Pediatric emergency care
-
Pediatric emergency care · Dec 2020
ReviewLocal and Topical Anesthetics for Pediatric Patients in the Emergency Department.
Painful diagnostic and therapeutic procedures are common in the emergency department. Adequately treating pain, including the pain of procedures is an essential component of the practice of emergency medicine. ⋯ Local and topical anesthetics when used appropriately, generally, have few, if any, systemic side effects, such as hypotension or respiratory depression, which is an advantage over procedural sedation. Use of local and topical anesthetics can do much toward alleviating the pain and anxiety of pediatric patients undergoing procedures in the emergency department.
-
Pediatric emergency care · Dec 2020
Case ReportsA Case Report of Pediatric Paraneoplastic Dysautonomia.
We present the case of a 16-year-old girl who presented with severe refractory orthostatic hypotension secondary to pandysautonomia. Initially, she was treated for Guillain-Barré syndrome given clinical symptoms and increased protein on cerebrospinal fluid, but the severity of symptoms and lack of response to intravenous immunoglobulin prompted further evaluation for an autoimmune etiology. ⋯ Rapid progression of severe disabling symptoms should raise suspicion for an underlying malignancy. The patient had limited response to splanchnic vasoconstrictors in addition to α-agonists, anticholinergics, and mineralocorticoids until initiation of modified Hodgkin lymphoma directed chemotherapy plus rituximab.
-
Pediatric emergency care · Dec 2020
Case ReportsSevere Agitation in a Teenager With Spastic Cerebral Palsy: A Clinical Challenge.
Neuroleptic malignant syndrome is a challenging diagnosis because it mimics many other conditions. We present a case of a 16-year-old boy with spastic cerebral palsy who presented with severe agitation, hyperthermia, and autonomic dysfunction. He arrived to a community pediatric hospital without a caregiver to provide a detailed history, which further complicated his management.
-
Pediatric emergency care · Dec 2020
Innovating Pediatric Emergency Care and Learning Through Interprofessional Briefing and Workplace-Based Assessment: A Qualitative Study.
Managing pediatric emergencies can be both clinically and educationally challenging with little existing research on how to improve resident involvement. Moreover, nursing input is frequently ignored. We report here on an innovation using interprofessional briefing (iB) and workplace-based assessment (iWBA) to improve the delivery of care, the involvement of residents, and their assessment. ⋯ Interprofessional briefing and iWBA are promising approaches for not only resident involvement and learning during pediatric emergencies but also enhancing team function and patient care. Nursing involvement was pivotal in the success of the innovation enhancing both care and resident learning.
-
Pediatric emergency care · Dec 2020
Exposures to Single-Use Detergent Sacs Reported to a Statewide Poison Control System, 2013-2015.
Single-use detergent sacs (SUDSs) represent a relatively new household hazard to children. Brand differences and packaging changes may contribute to differential risks with accidental exposure. We sought to identify high-risk features from SUDS exposures in children and to assess whether product packaging changed trends in SUDS exposures reported to poison centers. ⋯ Central nervous system and respiratory effects as well as certain brand types predict serious outcomes from SUDS exposures. Manufacturing changes had a brief beneficial effect on the volume of SUDS exposures reported between 2013 and 2015.