Pediatric emergency care
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Pediatric emergency care · Sep 2024
Hyperchloremia and Prolonged Acidosis During Treatment for Pediatric Diabetic Ketoacidosis.
Diabetic ketoacidosis (DKA) is characterized by metabolic acidosis with a high anion gap secondary to ketonemia. Intravenous hydration fluids used in treatment can cause chloride overload, leading to hyperchloremic metabolic acidosis (HMA). The development of HMA can lead to the persistence of acidosis despite the resolution of ketonemia. ⋯ During treatment of DKA, monitoring anion gap, blood ketones, and Cl-/Na+ ratio or using regression equations in addition to routine acid-base parameters may help differentiate DKA from HMA and prevent prolonged intravenous treatment.
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Pediatric emergency care · Sep 2024
The Last Straw: Trends in Straw-Related Emergency Department Visits.
With the recent societal push for eco-sustainability, there has been an increase in the prevalence of reusable utensils, particularly multiuse straws. This study is the first to investigate the epidemiology of plastic, glass, and metal straw-related injuries (SRIs) presenting to the emergency department (ED). ⋯ Although most injuries occurred as accidental poking while drinking, nearly half of all injuries were sustained while using straws in an off-label manner. Ensuring the proper use of straws and monitoring children when using a straw may help to decrease the incidence of SRI. Among the options for environmentally friendly straw materials, metal straws pose the greatest risk for injuries requiring ED presentation. Thus, their use should be avoided in the pediatric population.
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Pediatric emergency care · Sep 2024
Hair Today, OR Tomorrow: A Multicenter Case Series of Gastric Bezoars in Children Diagnosed With Point-of-Care Ultrasound.
Point-of-care ultrasound (POCUS) can expedite the diagnosis of pediatric abdominal pathologies including appendicitis and intussusception. In this patient series, we present cases from multiple pediatric emergency departments that demonstrate the use of POCUS in the diagnosis of trichobezoars in children. POCUS findings include the presence of an intragastric hyperechoic mass or a hyperechoic arch and associated posterior acoustic shadowing. These findings in the appropriate clinical context should prompt further diagnostic imaging and/or surgical consultation for removal.
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Pediatric emergency care · Sep 2024
Ultrasound Imaging of Various Ingested Foreign Bodies in an Ex Vivo Intestinal Model.
Foreign body ingestion is an increasingly prevalent issue for children who are in the preverbal to early verbal stages of life. Foreign bodies lodged in the gastrointestinal tract can cause issues such as obstruction, perforation, and fistulae. Radiographic imaging can often locate most foreign bodies; however, radiolucent objects may be missed. Ultrasound is an alternative imaging modality that can be used to locate and track foreign objects as they pass through the bowel. The objective of this study was to characterize the sonographic appearance of various ingested foreign bodies of varying characteristics in an ex vivo gastrointestinal tract segment. ⋯ Ultrasound evaluation to assess foreign body ingestion in the pediatric population may provide a useful alternative or supportive imaging modality in confirming the location and real-time tracking of the ingested item. This may be especially useful for objects of varying radiodensities that cannot always be reliably seen in traditional radiographs.
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Pediatric emergency care · Sep 2024
Risk of Urinary Tract Infection and Bacteremia in Infants Infected With COVID-19.
Our objective was to evaluate the risk of urinary tract infection (UTI) and bacteremia in infants 1 year or less of age infected with COVID-19. ⋯ Infants with fever found to have COVID-19 had lower risks of UTI and bacteremia.