Pediatric emergency care
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Pediatric emergency care · Feb 1992
Comparative StudyPediatric EMS transport: are we treating children in a system designed for adults only?
Unlike adults, small children and infants do not require stretchers or ambulances for transport from a prehospital scene to the emergency department (ED). This study was designed to determine the importance of this difference in patient transport needs. ⋯ Utilizing this model, police transports demonstrate shorter TTIs for brief scene-to-ED travel times or limited paramedic success rates, while paramedic intubations produced shorter TTIs for long scene-to-ED transports. These results suggest that nonambulance transport of pediatric patients be considered in the development of urban or suburban pediatric Emergency Medical Services.
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Pediatric emergency care · Feb 1992
A one-year series of pediatric emergency department wheezing visits: the Hawaii EMS-C project.
During a 12-month period ending on November 30, 1988, data were collected on 2468 pediatric patients with wheezing who visited a pediatric ED. Cohort characteristics included: sex (64% male, 36% female), history of prematurity (12%), evidence of concurrent infection (82%), taking theophylline (35%), taking beta adrenergics (60%), taking cromolyn (6%), and taking corticosteroids (4%). The hospitalization rate was 10.5%. ⋯ Initial oxygen saturation (OSAT) correlated with disease severity as measured by hospitalization risk and the number of bronchodilator treatments required in the ED. A suggestion for categorizing the treatment of asthma based on past history is proposed. Using this system in conjunction with pulse oximetry, wheezing severity and appropriate therapy can be more objectively determined.
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Prehospital pediatric trauma care is an important part of the EMS system. Review of 458 pediatric ALS trauma responses over two years treated in an urban, tiered ALS system revealed a male predominance. ⋯ ALS procedure success rates and field times reported here are lower than previously described. Benchmark standards for the prehospital care of pediatric trauma are proposed.
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Pediatric emergency care · Feb 1992
Case ReportsIntravascular hemolysis associated with hydrocarbon poisoning.
Hydrocarbon ingestion may result in serious complications such as adult respiratory distress syndrome, encephalopathy, and seizures. Hematologic disorders have appeared to be rare complications of hydrocarbon toxicity. ⋯ One patient required transfusion, but all recovered without sequelae. Intravascular hemolysis may be a more frequent complication of hydrocarbon poisoning than previously recognized.
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Pediatric emergency care · Feb 1992
Case ReportsAcute testicular pain: Henoch-Schönlein purpura versus testicular torsion.
A skilled examiner may not be able to exclude testicular torsion by physical examination maneuvers in a patient who presents with acute scrotal pain. Diagnostic adjunctive studies may be of assistance. However, if a diagnosis cannot be established with certainty, surgical exploration is warranted. Patients with Henoch-Schönlein purpura who present with a vascular eruption on the scrotum, lack a rash elsewhere, and have no arthritis or hematuria are likely to be explored.