Pediatric emergency care
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Pediatric emergency care · Mar 2011
Letter Comparative StudyConcentrated midazolam for intranasal administration: a pilot study.
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Pediatric emergency care · Mar 2011
Comparative StudyReducing blood culture contamination in a pediatric emergency department.
Blood cultures (BCs) are used to diagnose bacteremia in febrile children. False-positive BCs increase costs because of further testing, longer hospital stays, and unnecessary antibiotic therapy. Data from a study at our hospital showed the emergency department consistently exceeded established guidelines of 2% to 4%. A phlebotomy policy change was made whereby BC had to be obtained by a second venipuncture and no longer obtained during insertion of intravenous catheters. ⋯ The new policy significantly reduced BCC rates, thereby decreasing unnecessary testing and hospitalizations. Coagulase-negative staphylococci and viridans streptococci remain the most common BC contaminants. Further research should focus on additional interventions to reduce BCC.
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Pediatric emergency care · Mar 2011
Case ReportsSuccessful resuscitation from cardiopulmonary arrest due to profound hypothermia using noninvasive techniques.
Profound hypothermia is defined as a core body temperature of 20.0 °C or less. Successful resuscitation from this degree of hypothermia is rare. We present a case of successful resuscitation in a 2-year-old boy found in cardiac arrest due to profound hypothermia. Invasive techniques such as cavity lavage, extracorporeal membrane oxygenation, and cardiopulmonary bypass were not used.
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Pediatric emergency care · Mar 2011
Case ReportsDextromethorphan abuse masquerading as a recurrent seizure disorder.
Dextromethorphan (DXM) has unique toxicity that may be difficult to diagnose. We present a case of a young woman who presented to our emergency department (ED) initially diagnosed with recurrent seizures. Paramedics brought a 19-year-old woman to the ED. ⋯ The serum level of our patient was almost 10-fold greater than the reported therapeutic level. The toxicity of DXM is unique, and abuse should be considered in all patients presenting to the ED with new-onset seizure. Dextromethorphan abuse should be considered in young adults who present with previously undiagnosed seizure activity.
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Pediatric emergency care · Mar 2011
Comparative StudyProspective validation of two systems of classification for the diagnosis of acute appendicitis.
The objectives of this study were (1) to validate the Alvarado score and pediatric appendicitis score (PAS) in a prospectively identified pediatric cohort and (2) to assess abdominal ultrasonography (AUS) as a tool to increase the diagnostic reliability of both scores. ⋯ Both scores are a useful tool in the evaluation of children with possible AA. For extreme values of scores, the results really ensure their use in the emergency department. The AUS can help on decision making for intermediate values.