Pediatric emergency care
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Pediatric emergency care · Oct 1991
The clinical utility of pulse oximetry in the pediatric emergency department setting.
Pulse oximetry provides a noninvasive, painless, accurate, and rapid method for measuring arterial oxygen saturation (SaO2). It has been shown to be valuable in anesthesia and critical care and recently has been used extensively in the outpatient setting. As is often the case with new technologies, little has been published on the basic issues of reliability, reproducibility, and effect on patient care. ⋯ Sixty-nine (17%) patients were identified in whom SaO2 readings changed management plans; 27 (8%) were managed more aggressively (intubation, surgery, or admission), while 40 (11%) were managed less aggressively (discharged). In three cases, pulse oximetry was instrumental in the diagnosis of a serious illness. The results from this study indicate that pulse oximetry SaO2 readings are stable and reproducible and provide information which impacts significantly on patient assessment and management.
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Pediatric emergency care · Oct 1991
Case ReportsEmergency department management of blunt cervical tracheal trauma in children.
A case history of a young girl who sustained a small posterior laceration of her cervical trachea after blunt trauma is presented. She was brought to the emergency department (ED) by her parents roughly two hours after the incident with only minor symptoms. ⋯ Her signs and symptoms, resolved, and she was discharged after five days. This case illustrates the importance of urgent evaluation and careful observation of patients with possible tracheal damage, as even very small tears have the potential to cause life-threatening airway compromise.
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Pediatric emergency care · Oct 1991
Sickle cell screening practice in pediatric emergency departments.
Management of black children who present to a pediatric emergency department (ED) commonly requires knowledge of their sickle cell status. To determine the practice of sickle cell screening, 32 pediatric EDs were surveyed. Twenty-eight (88%) completed the survey, and, of these, 22 (79%) included sickle cell screening (differential solubility test for hemoglobin S) in the management of a black febrile six-month-old infant. ⋯ To determine sickle cell status, 30 (59%) patients required a sickle cell screening test in the ED. ED screening detected three (6%) newly diagnosed sickle cell trait patients. In summary, sickle cell screening is recommended for young black children who present to an ED with fever or signs and symptoms supportive of sickle cell disease complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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A convenience sample of 60 children, aged five to 12 years, reporting to Kuwait government hospital emergency departments was studied. All were native Arabic speakers. Our aim was to compare the diagnostic usefulness of the pain information provided by children and by accompanying adults when interviewed under standard emergency department conditions. ⋯ Most children provided useful pain information. Mothers received consistently higher scores for their VAS descriptions than their children did; otherwise, the pain data provided by adults were not judged to be significantly more useful. When clinicians and teachers were asked to differentiate which data they thought had been provided by a child and which by the accompanying adult, nearly half of their decisions were wrong.
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Pediatric emergency care · Aug 1991
A one-year series of pediatric prehospital care: I. Ambulance runs; II. Prehospital communication; III. Interhospital transport services.
During a 12-month period ending on November 30, 1988, all ambulance arrivals at a pediatric emergency department (ED), all prehospital communications with this ED, all first-responder ambulance runs on Oahu and the state of Hawaii, and all neonatal/pediatric interhospital transports were examined to evaluate pediatric prehospital care. Handicapped patients were more likely to use an ambulance, and their care was more likely to be perceived as a weakness on the part of ambulance personnel. Poorer communication clarity was associated with longer duration of communication. ⋯ Mean transport times were shorter on Oahu than on the outer islands. Premature newborns and handicapped children commonly required interhospital transport. The care of children can be improved by addressing some of the identified problem areas, eg, improving prehospital communication and improving the training of prehospital personnel in the care of infants and handicapped children.