Pediatric emergency care
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Acute gastroenteritis is a common reason for children to seek health care. Among the potential complications of acute gastroenteritis, the most common is dehydration. ⋯ Some authorities have suggested that the early administration of dextrose to patients receiving intravenous rehydration may help terminate vomiting and result in fewer outpatient treatment failures. The purpose of this report was to review the evidence supporting the effectiveness of early intravenous dextrose administration in the outpatient management of dehydration in children with acute gastroenteritis.
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Pediatric emergency care · Jan 2009
Comparative StudyRadiographic pneumonia in young, highly febrile children with leukocytosis before and after universal conjugate pneumococcal vaccination.
Studies before the introduction of conjugate pneumococcal vaccine demonstrated a high rate of radiographic pneumonia among highly febrile young children with leukocytosis and no other identified source of infection. We sought to evaluate the impact of universal vaccination with Prevnar (pneumococcal conjugate vaccine [PCV]) on the incidence and characteristics of occult and nonoccult radiographic pneumonia among these children. ⋯ Clinicians should continue to consider chest radiography in young highly febrile children with leukocytosis and no other identified source of infection.
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Pediatric emergency care · Jan 2009
Occurrence of serious bacterial infection in infants aged 60 days or younger with an apparent life-threatening event.
To describe the occurrence of serious bacterial infections (SBIs) in well-appearing, afebrile infants aged 60 days or younger with an apparent life-threatening event (ALTE). ⋯ Serious bacterial infection occurred in 2.7% of well-appearing, afebrile infants aged 60 days or younger with an ALTE. Prematurity was associated with having an SBI. For premature infants aged 60 days or younger who present with an ALTE, an evaluation for SBI should be strongly considered.
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Vomiting is a common adverse event after emergency department ketamine sedation in children. We sought to determine if the rate of vomiting is dose related to intravenous ketamine. ⋯ Within a wide range of intravenous doses, ketamine-associated vomiting is not related to either the initial loading dose or the total dose--except for a modest increase for those receiving high cumulative doses (>7 mg/kg).
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Pediatric emergency care · Jan 2009
ReviewUltrasound soft-tissue applications in the pediatric emergency department: to drain or not to drain?
Soft tissue infections frequently prompt visits to the pediatric emergency department. The incidence of these infections has increased markedly in recent years. ⋯ Ultrasound is an efficient, noninvasive diagnostic tool which can augment the physician's clinical examination. Ultrasound has been shown to be superior to clinical judgment alone in determining the presence or the absence of occult abscess formation, ensuring appropriate management and limiting unnecessary invasive procedures.