Pediatric emergency care
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Pediatric emergency care · Apr 2019
Early Recognition and Treatment of Acute Disseminated Encephalomyelitis in Pediatrics: A Case Series.
Our aim is to emphasize the varied presentation of acute disseminated encephalomyelitis (ADEM) to help health care professionals improve recognition of the disease in a timely manner, thereby allowing for the selection of an appropriate treatment regimen. Therefore, this may avoid neurocognitive consequences and the ultimate fatality of the patient. ⋯ Children presenting to the emergency department with nonspecific symptoms associated with any neurological deficits should undergo further investigation using magnetic resonance imaging and lumbar puncture to rule out rare yet possibly fatal diseases such as ADEM.
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Pediatric emergency care · Apr 2019
The Challenge of Patient Notification and the Work of Follow-Up Generated by a 2-Step Testing Protocol for Group A Streptococcal Pharyngitis in the Pediatric Emergency Department.
Current guidelines recommend confirmatory testing for negative rapid antigen detection tests (RADTs) for group A streptococcal pharyngitis in children. We sought to describe the work of follow-up generated by this process and frequency of our inability to notify patients of positive results. ⋯ Although confirmatory testing after a negative RADT in children is currently the standard of care, this practice requires a substantial amount of work. Furthermore, a significant fraction of patients are lost to follow-up or have unnecessary repeat visits.
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The aim of this study was to determine if there is an association between bronchiolitis and future development of asthma in children younger than 2 years. ⋯ In this limited sample, the predictor variables for asthma were male sex, age older than 5 months, more than 2 episodes of bronchiolitis, a history of atopy, and allergies.
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Pediatric emergency care · Apr 2019
A Call to Restore Your Calling: Self-care of the Emergency Physician in the Face of Life-Changing Stress-Part 1 of 6.
Few practicing emergency physicians will avoid life-changing stressors such as a medical error, personal illness, malpractice litigation, or death of a patient. Many will be unprepared for the toll they will take on their lives. Some may ultimately experience burnout, post-traumatic stress disorder, and suicidal ideation. ⋯ The authors identify internal constraints that inhibit healthy coping and tools for individuals, training programs, and health care organizations to consider adopting, as they seek to increase physician satisfaction and retention. The reader will learn to recognize physician distress and acquire strategies for self-care and peer support. The series will highlight the concept that professional fulfillment requires ongoing attention and is a work in progress.
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Pediatric emergency care · Apr 2019
Case ReportsRoller Coaster-Induced Subdural Hematoma in a Previously Healthy Teenager.
Of the multitude of neurologic injuries related to roller-coaster rides, a majority of them are reported about adults. In this case, we present a patient who presented to the pediatric emergency department with new-onset seizure and hemiplegia 2 days after a roller-coaster ride. ⋯ Advances in roller-coaster technology may surpass the passenger's physical capacity for acceleration and rotary forces, and we may see an increased number of medical complications after these rides. We recommend that emergency and pediatric health care providers consider amusement park thrill rides as a possible cause of subdural hematomas in previously healthy patients with new neurologic complaints.