Pediatric emergency care
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Pediatric emergency care · Aug 2017
Missed Fractures in Infants Presenting to the Emergency Department With Fussiness.
The aim of this study was to evaluate incidence of prior fussy emergency visits in infants with subsequently diagnosed fractures suggestive of abuse. ⋯ Fractures concerning for child abuse are an important cause of unexplained fussiness in infants presenting to the pediatric ED. A high index of suspicion is essential for prompt diagnosis and likely prevention of other abuse.
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Pediatric emergency care · Aug 2017
Utility of Lumbar Puncture in Children Presenting With Status Epilepticus.
Because meningitis may trigger seizures, we sought to determine its frequency in children with first-time status epilepticus (SE). ⋯ Bacterial meningitis is an uncommon cause of SE.
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Pediatric emergency care · Aug 2017
Case ReportsA Curiously Rare Case of Septic Shock From Clostridium difficile Colitis.
This case provides the first report of a young healthy child presenting in septic shock from Clostridium difficile colitis. This child had no identifiable risk factors for C. difficile, raising the suspicion for a hypervirulent strain. Once infection was recognized and treated appropriately, the child made a full recovery. This case presentation highlights the need to consider C. difficile colitis in the differential diagnosis of severely ill patients, even in the absence of traditional risk factors or symptoms.
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Pediatric emergency care · Aug 2017
Symptom-Guided Emergency Department Discharge Instructions for Children With Concussion.
The objective was to evaluate the use and utility of a novel set of emergency department discharge instructions (DIs) for concussion based on a child's ongoing symptoms: symptom-guided DIs (symptom DIs). Differences in clinical outcomes were also assessed. ⋯ Both study groups reported frequent use of the DIs. Caregivers with symptom DIs found them particularly helpful in determining when their child could return to school and physical activity. Larger-scale investigations are needed to further develop instructions that are easy to use and that may decrease the postconcussive period.
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Pediatric emergency care · Aug 2017
Case ReportsPoint-of-Care Ultrasound Identification of an Abdominal Hernia.
Pediatric emergency medicine physicians may be able to use point-of-care ultrasound (POCUS) as a tool to evaluate abdominal wall masses. We present a case of a 2-month-old infant with a lower abdominal mass identified as a hernia sac by POCUS. It was initially thought to represent a Spigelian-type abdominal wall hernia but subsequently determined to be an unusual presentation of an inguinal hernia with testicular entrapment. We review each of these diagnoses in addition to relevant POCUS findings.