Pediatric emergency care
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Pediatric emergency care · May 2020
Review Case ReportsUltrasound-Guided Posterior Tibial Nerve Block for Plantar Foot Foreign Body Removal.
Ultrasound-guided regional anesthesia is a growing modality within the pediatric emergency department. Here we present a case where a posterior tibial nerve block was used for anesthesia during foreign body removal from the plantar foot. We further review the technique and literature regarding this straightforward and highly effective procedure.
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Pediatric emergency care · May 2020
Randomized Controlled Trial Comparative StudyClinical Impact of Warmed Intravenous Saline in Sickle Cell Patients With Vasoocclusive Episodes.
In children with sickle cell disease treated for vasoocclusive episodes (VOEs), it is unknown if the temperature of infused fluids impacts clinical outcomes. We compared infusions of warmed and nonwarmed saline for treatment of VOE. We also assessed the tolerability and feasibility of infusing warmed saline in patients with VOEs. ⋯ It is feasible and tolerable to infuse warmed saline for the treatment of VOE, and it is well tolerated. Patient comfort was higher in those patients who received warmed saline, but there was no improvement in admission rates, disposition times, pain scores, and opioid dosages.
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Pediatric emergency care · May 2020
Case ReportsNonvitreoretinal Eye Injuries in 2 Infants Due to Nonaccidental Trauma.
Intraocular findings are well known and well documented in child abuse cases. However, eye deviation on physical examination can also be just as important in evaluating a child for maltreatment. We present 2 cases of infants younger than 6 months who presented to the emergency department with new-onset abnormal eye deviation, and further evaluation revealed other findings consistent with nonaccidental trauma. These cases were ruled as abusive head trauma and demonstrate the importance of conducting a thorough evaluation for any acute-onset ophthalmological and neurological finding.
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Pediatric emergency care · May 2020
Prevalence and Risk Factors for Burnout in Pediatric Emergency Medicine Fellows.
Burnout among emergency medicine (EM) physicians (57%) is significantly greater than among pediatricians (39%). Pediatric EM (PEM) providers are a unique population in that the majority first complete a pediatric residency and then a fellowship in pediatric emergency medicine. We sought to evaluate the prevalence and risk factors for burnout in PEM fellows.
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Pediatric emergency care · May 2020
Case ReportsHyperkalemia and Acute Kidney Injury in an Adolescent: Thinking Outside the Box.
Addison disease is a rare endocrine disorder, which typically presents with nonspecific symptoms including weight loss, fatigue, and nausea in conjunction with hyponatremia and hyperkalemia. This case demonstrates key diagnostic clues in evaluation of an adolescent who presented with severe hyperkalemia and acute kidney injury that was resistant to insulin, glucose, and sodium polystyrene sulfonate and was found to have primary adrenal insufficiency.