Pediatric emergency care
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The goals of this study were to identify the socioeconomic influences that may lead to newborn abandonment and the attributes common to individuals who abandon their infants, to develop an understanding of the legislative issues affecting the abandonment of newborns by state, and to describe an emergency care program designed to preserve newborn life. ⋯ There is still much to learn about infant abandonment. A national database to compile statistics about the incidence of abandonment is currently not available. Research is necessary to validate the findings collected in retrospective reviews. The choices parents make between the options of abandoning versus surrendering the infant to a safe haven require further study. Preventative programs and education of the public and particularly of the high-risk groups require a greater emphasis on improving child protection procedures. Programs in emergency departments must be developed to expedite care and to support and protect life.
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Pediatric emergency care · Apr 2003
Case ReportsEarly detection of cardiac disease masquerading as acute bronchospasm: The role of bedside limited echocardiography by the emergency physician.
We report two cases in which the patients experienced dyspnea, cough, and acute bronchospasm. Pulmonary pathology was initially suspected. Failure to respond to an initial trial of inhaled bronchodilator prompted the use of bedside limited echocardiography by the emergency physician. The potential role of limited echocardiography by the emergency physician as a triage tool in facilitating early diagnosis and emergent therapy, reducing time to final discharge, and enhancing interaction between the pediatric emergency physician and cardiology consultants is highlighted.
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During the summer, jellyfish stings are the most common envenomation situations encountered by humans in the marine environment. The more people swim, scuba dive, or snorkel, the more necessary it is to know what should be done immediately, how life can be saved, how to prevent early and late complications, and how to facilitate convalescence in the event of jellyfish envenomation. We describe an atypical case of a 14-year-old boy with severe dyspnea due to upper airway obstruction caused by a jellyfish sting to the face and outline a practical approach to the treatment of jellyfish stings.
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Pediatric emergency care · Apr 2003
Review Multicenter Study Comparative StudyRole of oblique radiographs in blunt pediatric cervical spine injury.
To determine the usefulness of oblique cervical spine radiography (OCSR) in the management of children who have sustained blunt cervical spine injury, particularly if OCSR is abnormal when no acute abnormalities are shown on standard cervical spine radiography (SCSR). ⋯ In our series of 109 children who underwent acute radiographic evaluation of blunt cervical spine trauma, oblique views were unlikely to be abnormal if no acute abnormalities were evident on standard anteroposterior and lateral radiographs. Although few patients are likely to benefit from the addition of these views on a routine basis, a useful role for oblique cervical spine radiographs in detecting cervical spine injury in children cannot be excluded based on the results of this study.
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The Ottawa Ankle Rules (OAR) are criteria for predicting ankle fractures in adults allowing for insignificant fractures, defined as small avulsion fractures. Because the clinical significance of avulsion fractures and Salter-Harris type I fractures in children is unclear, we sought to prospectively evaluate the use of the OAR in children and to determine whether different criteria should be used for predicting ankle fractures in children. ⋯ The OAR cannot be applied to children with the same sensitivity as adults.