Pediatric emergency care
-
Pediatric emergency care · Sep 2021
Case ReportsAcute Respiratory Failure With a Rare, Rapidly Progressing Pediatric Desmoid Tumor Anterior Mediastinal Mass.
We present an unusual case of a 6-year-old boy who presented with the sudden presence of left neck mass and acute hypoxemic respiratory failure, whose subsequent imaging demonstrated a previously undiagnosed anterior mediastinal mass (AMM) extending into the left neck. Biopsy of the mass was consistent with a desmoid tumor, which is a rare cause of AMM in children. Desmoid tumors are locally aggressive, often invading and enveloping surrounding tissues, but overall slow growing. ⋯ Anterior mediastinal masses may cause symptoms by compressing the heart, great vessels, and airways. However, the patient may adapt and develop compensatory mechanisms to counter the compressive effects. Emergency care of the patient with an AMM who presents with acute respiratory distress includes optimizing oxygenation through promoting a calm environment, oxygenating while minimizing positive end-expiratory pressure, maintaining the patient's compensatory mechanisms by minimizing sedation and muscle relaxation, positioning the patient to minimize compressive effects of the mass on the vital thorax structures, and early consultation with pediatric specialists to develop a shared-emergency treatment strategy and to secure an expedited disposition to the appropriate venue of care.
-
Pediatric emergency care · Sep 2021
Case ReportsPulmonary Alveolar Proteinosis: A Case of Profound Hypoxemia in a Previously Healthy Teenager.
The profoundly hypoxemic child presents an interesting set of diagnostic and management challenges in the pediatric emergency department. While common pathologies including pneumonia, asthma, bronchiolitis, and pneumothoraces are managed using evidence-based algorithms, more enigmatic pathologies may present the treating physician with less diagnostic and therapeutic clarity. We present the case of a profoundly hypoxemic 16-year-old girl who presented in minimal distress, with oxyhemoglobin saturation of 63% on room air.
-
Pediatric emergency care · Sep 2021
Quality Assurance for Point-of-Care Ultrasound in North American Pediatric Emergency Medicine Fellowships.
The American Academy of Pediatrics, the Society for Academic Emergency Medicine, and the American College of Emergency Physicians released a policy statement endorsing the use of point-of-care ultrasound (POCUS) by pediatric emergency medicine (PEM) providers. This statement specifically recommends that emergency departments have a credentialing and quality assurance (QA) program for POCUS. There is limited knowledge of how QA for POCUS is currently carried out in pediatric emergency departments with PEM training programs. ⋯ Point-of-care ultrasound is growing in PEM fellowship-training programs, with a majority of programs now having faculty members trained or interested specifically in POCUS. Most programs prefer more frequent and thorough QA processes, and programs with POCUS fellowships are more likely to have more frequent and thorough QA processes.
-
Pediatric emergency care · Sep 2021
Observational StudyPediatric Ocular Injury Due to Hand Sanitizer Exposure An Emerging Hazard.
The objective of this study was to describe the incidence and severity of ocular exposure to alcohol-based hand rub (ABHR) in children presenting to a tertiary medical center during the severe acute respiratory syndrome coronavirus 2 pandemic. ⋯ The utilization of ABHR during the severe acute respiratory syndrome coronavirus 2 pandemic resulted in childhood ocular injury. Prompt treatment led to good visual outcomes. These products should be regarded as potentially toxic and stored out of the reach of young children.
-
Pediatric emergency care · Sep 2021
Smartphone-Related Accidents in Children and Adolescents: A Novel Mechanism of Injury.
Smartphones have become an integral part of daily life, often grabbing full attention of its user. We hypothesized that smartphone-associated trauma in children and adolescents has increased in the last decade. The objective of this study was to analyze smartphone-related injuries in children at two German centers for pediatric emergency care. ⋯ Smartphone-associated injuries mainly caused by distraction gain increasing importance in pediatric traumatology. The frequency is higher in females compared with their male counterparts. The prevention of these accidents should become part of educational programs for children and adolescents.