Pediatric emergency care
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Pediatric emergency care · Jun 2020
Multicenter StudyNovel Approach to Emergency Departments' Pediatric Readiness Across a Health System.
A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. ⋯ Pediatric emergency care coordinators play an important role in ED readiness to care for pediatric patients. In a large health system, a service line PEM quality director with the support of emergency medicine and pediatrics, a committee with solid frontline ED base, and a diverse array of stakeholders can foster the engagement of all EDs and improve compliance with published guidelines.
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Pediatric emergency care · Jun 2020
Case ReportsA 7-Day-Old Male Infant With Carbon Monoxide Poisoning Treated With Hyperbaric Oxygen.
Children are presented with an unknown intoxication at emergency department (ED) after carbon monoxide (CO) poisoning. Although CO poisoning is well defined in the adult literature, little information exists regarding CO poisoning in childhood, especially in infants. The only diagnostic test for CO poisoning is elevation of the carboxyhemoglobin level in the blood. ⋯ If there is a baby with unexplained neurologic symptoms and signs, CO poisoning should be considered in the differential diagnosis. Early diagnosis and treatment prevent complications and sequelaes.
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Pediatric emergency care · Jun 2020
Case ReportsEpinephrine at 25°C Core Body Temperature and During Rewarming: Case Report of Successful Infant Resuscitation After Cold Water Submersion.
Epinephrine plays a controversial role in accidental hypothermia (<30°C). We report its use in the advanced life support of a 13-month-old white girl with pulseless electrical activity and 25°C core body temperature after 32 minutes of submersion in a fast-running Swiss mountain stream at 8°C. ⋯ Neurologic long-term outcome was excellent. We conclude that in the presence of nonshockable rhythm the benefits of epinephrine may outweigh the risks of side effects when used in pediatric advanced life support for accidental hypothermia.
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Pediatric emergency care · Jun 2020
ReviewSugammadex: A Limited But Important Role in Emergency Medicine.
Sugammadex reverses neuromuscular blockade by the steroidal nondepolarizing neuromuscular blocking agents rocuronium and vecuronium. In 2015, it was approved in the United States by the Food and Drug Administration for adult use. However, there are ongoing clinical trials investigating its use in the pediatric population. ⋯ In cases where rapid neurological examination is required after neuromuscular blockage with rocuronium or vecuronium, sugammadex can assist in facilitating a timely comprehensive neurological examination where pharmacologic or surgical management may depend on examination findings such as in the case of cerebral vascular accident, status epilepticus, or traumatic brain injury. Some clinicians have advocated for the use of sugammadex in the cannot intubate, cannot ventilate scenario. However, caution should be exercised in this situation as reversal of paralysis can take up to 22 minutes to occur.
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Pediatric emergency care · Jun 2020
Emergency Information Forms for Children With Medical Complexity: A Qualitative Study.
Children with medical complexity (CMC) are at risk for poor outcomes during medical emergencies. Emergency information forms (EIFs) provide essential medical information for CMC during emergencies; however, they are not widely used. We sought to identify factors related to optimal care for CMC to inform development of EIFs for CMC. ⋯ Stakeholders interviewed reported a preference for Web-based, sync-capable EIFs with portable copies. Emergency information forms could be maintained by providers but owned by patients to optimize emergency care and align with the concept of the medical home.