Pediatric emergency care
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Pediatric emergency care · Feb 1999
Comparative StudyDoctors, nurses, and parents are equally poor at estimating pediatric weights.
To evaluate the relative accuracy of physicians, nurses, and parents in estimating the weight of children presenting to the emergency department. ⋯ Emergency department pediatric weight estimates by parents, nurses, and physicians are significantly and similarly unreliable.
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To initiate investigation into the medication errors that occur in a pediatric emergency department. These errors have the potential for significant morbidity and mortality, as well as costly litigation. ⋯ Incorrect recording of patient weights leading to an incorrect medication dose and failure to note drug allergy are common causes for medication errors in the pediatric emergency department. Incorrect drugs and i.v. fluids are given because of similar names and packaging. Many of the errors in the ED seem to be preventable.
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Pediatric emergency care · Feb 1999
Case ReportsRecognition and management of Tillaux fractures in adolescents.
Tillaux fractures are relatively uncommon Salter Harris III fractures of the tibia. The importance of recognizing this fracture is that a residual deformity in the joint surface can lead to premature degenerative arthritis. For this reason, it is important that accurate imaging to assess the congruity of the joint, as well as adequate reduction, is obtained. ⋯ The fracture is of great importance because it involves a major weight-bearing articular surface. A residual deformity of the joint surface can lead to premature degenerative arthritis. We present a patient with a Tillaux fracture to elaborate on the mechanism of injury and to summarize the importance of its recognition and imaging and treatment options.
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Pediatric emergency care · Feb 1999
Incidence of bacteremia, urinary tract infections, and unsuspected bacterial meningitis in children with febrile seizures.
To determine the incidence of bacteremia, urinary tract infections, and unsuspected bacterial meningitis in a cohort of children diagnosed with febrile seizures. ⋯ Patients presenting for evaluation of febrile seizures are not at increased risk for bacteremia or urinary tract infections. Bacterial meningitis in the absence of initial laboratory evidence of meningoencephalitis is very uncommon in children diagnosed with febrile seizures.
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Traumatic torticollis is an uncommon complaint in the emergency department (ED). One important cause in children is atlantoaxial rotary subluxation. Most children present with pain, torticollis ("cock-robin" position), and diminished range of motion. ⋯ For minor and acute cases, a soft cervical collar, rest, and analgesics may be sufficient. For more severe cases, the child may be placed on head halter traction, and for long-standing cases, halo traction or even surgical interventions may be indicated. We describe two patients with atlantoaxial rotary subluxation, who presented with torticollis, to illustrate recognition and management in the ED.