Pediatric emergency care
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A case of knotting of a bladder catheter inserted to closely monitor a critically ill child is presented. The literature is reviewed, revealing knotting to be an unusual complication of this common pediatric procedure. Risk factors for knotting are discussed, and precautionary recommendations are presented.
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Pediatric emergency care · Mar 1989
Prehospital pediatric endotracheal intubation performance review.
Pediatric prehospital care was reviewed over a one-year period to determine success rate, causes of unsuccessful attempts, and complications of performing endotracheal intubation. The Milwaukee County Emergency Medicine Technician-Paramedics (EMT-Ps) responded to 1467 pediatric (less than 19 years of age) patient calls. This accounted for 11% of the patients who received EMT-P care during the study period. ⋯ Common difficulties in intubating the PNB patient included inability to visualize the glottis and cords secondary to mucus and/or vomitus, use of inappropriately small endotracheal tubes, and accidental extubation during transport. Difficulties in intubating impending respiratory failure patients included patient resistance and seizure activity. We recommend that the EMT-P training curriculum include a review of these difficulties and that prehospital pediatric endotracheal intubation performance be monitored and reviewed with the EMT-Ps.
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Pediatric emergency care · Mar 1989
Case ReportsNormal pulmonary function after baby powder inhalation causing adult respiratory distress syndrome.
We report a case of baby powder inhalation (BPI), causing adult respiratory distress syndrome (ARDS) in a 16-month-old girl, with follow-up after six years. Pulmonary function studies in the child and her monozygotic twin, used as a control, were normal. ⋯ A review of the literature of talcum aspiration indicates that the management of this condition is largely supportive. The long-term effects of BPI remain unknown, since serial follow-up studies are not available.
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A retrospective chart review of 102 consecutive cases of gunshot wound injuries in children was conducted. Victims were identified by emergency department log review and computer search for inpatient discharge diagnoses. Results are compared with other studies. ⋯ Nonpowder weapons were found to have inflicted major injury in as many patients as did handguns. Methodologic problems of studying gunshot wounds in children are discussed. It is suggested that injury prevention strategies address nonpowder weapons as well as handguns.