Pediatric emergency care
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Pediatric emergency care · Dec 1995
Emergency department presentation and management of pediatric heart transplant recipients.
The object of this study was to review and delineate the presenting complaints, signs, symptoms, and Emergency Department (ED) management of pediatric heart transplant recipients who presented to Loma Linda University Medical Center's (LLUMC) Emergency Department. A retrospective chart review was made of all of the pediatric heart transplant patients who presented to the ED at LLUMC from January 1986 through February 1993. The department is part of a 600-bed university hospital with an associated 250-bed children's hospital that includes a pediatric heart transplant center and an ED that sees over 38,000 patients per year. ⋯ Life-threatening conditions such as graft rejection are less likely. Nevertheless, the emergency physician should maintain caution in the evaluation of these patients. Close cooperation and consultation with the transplant team will assure the optimal outcome for these patients.
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Pediatric emergency care · Dec 1995
Comparative StudyPreferences of parents for pediatric emergency physicians' attire.
While several studies have evaluated patient/parent's preference for physicians' attire in pediatric clinics, pediatric wards, and in adult emergency settings, none has been done in a pediatric emergency department (PED). Furthermore, factors that may influence these preferences such as severity of illness, time of visit, and type of emergency department (ED) visit (surgical vs medical) have not been considered. This study was designed to evaluate parents' attitudes toward pediatric emergency department physicians' professional appearance. ⋯ Our study demonstrated that: 1) pediatric emergency physician's attire does not matter to most parents. However, when asked to choose, clear preferences for likes and dislikes become evident. 2) Parents/guardians prefer pediatric emergency physicians who wear formal attire, including white laboratory coat, and do not like casual dress with tennis shoes. 3) Severity of illness, insurance type, and age, race, and gender of guardians do not affect preferences. 4) Parents of patients with surgical emergencies are more likely to prefer doctors wearing surgical scrubs. 5) Parents visiting the ED during night shift (11 PM to 7 AM) showed less interest in formal attire. Our findings may assist in parent/physician interaction in a PED setting.
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Pediatric emergency care · Dec 1995
Lumbar puncture in the clinical evaluation of children with seizures associated with fever.
This study was prospectively conducted to determine the frequency and yield of lumbar punctures performed in children with fever and seizures and to identify the criteria that were used by emergency physicians in selecting patients for this diagnostic procedure. During the five-year period from 1988 to 1992, 200 previously healthy children aged three months to five years were brought consecutively to the pediatric emergency department, after their seizure associated with fever. ⋯ An age less than 18 months, a febrile illness lasting over 48 hours, suspicious symptoms and signs of meningitis, and complex seizure features had significant influence on the decision of performing a lumbar puncture. Most children with meningitis had lethargy, irritability, and vomiting, and all had complex seizure features.
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Pediatric emergency care · Dec 1995
Comparative StudyEvaluation of an end-tidal CO2 detector during cardiopulmonary resuscitation in a canine model for pediatric cardiac arrest.
Our objective was to evaluate a colorimetric end-tidal CO2 detector in a canine model for pediatric cardiac arrest. In a prospective unblinded study, cardiac arrest was induced in 11 anesthetized and paralyzed puppies, weighing 5.0 to 6.1 kg, by clamping the endotracheal tube (ETT) and discontinuing mechanical ventilation. During cardiopulmonary resuscitation (CPR), the detector and the capnometer were connected between the ETT and ventilator tubing. ⋯ A sudden rise in end-tidal CO2 indicated by both the capnometer and the detector occurred at return of spontaneous circulation (ROSC) in seven or < 1 minute before ROSC in four animals. This association was significant (P = 0.0009). We conclude that these results demonstrate that, in a canine model for pediatric cardiac arrest, the detector readings correlate with capnometry during CPR and indicate ROSC.