Pediatric emergency care
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After prevention, of all the elements in the care of the drowned child, none is more important than the early institution of respiration and appropriate resuscitation. Observation of the asymptomatic patient with any history of alteration of consciousness or respiration during a drowning accident for at least 12 to 24 hours is mandatory. ⋯ Transfer of these severely injured patients to a pediatric referral center where intracranial pressure monitoring and intensive support are available offers the best hope. Provisions for psychosocial support and follow-up for family members are essential.
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A model was constructed to predict pediatric asthmatic wheezing visits to the emergency department. All wheezing visits to the Children's Hospital of Philadelphia Emergency Department were analyzed for 1982 and 1983, for ages two to 18. Nine thousand four hundred twenty-five visits fit the study requirements, 27% of the total number of emergency department visits for all causes. ⋯ Carbon monoxide, barometric pressure, and relative humidity were also statistically significant predictors but were clinically insignificant, explaining only a few percentage points of the total variation. By taking advantage of the seasonal pattern of wheezing through the use of temperature velocity, predictive models for asthmatic wheezing can be greatly improved. They may also aid in planning emergency department staffing, and even help prevent emergency department visits by premedication or lifestyle change during high-risk periods.
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Pediatric emergency care · Mar 1987
Case ReportsEarly coma in intussusception: endogenous opioid induced?
A decreased level of consciousness with little abdominal pain or gastrointestinal symptoms is an uncommon, but well described, presentation of infantile intussusception. Its etiology is unclear. ⋯ We speculate that the coma and miosis were induced by an endogenous opioid which could also mask the abdominal pain, thus explaining this presentation of intussusception. If so, miosis would be a valuable clue for diagnosing such children.
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Pediatric emergency care · Dec 1986
Case ReportsVentricular septal defect following blunt chest trauma in childhood: a case report.
We report a case of a six-year-old male who sustained a ventricular septal defect following blunt trauma to the chest. Traumatically acquired VSD is rare in children. The diagnosis is made by characteristic history and physical examination and confirmed by echocardiogram or cardiac catheterization. Treatment is medical until surgical repair can be safely accomplished.