Pediatric emergency care
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Pediatric emergency care · Dec 2020
Case ReportsSevere Agitation in a Teenager With Spastic Cerebral Palsy: A Clinical Challenge.
Neuroleptic malignant syndrome is a challenging diagnosis because it mimics many other conditions. We present a case of a 16-year-old boy with spastic cerebral palsy who presented with severe agitation, hyperthermia, and autonomic dysfunction. He arrived to a community pediatric hospital without a caregiver to provide a detailed history, which further complicated his management.
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Pediatric emergency care · Dec 2020
Innovating Pediatric Emergency Care and Learning Through Interprofessional Briefing and Workplace-Based Assessment: A Qualitative Study.
Managing pediatric emergencies can be both clinically and educationally challenging with little existing research on how to improve resident involvement. Moreover, nursing input is frequently ignored. We report here on an innovation using interprofessional briefing (iB) and workplace-based assessment (iWBA) to improve the delivery of care, the involvement of residents, and their assessment. ⋯ Interprofessional briefing and iWBA are promising approaches for not only resident involvement and learning during pediatric emergencies but also enhancing team function and patient care. Nursing involvement was pivotal in the success of the innovation enhancing both care and resident learning.
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Pediatric emergency care · Dec 2020
Exposures to Single-Use Detergent Sacs Reported to a Statewide Poison Control System, 2013-2015.
Single-use detergent sacs (SUDSs) represent a relatively new household hazard to children. Brand differences and packaging changes may contribute to differential risks with accidental exposure. We sought to identify high-risk features from SUDS exposures in children and to assess whether product packaging changed trends in SUDS exposures reported to poison centers. ⋯ Central nervous system and respiratory effects as well as certain brand types predict serious outcomes from SUDS exposures. Manufacturing changes had a brief beneficial effect on the volume of SUDS exposures reported between 2013 and 2015.
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Pediatric emergency care · Dec 2020
Pediatric Emergency Department Return Visits: An Innovative and Systematic Approach to Promote Quality Improvement and Patient Safety.
Emergency department (ED) return visits (RVs) leading to hospital admission are a quality measure that can potentially signal gaps in patient care. Systematic capture and investigation of RVs at a case level can provide an understanding of patient- and visit-level factors associated with RVs, and thus inform system-level quality improvement (QI) opportunities. Our objective is to describe the development of a database that enables tracking and analyzing of all pediatric ED RVs, to understand recurring themes and inform QI initiatives. ⋯ Systematic monitoring and investigation of all ED RVs provides an innovative and effective approach to seeking provider- and system-level improvement opportunities.
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Pediatric emergency care · Dec 2020
Case ReportsPuss Caterpillar Envenomation: Erucism Mimicking Appendicitis in a Young Child.
A 4-year-old female presented to the emergency department with 2 days of abdominal pain, nausea, and vomiting. She was tachycardic and had abdominal tenderness. Laboratory studies revealed a leukocytosis, hypokalemia, and metabolic acidosis. ⋯ Topical icepacks have demonstrated inconsistent benefit in relieving pain. Oral medications, including acetaminophen, nonsteroidal anti-inflammatory drugs, and, rarely, opioids, typically suffice. Severe envenomations may require parenteral narcotics.