Pediatric emergency care
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Pediatric emergency care · Nov 2021
Case ReportsAtraumatic Spinal Epidural Hematoma as Initial Presentation of Hemophilia A in an Infant.
Hemophilia A is characterized by deficiency of factor VIII. We present a unique, illustrative case of an infant with a short history of neck pain and irritability without neurological deficits who was found to have a spinal epidural hematoma. The subsequent investigation for the etiology, including workup for nonaccidental trauma, led to a diagnosis of severe hemophilia A.
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Pediatric emergency care · Nov 2021
Clinical Indicators of Pediatric Shunt Malfunction: A Population-Based Study From the Nationwide Emergency Department Sample.
The majority of the previous literature on clinical predictors of shunt malfunction is from the neurosurgical data, looking at the symptoms of patients who had surgery. Because common childhood illnesses are filtered from these samples, the prevalence of shunt malfunction is markedly higher than it would be for the pediatrician's office or emergency department (ED). Clinical predictive values obtained from a representative population can better inform clinical judgment in these environments. ⋯ We identified peritonitis, papilledema, and oculomotor palsies as the strongest clinical indicators for shunt malfunction in pediatric ED visits with a CSF shunt. We found that patients presenting with headache, nausea/vomiting, convulsions, or fever were more likely to have an etiology other than shunt malfunction. Thus, after an appropriate shunt evaluation, other sources of symptoms should be investigated.
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Pediatric emergency care · Nov 2021
The Effectiveness of a Pediatric Emergency Medicine Block Education Session for Pediatric Residents.
There exists no standardized curriculum for pediatric residents to develop procedural skills during residency training. Many pediatric residency programs are transitioning to block education sessions; the effectiveness of this format for delivering pediatric emergency medicine (PEM) procedural curriculum has not been evaluated. The objective is to determine if a PEM block education session improved pediatric residents' knowledge and confidence in 4 domains: laceration repair, splinting of extremities, resuscitation/airway management, and point-of-care ultrasound. ⋯ The PEM block educational session improved both pediatric residents' knowledge and confidence in domains frequently encountered in the pediatric emergency department.
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There are many tick-borne infections that affect children and adolescents in the United States. These illnesses often begin with non-specific flulike symptoms such as fever, chills, headache, and myalgia, so obtaining a good travel history is important. ⋯ Often, treatment should commence before formal illness identification, as delays may cause more severe disease, and rapid laboratory confirmation is difficult. One of the most important issues is prevention of tick bites with insect repellents, accompanied by thorough tick checks after being outdoors in a tick-infested region.