Pediatric emergency care
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Pediatric emergency care · Dec 2019
Comparative StudyIs Radiography Necessary for Pediatric Emergency Department Clinicians to Safely Manage Ankle Injuries?
Ankle radiography in the pediatric emergency department exposes a radiosensitive population to harmful ionizing radiation and is costly to health care systems. This study aimed to determine if ankle injuries in children could be managed safely and effectively without radiography. ⋯ This study found that radiographs are necessary for the management of pediatric ankle injuries. However, there is scope to reduce radiography by implementing the Low Risk Ankle Rule.
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Pediatric emergency care · Dec 2019
Case ReportsA Systematic Review of Testicle Survival Time After a Torsion Event.
The time window for possible salvage and survival of a torsed testicle is commonly thought to be 6 to 8 hours. However, survival of torsed testicles with or without subsequent atrophy is known to occur outside that critical time window. In this article, we performed a systematic review of the English literature to provide a more accurate understanding of reported time frames of testicle survival after a torsion event. ⋯ Survival of the testicle irrespective of subsequent atrophy, decreased spermatogenesis or impaired endocrine function after TT can be much longer than the 6 to 8 hours that is commonly taught. Our systematic review of the literature demonstrates that survival percentages are significant even past 24 hours of torsion. This information should encourage aggressive management of patients presenting with TT pain that has been ongoing for many hours.
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Pediatric emergency care · Dec 2019
Comparative StudyLower Extremity Fractures in Hospitalized Pediatric Patients Following Road Traffic Accidents.
Lower extremity fractures (LEFs) caused by road traffic accidents (RTAs) can result in significant morbidity and account for a substantial part of nonfatal injuries requiring hospitalization. This study investigated the epidemiology of RTA-associated LEFs in the pediatric population. Based on the National Trauma Registry, data of 28,924 RTA hospitalized pediatric patients were reviewed. ⋯ As patients were older, the greater the chance they required further treatment in the operating room (P < 0.0001). This large-scale study on the epidemiology of LEFs in the pediatric population following RTA provides unique information on epidemiological characteristics of LEF, pertinent both to medical care providers and to health policy makers allocating resources and formulating prevention strategies in the attempt to deal with the burden of road traffic accidents. Level of Evidence: Prognostic and epidemiologic study, level II.
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Pediatric emergency care · Dec 2019
Case ReportsKawasaki at the Extremes of Age: Thinking Outside the Box.
Kawasaki disease is an acute vasculitis syndrome that typically occurs in children aged 1 to 4 years. Because there is no specific diagnostic test for Kawasaki disease, the diagnosis is made clinically based on specific characteristic signs and symptoms. Cases in which patients fall outside of the typical age range are uncommon and often challenging to diagnose because they have atypical presentations. ⋯ These cases illustrate the challenge of diagnosing Kawasaki disease in patients beyond the typical age range. Both patients were return visits to the emergency department after inpatient stays. When fever persists longer than 5 days, clinicians must have a high index of suspicion for Kawasaki disease in all pediatric age groups to prevent treatment delay and disease sequelae.
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We report the case of a 17-year-old male football player with blunt abdominal trauma. Careful evaluation, including computed tomography and laboratory, revealed a pancreatic body laceration. Pancreatic injuries are relatively uncommon and associated with significant morbidity and mortality and require early diagnosis for optimal management and outcome.