Pediatric emergency care
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Pediatric emergency care · Apr 2009
Review Comparative StudyCrotalidae polyvalent immune Fab for the treatment of pediatric crotaline envenomation.
Crotaline snakebites occur frequently in children, often resulting in significant morbidity. Crotalidae Polyvalent Immune Fab antivenom (FabAV) became available for clinical use in the US in 2000 and is currently the standard of care for the treatment of crotaline envenomation. The pediatric emergency care provider should be familiar with FabAV because its judicious use in affected children can greatly decrease morbidity caused by crotaline snakebites. This article will review the use of FabAV for the treatment of pediatric crotaline envenomation.
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Pediatric emergency care · Apr 2009
Comparative StudyRevisiting predictors of parental health care-seeking behaviors for nonurgent conditions at one inner-city hospital.
To determine important predictors of why parents seek care for their children at a pediatric emergency department (ED) compared to their child's primary care provider's (PCP's) walk-in clinic. ⋯ Single parenting, Hispanic ethnicity, and perceptions of health are associated with health care-seeking behaviors in high cost settings among Medicaid beneficiaries. Targeted education programs could be used to influence future site of care.
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Pediatric emergency care · Apr 2009
The utility of bedside ultrasonography in identifying fractures and guiding fracture reduction in children.
To compare bedside ultrasonography (BUS) to radiography for identifying long bone fractures, the need for reduction, and the adequacy of reduction. ⋯ These data suggest that BUS evaluation of upper extremity injuries not involving joints maybe comparable to radiography for identifying fractures, the need for reduction, and the adequacy of reduction in children. If further investigations which include a larger number of lower extremity, growth plate, and joint injuries support our findings, BUS may gain a more prominent role in managing children with all long bone injuries.
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We describe the first ziprasidone overdose with quantitative serum levels of a pediatric patient in coma and with pinpoint pupils. This case is an important contribution to the pediatric ziprasidone literature because it illustrates that ingestion of just 1 pill may result to profound mental status and respiratory depression in a child. H. ⋯ The mechanism of miosis associated with overdose of atypical antipsychotics is unclear but is likely related to interference with central innervation of the pupil. Pupil size is maintained by a balance between sympathetic and parasympathetic neurohumeral tones. We propose that an overdose of an alpha-1 receptor blocking agent, such as ziprasidone, results in unopposed parasympathetic stimulation resulting in miosis.
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Pediatric emergency care · Apr 2009
Case ReportsIntraperitoneal bladder rupture as an isolated manifestation of nonaccidental trauma in a child.
Nonaccidental trauma is a significant cause of morbidity and mortality in children. We describe a case of a child who presented with intraperitoneal bladder rupture after sustaining blunt abdominal trauma. ⋯ Emergency exploratory laparotomy revealed rupture at the dome of the bladder. Bladder rupture as a result of nonaccidental trauma has been reported in 3 previous cases.