Pediatric emergency care
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During one year, four (6.5%) of the 61 children who were hospitalized for burns at a children's hospital sustained their injuries in a walker. Records from a total of nine children hospitalized with walker burns were compared to those from other hospitalized burned children. Patients who were burned while in a walker had a greater body surface area burned (11.6%) than those with burns from abuse (1.7%), neglect (2.5%), or other accidents (6.2%). ⋯ Walker-related burn patients required more physical or occupational therapy and a longer mean hospital stay. Social histories of infants with walker and other accidental burns differed from those associated with abuse or neglect. Walkers expose infants to unnecessary hazards, including potentially serious burns; their use should be discouraged.
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Pediatric emergency care · Mar 1990
Children with abdominal pain: evaluation in the pediatric emergency department.
In a retrospective study of children with abdominal pain in a pediatric emergency department, 371 children were identified during four seasonally diverse months. Half of the children were two to six years old, 32% were seven to 11 years old, and 19% were 12 to 16 years old. Forty-eight different diagnoses were made, but 10 diagnoses were given to 83% of the patients. ⋯ Appendicitis was the only surgical problem that occurred in more than one percent of the children. The diagnoses were classified as medical (64.4%), surgical (6.5%), and nonspecific (29.1%). chi 2 and multinomial logit analysis revealed that guarding and abdominal tenderness were the two symptoms which were most strongly associated with a surgical diagnosis. The goal of this work is to assist the busy emergency clinician with the difficult task of making expeditious and accurate diagnoses for children with abdominal pain.
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Pediatric emergency care · Mar 1990
Case ReportsBack pain with cardiovascular collapse in a pediatric emergency department patient.
Severe back pain in the pediatric patient is an infrequent complaint. The following case report illustrates the disastrous outcome for this patient with back pain secondary to aortic dissection. ⋯ Just as in the adult patient, the possibility of aortic dissection should be included in the differential diagnosis of acute onset of severe back pain with preexisting hypertension in the pediatric patient. A high index of suspicion is warranted.
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Pediatric emergency care · Dec 1989
Case ReportsSurvival after emergency department thoracotomy in a child with blunt multisystem trauma.
A 14-year-old boy sustained severe blunt, multisystem trauma. On presentation, vital signs were present but disappeared despite maximal resuscitation. ⋯ Ultimately, the child survived with normal neurologic function and quality of life. This case illustrates the potential value of EDT in selected patients who present with detectable vital signs and deteriorate in the face of maximal conventional therapy.