Pediatric emergency care
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Pediatric emergency care · Jul 2021
Case ReportsParaplegia After Basketball Play: A Case of Spinal Cord Infarction Secondary to Fibrocartilaginous Embolization.
Pediatric emergency medicine providers must be astute at generating the differential diagnosis and performing the appropriate evaluation to promptly determine the underlying cause of new onset paraplegia. Spinal cord infarction (SCI) is a potential etiology of paraplegia in children, and fibrocartilaginous embolization is a rare underlying cause of SCI. We present an illustrative case of SCI secondary to fibrocartilaginous embolization in an otherwise healthy adolescent who developed symptoms of spinal cord dysfunction after basketball play.
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Pediatric emergency care · Jul 2021
Treatment Outcomes of Pediatric Status Epilepticus in a Tertiary Pediatric Intensive Care Unit.
Status epilepticus is associated with high rates of morbidity and mortality; thus, early diagnosis and proper treatment are crucial. We aimed to study the etiology, clinical features, and treatment among pediatric patients with convulsive status epilepticus. ⋯ Phenytoin is still one of the most efficient antiepileptic drugs. If the duration of status epilepticus can be shortened by prompt treatment, neurological complications may be prevented.
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Pediatric emergency care · Jul 2021
Decreased Mortality After Establishing a Pediatric Emergency Unit at an Urban Referral Hospital in Ghana.
Emergently ill infants and children are often inadequately recognized and stabilized by health care facilities in low- and middle-income countries. Limited reports have shown that process improvements and prioritization of emergency care for children presenting to the hospital can improve pediatric hospital mortality. A dedicated pediatric emergency unit (PEU) was established for nontrauma emergencies at a busy teaching and referral hospital in Kumasi, Ghana, in response to high inpatient mortality early during hospitalization. ⋯ Relative risk values of mortality 1 year and 2 years immediately before and after implementation of the PEU were 0.70 (0.62-0.78) and 0.69 (0.64-0.74) respectively, representing a one-third reduction in mortality. The only other mortality improvements seen in the year-to-year analysis were between July 2004-June 2005 compared with July 2005-June 2006 with a relative risk of 0.86 (0.77-0.96). Prioritizing and redirecting limited resources toward pediatric emergency care in low- and middle-income country hospitals is associated with reductions in inpatient mortality that are both immediate and sustained.
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Pediatric emergency care · Jul 2021
Evaluation of Pain in the Pediatric Emergency Department and the Request of Analgesia.
To determine the acute pain level associated with request for analgesia by children and their parents in the pediatric emergency department (ED) when pain was assessed by verbal numeric scale (VNS), visual analog scale (VAS), and verbal rating scale (VRS). ⋯ Children who requested analgesia had higher pain scores on the VNS and the VAS, than those who did not request analgesia. No difference was demonstrated with the VRS. The pain scores between the analgesia request categories could overlap. This suggests that children seen in the ED should be asked if they want analgesia to decrease their acute pain.