Pediatric emergency care
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Pediatric emergency care · Aug 1998
Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant.
The differentiation of severe systemic infection, such as sepsis or meningitis, from a congenital obstructive left heart abnormality presents a unique challenge to clinicians responsible for the care of such infants in the first few weeks of life. Clinical findings are very similar in the two populations. Failure to identify the need for specific intervention, such as prostaglandin administration, by the primary care or emergency physician may result in increased morbidity or death in these infants. ⋯ We conclude that while it is very difficult to differentiate these two groups at presentation, early clinical suspicion of COLHS with attention to key clinical parameters identified in this study may expedite appropriate intervention and enhance outcome. The multivariate model derived may provide a template from which further research can elucidate a more clinically useful tool for the clinician.
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Pediatric emergency care · Aug 1998
Unexpected second foreign bodies in pediatric esophageal coin ingestions.
To determine the frequency of unexpected second foreign bodies in children who present to the pediatric emergency department with esophageal coin impaction. ⋯ Unexpected second foreign bodies in pediatric esophageal coin ingestions with adequate radiographic studies are rare and generally do not cause significant esophageal injury.
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Pediatric emergency care · Aug 1998
Parental perception of the adequacy of pain control in their child after discharge from the emergency department.
To determine how well the pain of pediatric patients who are discharged from our emergency department (ED) is managed. ⋯ Our pediatric pain management study showed high analgesic use and high parental satisfaction. Lectures and bedside education may be a way to improve pain management in pediatric patients.
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Pediatric emergency care · Aug 1998
Childhood hypoglycemia in an urban emergency department: epidemiology and a diagnostic approach to the problem.
To 1) determine the prevalence of hypoglycemia in childhood in a pediatric emergency department (ED), 2) determine epidemiology of idiopathic ketotic hypoglycemia (IKH), 3) determine diagnostic yield of the workup of hypoglycemia, and 4) review a diagnostic approach to hypoglycemia. ⋯ IKH is the most common cause of hypoglycemia in children beyond the infancy period. In its typical presentation (previously healthy one- to five-year-old, with normal growth and development, who presents with a first episode of symptomatic fasting hypoglycemia and appropriate degree of ketonuria, without hepatomegaly, and with resolution of symptoms on administration of glucose), an extensive and overzealous workup for endocrinopathy or inborn error of metabolism is not necessary.