasal midazolam for the emergency management of hypercyanotic spells in tetralogy of fallot.
The case of a 2-month-old boy with previously diagnosed tetralogy of Fallot who was brought to the emergency department with a hypercyanotic spell is described. Because partly of the difficulty of intravenous placement, especially in an infant crying with marked hypernea and deeply cyanotic, intranasal midazolam was administered. ⋯ Sedation is an important step in the management of patients with cyanotic spells. Intranasal midazolam offers an alternative use as an initial method of calming the child that was effective in a patient with a severe cyanotic spell because of tetralogy of Fallot in the emergency department.
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Pediatric emergency care · Apr 2015
Methicillin-Resistant Staphylococcus aureus: Decolonization and Prevention Prescribing Practices for Children Treated With Skin Abscesses/Boils in a Pediatric Emergency Department.
This study aimed to describe methicillin-resistant Staphylococcus aureus (MRSA) eradication/prevention practices of clinicians managing patients with skin and soft tissue infections (SSTIs), specifically, in those patients undergoing abscess incision and drainage (I&D) in a pediatric emergency department (ED). ⋯ Methicillin-resistant S aureus eradication/prevention discussions are not commonly included in discharge instructions for patients undergoing abscess I&D. Given the significant proportion with previous MRSA infection, the ED may be a setting to provide instructions to patients/families with recurrent infections.
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Pediatric emergency care · Apr 2015
Case ReportsPrimary hyperparathyroidism: an uncommon cause of hip pain.
Hip pain is a common complaint in a pediatric emergency department. The causes of hip pain are diverse and generally include traumatic and infectious causes. We report a case of hip pain caused by deep soft tissue infection associated with hypercalcemia and primary hyperparathyroidism. Atypical presentation of primary hyperparathyroidism may result in a delay in diagnosis.
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Pediatric emergency care · Apr 2015
Observational StudyA Novel Briefing Checklist at Shift Handoff in an Emergency Department Improves Situational Awareness and Safety Event Identification.
Emergency department (ED) shift handoffs are sources of potential medical error, delays in care, and medicolegal liabilities. Few handoff studies exist in the ED literature. We aimed to describe the implementation of a standardized checklist for improving situational awareness during physician handoffs in a pediatric ED. ⋯ The Physician Active Shift Signout in the Emergency Department briefing checklist was used often and at a high completion rate, frequently identifying potential safety events. The users found that it improved the quality of care and team communication. Future studies on outcomes and processes are needed.
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Pediatric emergency care · Apr 2015
Case ReportsRecurrent rhabdomyolysis in a teenager with psychosis-intermittent hyponatremia-polydipsia syndrome.
To report a case of recurrent hyponatremia and rhabdomyolysis in a teenager with psychogenic polydipsia. ⋯ Severe hyponatremia and rhabdomyolysis can complicate psychogenic polydipsia. Patients receiving antipsychotic drugs with concomitant severe hyponatremia need to be monitored for rhabdomyolysis.