Pediatric emergency care
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Pediatric emergency care · Oct 2000
ReviewThe use of physical and chemical restraints in the pediatric emergency department.
Restraining patients is potentially dangerous and should be viewed as a last resort, to be used when no other modality of care is sufficient or when other efforts to calm the patient have been exhausted. Protocols and staff training are essential to limit inappropriate use of restraints and to protect both the patient and staff. Further clinical studies are needed in the area of chemical restraint of children and to evaluate the safety and efficacy of different methods of physical restraint.
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Ecstasy (MDMA) is an amphetamine derivative of growing popularity. The drug produces a range of toxicities when taken either in standard doses or overdose. In overdose it has major toxicity, producing several different life-threatening manifestations. ⋯ The drug can produce long-term, if not permanent, neurologic sequelae by destruction of serotonergic neurons. Chronic Ecstasy use can result in psychosis, depression, and suicidal ideation. In the ED setting, it is essential for physicians to recognize and treat appropriately those who present with intoxication from this drug.
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Pediatric emergency care · Oct 2000
Potential impact of a computerized system to report late-arriving laboratory results in the emergency department.
Results of some laboratory tests for Emergency Department (ED) patients return hours to days after the patient is discharged. Inadequate follow-up for these late-arriving results poses medical and legal risks. We have developed, but not yet implemented, a computerized system called the Automated Late-Arriving Results Monitoring System (ALARMS). ALARMS scans the hospital's laboratory and ED registration databases to generate an electronic daily log of all late-arriving abnormal laboratory results for ED patients. ⋯ Our current system of documented follow-up for late-arriving laboratory results has deficiencies. ALARMS, a computerized system of alerts for emergency physicians, has the potential to substantially improve documented follow-up of late-arriving laboratory results in the ED.
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Pediatric emergency care · Oct 2000
Case ReportsSerial bedside emergency ultrasound in a case of pediatric blunt abdominal trauma with severe abdominal pain.
We present a case of a teenager with isolated left renal laceration with perirenal hematoma. The patient had presented with severe left upper quadrant (LUQ) pain following blunt abdominal trauma (BAT) sustained during a sledding accident. A screening bedside focused abdominal sonogram for trauma (FAST) rapidly excluded free fluid on two serial examinations, 30 minutes apart. ⋯ Our hospital, like many pediatric hospitals around the nation, does not have in-house 24-hour radiology support. We suggest that the use of the bedside US be extended to the stable pediatric patient in severe abdominal pain following BAT. It can serve as a valuable, rapid, noninvasive, bedside, easily repeated, fairly accurate triage tool to evaluate pediatric BAT with severe pain.