Pediatric emergency care
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Pediatric emergency care · Nov 2019
Effects of the Introduction of Intranasal Fentanyl on Reduction of Pain Severity Score in Children: An Interrupted Time-Series Analysis.
Children are at risk of inadequate analgesia due to paramedics' inexperience in assessing children and challenges in administering analgesics when the patient is distressed and uncooperative. This study reports on the outcome of a change to practice guidelines that added intranasal fentanyl and intramuscular morphine within a large statewide ambulance service. ⋯ This large study of a system-wide clinical practice guideline change has demonstrated a significant improvement in the outcome of interest. However, a proportion of children with moderate to severe pain did not receive analgesia.
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Pediatric emergency care · Nov 2019
Case ReportsFatal Refractory Ventricular Fibrillation Due to Ingestion of Hydrofluoric Acid.
Hydrofluoric acid (HF) is a colorless and odorless solution of the hydrogen fluoride in water. It is used in some household products. ⋯ In this case report, we present a 3.5-year-old girls who unintentionally drunk a rust remover that contained 8% HF. She died in a short period as a result of refractory ventricular fibrillation, which was developed due to fluoride intoxication.
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Pediatric emergency care · Nov 2019
Case ReportsAn Extraordinary Complication in a Child With Combined Familial Mediterranean Fever and Inflammatory Bowel Disease: Multiple Ileal Perforations.
Familial Mediterranean fever (FMF) is a recurrent disease with autosomal recessive trait and fever that is generally self-limiting. Clinical manifestations are pain in the abdomen, chest, and joints as a result of inflammation in the serous surfaces. ⋯ Here, we report a case of a 5-year-old girl who was being followed up with the diagnosis of FMF and who also had inflammatory bowel disease, which was complicated with multiple ileal perforations. Our aim is to point out a rarely encountered co-occurrence and also the importance of evaluation of additional diseases with FMF that are unresponsive to treatment so as to prevent complications.
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Pediatric emergency care · Nov 2019
Long-Term Follow-Up of Infants After a Brief Resolved Unexplained Event-Related Hospitalization.
A brief resolved unexplained event (BRUE) in infancy is a common reason for visiting the emergency department. However, little is known about the long-term outcomes of such an event. This study evaluates future mortality, morbidity, and/or developmental outcome after a BRUE. ⋯ Low-risk hospitalized infants younger than 1 year who experienced a BRUE seem to generally have an excellent prognosis.
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Pediatric emergency care · Nov 2019
Nationwide Survey of Hospitalization Due to Pediatric Food-Induced Anaphylaxis in the United States.
Anaphylaxis is a common, serious, systemic allergic reaction. In the United States, the change of annual hospitalization rates by anaphylaxis-trigger foods and risk factors associated with severity remain unclear. ⋯ The annual hospitalization rates in the entire United States showed an increasing trend during 2006-2012. The rates of peanuts, tree nuts and seeds, and milk products demonstrated upward trends. Milk products, ages between 13 and 20 years, and comorbidities of asthma were related to severity and morbidity.