Pediatric emergency care
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Pediatric emergency care · Sep 2009
Comparative Study Controlled Clinical TrialUse of a discharge facilitator improves recall of emergency department discharge instructions for acute gastroenteritis.
To determine whether the use of a bilingual discharge facilitator (DF) improves parental recall of discharge instructions in acute gastroenteritis in a pediatric emergency department (ED). ⋯ Verbal reinforcement of written discharge instructions by a bilingual DF improves parental recall of discharge instructions for gastroenteritis.
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Pediatric emergency care · Sep 2009
Comparative StudyInitial base deficit as predictors for mortality and transfusion requirement in the severe pediatric trauma except brain injury.
The initial base deficit (BD) is an important indicator of shock in adult trauma patients, but its value is unclear in pediatric trauma patients. This study assessed the ability of the initial BD to predict mortality and blood transfusion requirements in children except severe brain injury patients. ⋯ The initial BD in pediatric trauma patients except severe brain injury was an independent predictor of mortality and blood transfusion requirement within 24 hours. Mortality and blood transfusion requirement were significantly high when initial BD was less than -8 mEq/L.
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Pediatric emergency care · Sep 2009
Comparative StudyPediatric emergency medicine fellowship research curriculum: a survey of fellowship directors.
To determine how pediatric emergency medicine (PEM) fellowship directors organize research training and to identify factors believed to be associated with successful research training. ⋯ Besides the fellow's eagerness to apply self, scheduling adequate time for research was reported as a highly important factor in achieving research competency among PEM fellows. Providing protected (no clinical responsibilities) research months to fellows and arranging more opportunities for PEM faculty to serve as research mentors may maintain or possibly improve the likelihood of PEM fellows to becoming research competent.
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Pediatric emergency care · Sep 2009
Case ReportsTraumatic posterior dislocation of the hip in a 3-year-old child.
We report the case of a traumatic posterior dislocation of the hip in a 3-year-old boy. After a fall in the garden, the boy was brought to our emergency department where an x-ray confirmed a posterior dislocation of his right hip. A successful prompt reduction was performed in the operating room under general anesthesia. This uncommon injury represents an orthopedic emergency and requires prompt reduction to lessen the risk of complications including avascular necrosis of the femoral head.
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Pediatric emergency care · Sep 2009
Comparative StudyIntravenous contrast agents and associated changes in serum osmolality.
Anecdotal data suggest that intravenous contrast agents given to enhance the sensitivity of computed tomography (CT) can produce increases in serum osmolality, producing an osmolal gap. An unexplained osmolal gap often prompts extensive evaluation for the presence of unidentified toxins, particularly the toxic alcohols (methanol, ethanol, isopropyl alcohol, and ethylene glycol). The ability of intravenous contrast media to raise serum osmolality with a resulting osmolal gap has not been systematically investigated. ⋯ These data suggest that intravenous contrast agents, when administered at conventional doses, do not significantly increase serum osmolality or produce an osmolal gap. Patients who are found to have an osmolal gap after the performance of a contrast-enhanced CT scan should undergo thorough evaluation to identify its etiology rather than attributing the gap to contrast administration.