Pediatric emergency care
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Pediatric emergency care · Jul 2021
Utility of Chest Radiographs in Children Presenting to a Pediatric Emergency Department With Acute Asthma Exacerbation and Chest Pain.
Previous studies have not evaluated the utility of obtaining chest radiographs (CXR) in patients with acute asthma exacerbation reporting chest pain. The aims of this study were to evaluate the symptom of chest pain as a predictor for clinicians obtaining a CXR in these patients and to evaluate chest pain as a predictor of a positive CXR finding. ⋯ Providers are more likely to obtain CXRs in asthmatic patients complaining of chest pain; however, these CXRs infrequently yield positive findings. This further supports limiting the use of chest radiography in patients with acute asthma exacerbation.
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Pediatric emergency care · Jul 2021
Dexamethasone Versus Prednisone for Pediatric Acute Asthma Exacerbations: Specialists' Practice Patterns.
Dexamethasone has emerged as a viable alternative to prednisone in the treatment of pediatric acute asthma exacerbations, with the potential for improved compliance secondary to decreased frequency of dosing, improved taste, and decreased cost. The objective of this study is to identify whether providers are prescribing dexamethasone for pediatric acute asthma exacerbations. Secondary objectives are to describe variation in practice between different specialties and to identify the commonly used dosing and frequency for dexamethasone. ⋯ Although most pediatric emergency medicine academic physicians have transitioned to using dexamethasone to treat acute pediatric asthma exacerbations, other specialties continue to favor prednisone.
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Pediatric emergency care · Jul 2021
Case ReportsAbdominal Tuberculosis in an Infant Presenting With a Small Bowel Obstruction.
Abdominal tuberculosis (TB) is rare in children and usually spread in the peritoneum or gastrointestinal tract. Symptoms tend to be vague and nonspecific, with no extra-abdominal involvement, presenting a challenge for clinicians and delayed diagnosis. ⋯ We present a case of a 2-month-old infant presenting with an acute bowel obstruction secondary to abdominal TB acquired through contact with maternal TB mastitis. This unique case emphasizes the importance of considering abdominal TB in the differential for at-risk infants presenting with small bowel obstruction.
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Pediatric emergency care · Jul 2021
Emergency Management of Acute Late-Presenting Congenital Diaphragmatic Hernia in Infants and Children.
Acute late-presenting congenital diaphragmatic hernia (CDH) might result in mediastinal shift away from the lesion and even sudden cardiopulmonary arrest. This study aimed to discuss the prompt and effective emergency management of acute late-presenting CDH. ⋯ Acute late-presenting CDH is a clinical emergency that can be fatal. The sudden and progressive expansion of the stomach is mainly responsible for this emergent condition. The prompt and effective management is key to decrease the mortality and achieve favorable prognosis.
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Pediatric emergency care · Jul 2021
Acupuncture as a Nonpharmacologic Treatment for Pain in a Pediatric Emergency Department.
With epidemic opioid deaths and abuse in the United States, government agencies recommend nonpharmacological treatments for pain. However nonopioid treatment options for moderate to severe pain in the pediatric emergency department (PED) are limited. Acupuncture has been shown to be effective for pain. The objective of this study was to evaluate the feasibility of using traditional acupuncture (TA) and battlefield acupuncture (BFA) in the treatment of pain in the PED. ⋯ This study suggests that acupuncture is a potential nonpharmacologic therapeutic option for acute pain management in the PED.