Pediatric emergency care
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Children with either acute or chronic upper airway obstruction are at risk for postobstructive pulmonary edema. Appropriate diagnosis and management are important in leading to a good outcome for the patient. ⋯ In the first case, a child choked on a hot dog and in the second on a "jawbreaker." Both children developed symptoms of complete upper airway obstruction and were managed initially with the Heimlich maneuver and subsequently developed increased work of breathing associated with an oxygen requirement after relief of the obstruction. Both children were managed in the pediatric intensive care unit and were discharged after resolution of symptoms without sequelae.
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Pediatric rapid sequence intubation is a skill of great importance to emergency medicine physicians. Developing a systematic strategy for approaching an emergent airway aids in the proper handling of this event. This paper is a review of the current recommendations for pediatric rapid sequence intubation including current medications and surgical rescue techniques.
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Pediatric emergency care · May 2004
Utility of an immunization registry in a pediatric emergency department.
Determine prevalence of participation and underimmunization rate in a regional immunization registry (IR) among patients presenting to a university pediatric emergency department (PED). Rate of agreement between parental report and documented immunization status was also measured. ⋯ A significant number of patients seen in the PED were in the CNY IR. More than one-half of the parents of enrolled children did not recall that they had previously registered their child. Only 61% of patients were UTD, whereas parents reported that almost all were. In the PED, use of an IR would create an opportunity for intervention in a large number of patients who were not UTD.
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Pediatric emergency care · May 2004
Case Reports Comparative StudyInto hot water head first: distribution of intentional and unintentional immersion burns.
Experience with several, previously unreported, intentional face-first immersion burns led us to evaluate the distribution of inflicted and unintentional immersion scald burns in a hospital series. ⋯ Craniofacial immersion injury, although seen by the authors in legal cases, is infrequent. It was present incidentally in one inflicted tap water burn in the consecutive hospital series. This series affirms the predominance of bilateral lower extremity burns in inflicted tap water immersions. Buttock/perineal immersions were more common with abuse than with unintentional injury.