Pediatric emergency care
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Pediatric emergency care · Oct 2020
Case ReportsA Novel Pediatric Multisystem Inflammatory Syndrome During the COVID-19 Pandemic.
In late March and early April, New York City was an epicenter of the COVID-19 pandemic. Citizens were ordered to stay at home to flatten the curve. The adult population was affected with a severe respiratory illness as well as acute kidney injury, cardiomyopathy, arrhythmia, and thromboembolism. ⋯ All 4 patients were found to have antibodies to COVID-19. All patients required admission, but 2 required the pediatric intensive care unit for cardiac and/or respiratory support or closer monitoring. Upon follow-up on our patients, it seems that most patients are recovering with treatment, and overall, there is a low reported mortality rate.
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Pediatric emergency care · Oct 2020
Observational StudyThe Predictors for Positive Yield Abdominal Computed Tomography in Pediatric Abdominal Trauma.
Abdominal computed tomography (ACT) use in the initial evaluation of pediatric abdominal trauma is liberal in most instances. The aim of this study was to identify the predictors for a positive yield ACT scan in this population. ⋯ Integrating the abdominal examination findings, relevant laboratory values, and focused assessment with sonography for trauma results with the physicians' suspicion may aid in stratifying patients for ACT scan. Further efforts should be made to decrease number of normal ACT scans; yet not to increase the number of delayed or missed injures with its inherent morbidity and mortality.
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Pediatric emergency care · Oct 2020
Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay.
In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. ⋯ Video recording is a useful tool to evaluate patient management in the pediatric resuscitation bay. Analyzing errors of missing the adherence to the guidelines helps to pay attention and focus on specific items to improve patient care.
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Pediatric emergency care · Oct 2020
Case ReportsRole of Hemodialysis in the Management of Cyanide Intoxication From Apricot Kernels in a 3-Year-Old Child.
Cyanide (CN) is one among the most potent and rapidly acting lethal poisons, and it may cause death unless immediately diagnosed and treated. We report an unusual case of pediatric CN poisoning after ingestion of apricot kernels containing amygdalin, who survived with antidotal therapy and hemodialysis. A 3-year-old girl presented with respiratory distress and coma following tonic-clonic convulsions after ingestion of 3 apricot kernels. ⋯ In addition, when hydroxocobalamin was obtained, it was then administered. During follow-up, she was completely asymptomatic with blood pressure, and other hemodynamic parameters normalized. This case presents hemodialysis as a way to correct metabolic derangements from CN poisoning and suggests that it may have a role in select cases of pediatric CN poisoning, especially when CN-scavenging antidotes may be unavailable.
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Pediatric emergency care · Oct 2020
Randomized Controlled Trial Comparative StudyComparison of 4 Pediatric Intraosseous Access Devices: A Randomized Simulation Study.
Obtaining intravascular access can be challenging or even impossible in several clinical situations. As an alternative, medications and fluids can be administered via the intraosseous (IO) route, which is a well-tolerated and established alternative, especially in the emergency setting. ⋯ Although the efficacy of devices was demonstrated in simulated environment in novice users, further studies are needed to assess the efficacy and safety of devices in clinical comparative settings. With more experienced users, the success rate may differ considerably as compared with naive users.