Pediatric emergency care
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Pediatric emergency care · Oct 1996
ReviewThe laryngeal mask airway: a review for the emergency physician.
The laryngeal mask airway has recently been released as a adjunct to airway management. It has gained widespread acceptance as an alternative to the face mask for the provision of general anesthesia. The LMA is available in various sizes for use in every age and weight patient (Table 1). ⋯ While it is used frequently in the operating room as a replacement for the anesthesia mask, its role outside of the operating room may include an adjunct in the management of the difficult airway. In this setting it may be used as a guide to blind endotracheal intubation or for fiberoptic-guided intubation. More importantly, it may be life-saving in the cannot intubate/cannot ventilate scenario.
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Pediatric emergency care · Oct 1996
Comparative StudyLaboratory presentation in diabetic ketoacidosis and duration of therapy.
To determine if initial emergency department (ED) laboratory parameters in children with diabetic ketoacidosis (DKA) can predict the minimum duration of continuous insulin therapy and aid in ED triage. ⋯ Initial laboratory presentation can help predict the minimum necessary duration of therapy in pediatric patient with DKA, aid early triage decision in the ED, and select a subgroup of patients who may be considered for outpatient management.
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Pediatric emergency care · Oct 1996
Comparative StudyViews of pediatric emergency fellows and fellowship directors concerning training experiences in child abuse and neglect.
Emergency physicians are an important part of the teams responsible for the management of victims of child abuse and neglect. As the number of fellowship-trained pediatric emergency physicians working in these emergency departments increases, their influence on the field of child abuse will increase. An evaluation of the experiences and possible weakness in the child abuse training of pediatric emergency fellows will assist in improving their fellowship experience. ⋯ Child abuse training is an important part of the fellowship experience of pediatric emergency fellows. Because a majority of pediatric emergency medicine fellows report that their respective programs are providing less than adequate training in child abuse management, further evaluation of fellowship curriculums and training experiences is required. The establishment and utilization of regional or national child abuse training centers is one option for improving this situation.
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Pediatric emergency care · Oct 1996
The use of the Beck Airway Airflow Monitor for verifying intratracheal endotracheal tube placement in patients in the pediatric emergency department and intensive care unit.
Traditional methods of confirming that the endotracheal tube is in the trachea are often unavailable or difficult to perform in some clinical situations, such as interfacility transport or other times outside the neonatal intensive care unit. We evaluated the Beck Airway Airflow Monitor (BAAM), through which airflow makes a whistling sound, for its safety and efficacy in neonates. ⋯ No adverse effects or complications were noted. The results support the safety and efficacy of the BAAM in confirming intratracheal endotracheal tube position in neonates.
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Pediatric emergency care · Oct 1996
Case ReportsCoital injury presenting in a 13 year old as abdominal pain and vaginal bleeding.
This 13-year-old girl presented with a four-day history of increasing lower abdominal pain associated with heavy vaginal bleeding which was now resolving. Her last normal menstrual period was 19 days before this incident, with a history of regular periods. Repeated questioning revealed a history of the patient engaging, for the first time, in consensual sexual intercourse one day prior to the onset of complaints. ⋯ Over the next 12 hours her abdominal examination revealed increased rigidity, and the patient was taken to the operating room with the a preoperative diagnosis of ruptured appendix. On exploratory laparotomy a hemoperitoneum was found, and approximately 600 ml of blood were suctioned from the peritoneal cavity. A 2-cm posterior vaginal wall laceration was subsequently repaired and a normal appendix removed.