Pediatric emergency care
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Pediatric emergency care · Apr 2010
Case ReportsTension gastrothorax-colothorax secondary to traumatic diaphragmatic hernia.
Traumatic diaphragmatic hernia secondary to diaphragmatic injury is a recognized complication following trauma. It is frequently unrecognized in acute trauma, and delayed presentations with complications are not uncommon. We report the case of a 12-year-old boy presenting in respiratory distress 1 year after blunt abdominal trauma. ⋯ The hernia was reduced, and a noncongenital diaphragmatic defect was repaired. Although well described in patients with congenital diaphragmatic hernia, tension gastrothorax-colothorax has not been well characterized in traumatic diaphragmatic hernia. We present the second reported pediatric case and discuss the diagnostic workup, operative approach, and postoperative course of this unusual condition.
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Pediatric emergency care · Apr 2010
Adolescents' perceptions of interpersonal communication, respect, and concern for privacy in an urban tertiary-care pediatric emergency department.
To measure adolescents' perceived overall satisfaction with health care in a pediatric emergency department (PED), identify key factors that contributed to satisfaction, and determine how these factors interacted with length of stay (LOS) and triage acuity. ⋯ Adolescents expressed high levels of satisfaction with their overall PED experience at our institution. Interpersonal communication and respect highly correlated with overall satisfaction. A multicenter study using a similar self-administered survey would further support the relationship between key factors and PED adolescent satisfaction. Utilization of a self-administered survey for adolescent research is feasible in the PED and could be used to improve quality control measures for adolescent care.
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Pediatric emergency care · Apr 2010
Radiographic findings in the diagnosis of pediatric ileocolic intussusception: comparison to a control population.
Several previous studies have evaluated the usefulness of plain abdominal radiographs for the diagnosis of pediatric intussusception, although investigation of the most specific clues to diagnose intussusception has not been studied alone. The 3 most specific findings of intussusception include intraluminal mass or intussusceptum, nonvisualized air-filled cecum, and obscured liver margin or right upper-quadrant mass. ⋯ The cases were reviewed by 2 blinded, board-certified pediatric radiologists to aid in the determination of sensitivity and specificity. The sensitivity and specificity of plain radiographs to correctly diagnose ileocolic intussusception in pediatric patients compared with a control population were 77% and 97%, using a 50% or greater receiver operating characteristic curve cutoff.
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Pediatric emergency care · Mar 2010
Randomized Controlled Trial Multicenter StudyRepeat dosing of albuterol via metered-dose inhaler in infants with acute obstructive airway disease: a randomized controlled safety trial.
Airway obstruction and bronchial hyperactivity often times lead to emergency department visits in infants. Inhaled short-acting beta2-agonist bronchodilators have traditionally been dispensed to young children via nebulizers in the emergency department. Delivery of bronchodilators via metered-dose inhalers (MDIs) in conjunction with holding chambers (spacers) has been shown to be effective. ⋯ Cumulative dosing with albuterol HFA 180 microg or 360 microg via MDI-spacer and face mask in children younger than 2 years did not result in any significant safety issues and improved MTASS by at least 48%.