Pediatric emergency care
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Isolated avulsion fractures of the greater and lesser trochanter are usually seen in adolescents prior to the fusion of the apophysis. Greater trochanter fractures in adults have a high incidence of intertrochanteric extension and lesser trochanter fractures are regarded as a pathognomonic sign of metastatic disease. These fractures are very rare among children. ⋯ IV Case series.
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Pediatric emergency care · May 2019
Case ReportsLead Pellet Ingestion in 3 Children: Another Source for Lead Toxicity.
Acute ingestions of spherical lead ammunition foreign bodies such as bullets and lead shot can cause acute blood lead level elevations and clinical symptoms necessitating emergency department evaluations and sometimes treatment. This article presents 3 cases of children ingesting lead ammunition, all receiving gastrointestinal (GI) decontamination and chelation therapy for significantly elevated blood lead level. Case-specific exposures and treatments for the lead ammunitions are presented. ⋯ More rapid GI absorption has the potential to result in possible irreversible neurotoxicity and neurocognitive deficits as well as behavioral changes. Failure of lead foreign bodies to pass from the GI tract may require more aggressive interventions for their removal to prevent ongoing absorption. Emergency health care providers should be aware of alternative lead sources besides the most common source of paint, as these lead foreign bodies also need urgent evaluation and possibly treatment.
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Pediatric emergency care · May 2019
Prehospital Analgesic Administration by Parents for Pain Relief in Children.
Undertreatment of pain by caregivers before presentation to the pediatric emergency department (ED) has been well documented. What has yet to be elucidated are the reasons why caregivers fail to adequately treat pain before arrival in the ED and whether there are differences based on ethnic background or age of the child. The objectives of this study were to determine the barriers to giving pain medication for injuries before ED arrival and to determine if there are any ethnic- or age-related variations to giving pain relief at home. ⋯ In this study, approximately half of all children receive an analgesic for their painful condition before coming to the ED. Continued education regarding pain relief before coming to the ED is needed. Future studies will focus on educating parents to provide analgesia at home.
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Pediatric emergency care · May 2019
The Effect of a Primary Care Provider Incentive Program on Pediatric Emergency Medicine Visits.
The aim of the study was to analyze the effect of a financial incentive program targeting primary care providers (PCPs) with the goal of decreasing emergency department (ED) utilization. ⋯ A financial incentive program to provide PCPs with specific targets and goals to decrease pediatric ED utilization can decrease ED visits.