Pediatric emergency care
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Pediatric emergency care · Oct 2021
ReviewDiagnosis and Acute Management of COVID-19 and Multisystem Inflammatory Syndrome in Children.
Most children with coronavirus disease 2019 (COVID-19) infection are asymptomatic or have mild disease. About 5% of infected children will develop severe or critical disease. ⋯ This article is intended for pediatricians, pediatric emergency physicians, and individuals involved in the emergency care of children. It reviews the current epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children, summarizes key aspects of clinical assessment including identification of high-risk patients and manifestations of severe disease, and provides an overview of COVID-19 management in the emergency department based on clinical severity.
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Pediatric emergency care · Oct 2021
An Exploration of Emergency Department Visits for Home Unintentional Injuries Among Children With Autism Spectrum Disorder for Evidence to Modify Injury Prevention Guidelines.
Current childhood injury prevention guidance is anchored by a child's age. For example, children are considered at high risk for falls at ages 4 years and less, and guidance for prevention focuses on these ages. However, these guidelines may not be adequate for children with autism spectrum disorders (ASD). ⋯ Analyses suggest that unintentional home injury prevention for children with ASD may require prevention guidance extended through older ages.
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Pediatric emergency care · Oct 2021
Case ReportsCongenital Adrenal Hyperplasia-When Clinical Symptoms Are Missing.
Congenital adrenal hyperplasia is an autossomic recessive condition. The most common mutation is in the CYP21A2 gene situated in chromosome 6, leading to a 21-hydroxylase deficiency. Clinical presentation ranges from light hyperandrogenism to potentially fatal adrenal salt-losing crisis. In this study, we describe a case of congenital adrenal hyperplasia in a male newborn. ⋯ Because of the severity of this disease and the risk for rapid hemodynamical collapse, clinicians should be aware of this condition. In this specific case, we highlight the absence of testicular hyperpigmentation, which is a hallmark of this condition.
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Pediatric emergency care · Oct 2021
Occult Pneumothorax Identification on Extended Focused Assessment with Sonography for Trauma Examination in Children.
Occult pneumothoraces (OPTXs) are defined by air within the pleural space that is not visible on conventional chest radiographs (CXR). The aim of this study was to understand how frequently the Extended Focused Assessment with Sonography for Trauma (eFAST) examination identifies occult PTX in a pediatric blunt trauma population as compared with a criterion standard of chest computed tomography (CCT). ⋯ Although the sample size in this data set was small, our eFAST examinations identified none of 16 proven and 4 presumed OPTXs. The standard eFAST examination performed poorly in the detection of OPTXs in this single-center study of pediatric blunt trauma victims.
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Pediatric emergency care · Oct 2021
The Use of Rapid Sequence Magnetic Resonance Imaging of the Brain as a Screening Tool for the Detection of Gross Intracranial Pathology in Children Presenting to the Emergency Department With a Chief Complaint of Persistent or Recurrent Headaches.
The purpose of the study, was to assess the utility of rapid sequence brain magnetic resonance imaging (RS-MRI), as a screening tool to detect gross intracranial pathology in children that present to the emergency department, with a chief complaint of persistent or recurrent headaches. Rapid sequence MRI of the brain is a radiation-free technique that is used to evaluate ventricular size in children with shunted hydrocephalus, who present to the emergency department with symptomatology consistent with shunt malfunction. ⋯ Rapid sequence MRI is a radiation-free useful alternative to computer tomography of the brain, when used as a screening tool for children with persistent or recurrent headaches presenting to the emergency department. This rapid imaging modality was particularly useful in identifying children with sinus disease, and contributed significantly to patient/family satisfaction with the care they receive during the emergency department visit. Additionally, RS-MRI screening was successful in detecting a serious neurosurgical emergency in one child with a cerebellar mass causing increased intracranial pressure. Further studies with large sample size are needed to corroborate our findings.