Pediatric emergency care
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Classic appendicitis is a common condition easily diagnosed by emergency care providers. However, atypical cases represent a diagnostic challenge and can contribute to increased morbidity from a delay in definitive care. It is important to recognize that atypical presentations have an increased risk for underlying anatomic variants, which may require additional imaging as part of management. We present a case of a 13-year-old previously healthy adolescent boy with acute onset of left-sided abdominal pain who was found to have appendicitis in the setting of underlying malrotation.
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Pediatric emergency care · May 2021
Providers' Ability to Identify Sentinel Injuries Concerning for Physical Abuse in Infants.
The objectives of this study were to assess the ability of pediatric health care providers and social workers to recognize sentinel injuries in infants under 6 months of age and to determine what factors influence their decision to evaluate for physical abuse. ⋯ Sentinel injuries are not uniformly recognized as potential signs of child abuse requiring further evaluation by pediatric health care providers. Additional evidence and education are needed regarding sentinel injuries.
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Pediatric emergency care · May 2021
Adherence to Guidelines in the Treatment of Diabetic Ketoacidosis in Children: An Austrian Survey.
The aim of this study is to assess the adherence of Austrian physicians to International Society for Pediatric and Adolescent Diabetes guidelines 2009 concerning treatment in diabetic ketoacidosis and whether there is a difference between specialty (endocrinologists or intensivists) or clinical experience. ⋯ Adherence to the actual guidelines is 60% and does neither depend on speciality nor on clinical routine. Essential treatment measures (eg, amount of fluids, consequence of rapid glucose fall, bicarbonate use) are not commonly known.
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Pediatric emergency care · May 2021
Case ReportsPoint-of-Care Ultrasound Facilitates Management of Ruptured Ectopic Pregnancy.
Abdominal pain in the pregnant adolescent presents a diagnostic dilemma with potential life-threatening etiologies. We present a case where point-of-care ultrasound was used to facilitate diagnosis and expedite lifesaving management of a ruptured ectopic pregnancy. We further review the technique and literature for first-trimester transabdominal point-of-care ultrasound.
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Pediatric emergency care · May 2021
Outcomes of Short Versus Long Leg Casts for Childhood Accidental Spiral Tibial CAST Fractures.
The objective of the current study was to analyze the outcomes of short versus long leg casts in the treatment of childhood accidental spiral tibial (CAST) fractures. ⋯ A short leg walking cast seems to be an effective and safe method of treatment for CAST fractures and could be considered as potentially preferable to long leg casts because of the added benefits of increased mobility and function. Follow-up to this preliminary study is warranted to better elucidate any differences in benefit between these treatment options, and clinical judgment should be used when considering immobilization options.