Pediatric emergency care
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Pediatric emergency care · Feb 1998
A prospective evaluation of pediatric emergency care during the 1996 Summer Olympic Games in Atlanta, Georgia.
To explore the impact that a temporary influx of millions of people can make on the local pediatric emergent and urgent care systems. The spectrum of illness was also explored. ⋯ A large influx of people resulted in a relatively minor impact on the emergent care system for children. Care could have been improved if those with chronic illnesses were better informed of regional health care centers, essential medical needs for travel, and if travel included a physician's medical summary. In addition, anticipation of the Olympic Games helped the pediatric emergency medicine community improve disaster preparedness, and enhance its working relationship with the adult emergency medicine community and the regional poison center. Ongoing efforts for disaster preparedness with periodic reevaluation have also been established.
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Pediatric burn injuries present a major challenge to the health care team, but an orderly, systematic approach can simplify the initial stabilization and management. A clear understanding of the pathology of burn injuries is essential in providing quality burn care in the prehospital setting and at the referring hospital. After the patient has been rescued from the offending agent, assessment of the burn victim begins with the primary survey and life-threatening injuries initially addressed first. ⋯ During the initial assessment and treatment and throughout the transport, an adequate airway, breathing, circulation, fluid resuscitation, urine output, and pain control must be assured. Ideally, transport of burn victims will occur through and organized, protocol driven plan that includes specialized transport mechanisms and personnel. Successful transport of burn victims, whether in the pre-hospital phase or during inter-hospital transfer, requires careful attention to treatment priorities, protocols, and attention to detail.
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Pediatric emergency care · Dec 1997
Comparative StudyBoomerang babies: emergency department utilization by early discharge neonates.
Since 1987 the average length of stay for infants following hospital delivery has decreased 1.8 days. This study was undertaken to evaluate the null hypothesis that early discharge of newborns from nurseries does not result in increased emergency department (ED) utilization during the first 10 days of life. SITE: Thirty community EDs, one university ED. ⋯ The null hypothesis is rejected. Early discharge of neonates does result in increased ED utilization. No increase in admission rates for these infants was documented, indicating that patient severity did not increase with ED utilization. There is a need for improved predischarge education and greater access for episodic ambulatory complaints.
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Pediatric emergency care · Dec 1997
Review Case ReportsExertional rhabdomyolysis in an adolescent athlete.
Exertional rhabdomyolysis has been previously reported in adult patients following such strenuous activities as military basic training, weight lifting, and marathon running. Exertional rhabdomyolysis in previously healthy pediatric athletes, however, is rarely encountered. ⋯ Thus, the emergency physician must have a high index of suspicion for this entity based on the appropriate clinical setting. We report a classic case of exercise-induced rhabdomyolysis complicated by acute renal failure in a previously healthy adolescent athlete, whose initial presentation was nonspecific, prompting the diagnosis of overexertion.
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Acute pediatric elbow trauma is commonly seen in the emergency department (ED). Reports confirm that, compared to other fractures, children's elbow fractures are commonly misdiagnosed in the ED. In addition, missed orthopedic injuries are one of the leading causes of malpractice claims in emergency medicine. ⋯ Acute neurovascular injury is frequently associated with these injuries, but is often difficult to assess in an apprehensive child. Immediate orthopedic consultation is indicated for any child with an elbow injury in whom neurologic or vascular compromise is suspected. Consultation should be strongly considered for children with displaced supracondylar fractures and/or significant echymosis and swelling about the cubital fossa.