Pediatric emergency care
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Pediatric emergency care · Mar 2009
Case ReportsDiagnosis of pediatric intussusception by an emergency physician-performed bedside ultrasound: a case report.
The past decade has seen a rapid evolution in the use of bedside ultrasound (BUS) in the emergency department (ED). In addition, it has been increasingly used in the pediatric population for a variety of indications. ⋯ We report a case of a 9-month-old infant who presented with signs and symptoms suggestive of intussusception, whose diagnosis was made using ED BUS in the pediatric ED. Knowledge of the sonographic appearance of intussusception can aid the emergency physician in the prompt diagnosis of this condition while potentially minimizing complications that may result from a delay in diagnosis.
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Saddleback caterpillar sting has been very rarely reported in European countries. We report a French case of a stung toddler. ⋯ Saddleback caterpillars can be imported to France and carried across the Atlantic Ocean on house or garden plants especially Areca trees. French garden store owners should be informed about this risk and should check and treat host plants (especially Areca trees) at the arrival time.
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Pediatric emergency care · Feb 2009
ReviewCerebrospinal fluid pleocytosis in children in the era of bacterial conjugate vaccines: distinguishing the child with bacterial and aseptic meningitis.
Although bacterial meningitis remains an important cause of childhood morbidity and mortality, the incidence of bacterial meningitis has greatly decreased with the advent of polysaccharide-protein conjugate vaccines in the past 2 decades. Most children with cerebrospinal fluid pleocytosis have aseptic rather than bacterial meningitis, raising the possibility that some patients may be managed as outpatients. In this article, we review the changing epidemiology of bacterial meningitis as well as the available clinical decision rules that may assist the clinician in distinguishing aseptic from bacterial meningitis in patients with cerebrospinal fluid pleocytosis.
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Pediatric emergency care · Feb 2009
Comparative StudyClinician judgment versus a decision rule for identifying children at risk of traumatic brain injury on computed tomography after blunt head trauma.
To compare a decision rule with clinician judgment for identifying children at risk of traumatic brain injury (TBI) after blunt head trauma. ⋯ A decision rule trended toward greater sensitivity than clinician judgment for identifying children with TBI on CT after blunt head trauma but was less specific. Because decisions to order cranial CT did not strictly follow clinician judgment, however, use of the decision rule would have resulted in less frequent use of CT.