Pediatric emergency care
-
Pediatric emergency care · Jan 2004
Difficulty in obtaining peak expiratory flow measurements in children with acute asthma.
To determine the frequency with which children >or=6 years with acute asthma can perform peak expiratory flow rate measurements (PEFR) in an emergency department (ED). ⋯ Adequate PEFR measurements are difficult to obtain in children with acute asthma. Treatment and research protocols cannot rely exclusively on PEFR for evaluation of severity.
-
Pediatric emergency care · Jan 2004
Comparative StudyPatient-controlled analgesia for sickle cell pain crisis in a pediatric emergency department.
To determine whether a protocol to start patient-controlled analgesia (PCA) in the emergency department (ED-PCA) would shorten the length of time between narcotic bolus doses and PCA initiation as compared with standard inpatient initiation of PCA (IP-PCA). Also, to compare patient satisfaction and inpatient length of stay for the 2 groups. ⋯ A protocol to initiate PCA for sickle cell patients in a pediatric emergency department shortened the time of its initiation and was preferred by patients.
-
Pediatric emergency care · Jan 2004
Case ReportsTraumatic dissection of the internal carotid artery.
We present the case of an 11-year-old male who had a dissection of his left internal carotid artery following a rather innocuous mechanism of injury. Although this phenomenon is documented in the medical literature, it remains a relatively rare event following blunt injury to the head and neck (0.3% occurrence rate in 1 study spanning 7 years). (Despite its rarity, it remains an important cause of cerebrovascular accidents in children. 2) Children presenting with gross neurologic abnormalities following blunt trauma to the head or neck should be considered to have sustained injury to the carotid arteries until proven otherwise.
-
Pediatric emergency care · Jan 2004
The educational experience of pediatric emergency medicine fellows in the use and application of procedural sedation/analgesia.
The purpose of this study is to describe the clinical and educational experience provided to the pediatric emergency medicine (PEM) fellows in procedural sedation/analgesia during their course of training. ⋯ There is wide variation in the educational methods used by PEM fellowship training programs in procedural sedation/analgesia.
-
Pediatric emergency care · Jan 2004
Case ReportsConservative management of large avulsions of the lip and local landmarks.
Large lip avulsion injuries that involve significant tissue loss to the lip vermilion and other local landmarks can often pose a surgical dilemma for the reconstructive surgeon. Immediate reconstruction of these injuries are frequently performed using local flaps and adjacent tissue transfer to close the defect, but these repairs frequently suffer from the unfortunate consequence of increased associated scarring and further permanent distortion of the local anatomy. ⋯ A single minor surgical revision of 1 patient's cupid's bow was performed 1 year after injury. In cases of significant traumatic avulsion involving the lip vermilion and the perioral composite soft tissue, even with injuries including delicate anatomic landmarks, healing by secondary intention can be instituted as the initial treatment of choice in younger patients, often providing optimal results.