Pediatric emergency care
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Pediatric emergency care · Jun 2019
Medical Errors and Malpractice Lawsuits: Impact on Providers- Part 2 of 6.
Every pediatric emergency medicine provider will be involved in medical errors during their career and many will face the prospect of at least one malpractice lawsuit. These events can cause significant stress, including detrimental effects on providers' mental and physical health. This stress may also impact the provider's ability to care for future patients. In this installment of our series, "A Call to Restore Your Calling: Self-care of the Emergency Physician in the Face of Life-Changing Stress," we examine how medical errors and malpractice lawsuits may affect providers and how individuals and organizations can address these events.
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Pediatric emergency care · Jun 2019
Case ReportsAcquired Constriction Ring: A Case of Rubber Band Syndrome.
Rubber band syndrome is a rare entity seen in younger children mainly in communities where rubber bands are worn around the wrist for decorative purposes. When the band is worn for a long duration, it burrows through the skin and soft tissues resulting in distal edema, loss of function, and even damage to the neurovascular structures. These symptoms are difficult to relate to this rare but typical condition. ⋯ The child had excellent recovery postoperatively. The cardinal features of a linear constricting scar around the wrist in the presence of a swollen hand should always alert the clinician to the possibility of a forgotten band around the wrist, which might have burrowed into the soft tissues for a period. Early recognition may be important to prevent further damage of essential structures.
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Pediatric emergency care · Jun 2019
Effectiveness of a High-Fidelity Simulation-Based Training Program in Managing Cardiac Arrhythmias in Children: A Randomized Pilot Study.
Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias. ⋯ A simulation-based training with debriefing had positive effects on stress and satisfaction about skills of pediatric residents and nurses and on observed TSs and NTSs of the leaders during simulation sessions. A future study should assess the effectiveness of this training in a larger sample and its impact on skills during actual emergencies.
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Pediatric emergency care · Jun 2019
ReviewCurrent Approach to the Evaluation and Management of Acute Compartment Syndrome in Pediatric Patients.
Acute compartment syndrome is an emergent condition caused by increased pressure within a closed compartment. The most common etiology is fractures, but there a number of atraumatic causes cited in the literature. Acute compartment syndrome occurs most frequently in the anterior compartment of the lower leg, followed by the volar forearm. ⋯ No finding in isolation can exclude the diagnosis. Direct measurement of the intracompartmental pressure is the most important diagnostic test. Treatment involves removal of compressive dressings and surgical consultation for emergent fasciotomy.
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Pediatric emergency care · Jun 2019
Case ReportsLife-Threatening Accidental Intravenous Epinephrine Overdose in a 12-Year-Old Boy.
Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with a long-lasting skin rash and dyspnea who was incorrectly diagnosed with early anaphylactic shock and was treated with 10-fold the recommended dose administered by the wrong route (intravenous instead of intramuscular). ⋯ Despite this ultimately favorable outcome, we report this case to remind the scientific community that inadvertent and accidental epinephrine overdosing is probably an underrecognized event, which can result in potentially lethal complications. Heightening the awareness of the personnel, implementing safety precautions for the dosage and the route of administration, stocking of prefilled intramuscular dose syringes for emergency use in anaphylaxis and, ideally, introducing a standardized drug order form should reduce potential risks and facilitate proper and optimal treatment for all acutely ill children.