Pediatric emergency care
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Pediatric emergency care · Feb 1999
Case ReportsEmergency cardiopulmonary bypass for cardiac arrest refractory to pediatric advanced life support.
We report the application of emergent cardiopulmonary bypass (CPB) for three pediatric patients in the cardiac catheterization laboratory with cardiac arrest who did not respond to conventional resuscitation efforts. All three patients had return of baseline prearrest rhythms within minutes of the initiation of artificial cardiopulmonary support and the return of spontaneous circulation upon weaning CPB. Two patients had normal neurologic outcomes despite an interval of over 30 minutes from arrest to CPB. The continued judicious application and study of this technology in a small subpopulation of pediatric cardiac arrest patients is warranted.
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To describe a series of patients seen in a pediatric emergency department with adverse effects following an ingestion of a caterpillar. ⋯ Previously not described, significant adverse effects can occur following ingestion of a caterpillar. In addition, although not previously reported, the caterpillar of the Hickory Tussock moth can cause adverse effects in humans.
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Pediatric emergency care · Dec 1998
Review Case ReportsDelayed diagnosis of splenic injury after falls from less than 10 feet.
Splenic injury is the most common abdominal organ injury in children who sustain blunt trauma and may result from apparently minor injuries. We present two cases of delayed diagnosis of splenic injury in children who fell from a moderate height of less than 10 feet. Careful physical examination and close follow-up with reevaluation are necessary to identify children with possible splenic injury after relatively minor blunt trauma.
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Pediatric emergency care · Dec 1998
Comparative StudySedation of pediatric patients for minor laceration repair: effect on length of emergency department stay and patient charges.
Sedating children can facilitate minor laceration repair by minimizing physical and psychic discomfort. However, some clinicians are reluctant to use sedation, in part because of concern about increased patient charges and fear that the emergency department (ED) stay will be prolonged. The purpose of this study was to determine the extent to which sedative use during the repair of simple facial lacerations in children increased the length of ED stay and patient charges. ⋯ The results of this study demonstrate that sedation with ketamine or midazolam increases the length of ED stay compared with using no sedation. However, the increased lengths of stay were modest, particularly for midazolam. Fear of prolonged recovery time should not dissuade clinicians from using either sedative for minor procedures. The patient charges are considerably higher with both midazolam and ketamine, but they may not reflect the actual cost of patient care.