Pediatric emergency care
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Pediatric emergency care · Mar 2009
Comparative StudyEffect of volume resuscitation on regional perfusion in dehydrated pediatric patients as measured by two-site near-infrared spectroscopy.
The aim of this study was to measure the change of cerebral and somatic regional oxygen saturation (rSO2) using near-infrared spectroscopic (NIRS) monitoring during volume resuscitation of dehydrated children. ⋯ In children with acute dehydration, cerebral rSO2 is preserved in moderate dehydration. Somatic tissue beds show an increase in rSO2 by NIRS oximetry with rehydration. Two-site NIRS monitoring is a continuous, noninvasive quantitative method for early detection of regional hypoperfusion in dehydrated children.
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Pediatric emergency care · Mar 2009
Case ReportsRight atrial rupture from blunt thoracic trauma in a 4-year-old child.
Blunt cardiac injury in the pediatric population has been less frequently reported than in the adult population. Cardiac chamber rupture is a rare but highly lethal injury in both populations. ⋯ A high index of suspicion and early use of the appropriate imaging studies are essential for the timely diagnosis of this condition. In this report, we present a 4-year-old child who survived 10 hours of pericardial tamponade secondary to blunt right atrial rupture.
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Pediatric emergency care · Mar 2009
Comparative StudyPediatric procedural sedation by a dedicated nonanesthesiology pediatric sedation service using propofol.
To evaluate the success and dosing requirements of propofol in children for prolonged procedural sedation by a nonanesthesiology-based sedation service. ⋯ Although it seems that the mean dosing of propofol does not vary significantly with age, there is greater variability in induction dosage for those younger than 1 year and in maintenance dosing for those 7 years or older. The results and general dosing parameters may assist pediatric subspecialists in using propofol for prolonged procedural sedation.
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Pediatric emergency care · Mar 2009
Comparative StudyTraumatic epidural hematomas in children and adolescents: outcome analysis in 39 consecutive unselected cases.
Despite early diagnosis of traumatic epidural hematomas (EDHs) in children, mortality remained quite high in recent series. The aims of this analysis were to review the cause and outcome of pediatric EDH nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. ⋯ Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH are excellent.
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Pediatric emergency care · Mar 2009
Comparative StudyImpact of an observation unit and an emergency department-admitted patient transfer mandate in decreasing overcrowding in a pediatric emergency department: a discrete event simulation exercise.
The primary objective was to examine the effects of a simulated observation unit (OU) and a transfer mandate for admitted patients on pediatric emergency department (PED) patient flow indicators. The secondary objective was to report on the occupancy rate of the simulated OU. ⋯ Simulation scenario analyses predict that an OU and a transfer mandate would reduce overcapacity in the PED, with more substantial reductions in time to be seen and length of stay for patients of high acuity.