Pediatric emergency care
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Pediatric emergency care · Nov 2008
Multicenter StudyPredicting need for hospitalization in acute pediatric asthma.
To develop and validate predictive models to determine the need for hospitalization in children treated for acute asthma in the emergency department (ED). ⋯ Successful discharge from the ED for children with acute asthma can be predicted accurately using a simple clinical model, potentially improving disposition decisions. However, predicting correct placement of patients requiring extended care is problematic.
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Pediatric emergency care · Oct 2008
ReviewAnticonvulsant medications in the pediatric emergency room and intensive care unit.
Seizures are common in pediatric emergency care units, either as the main medical issue or in association with an additional neurological problem. Rapid treatment prolonged and repetitive seizures or status epilepticus is important. ⋯ A status epilepticus treatment algorithm is suggested, incorporating changes from traditional algorithms based on these new data. Treatment issues specific to complex medical patients, including patients with brain tumors, renal dysfunction, hepatic dysfunction, transplant, congenital heart disease, and anticoagulation, are also discussed.
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Pediatric emergency care · Oct 2008
Review Case ReportsThe edematous toddler: a case of pediatric Ménétrier disease.
Ménétrier disease is a protein-losing gastroenteropathy, characterized clinically by nonspecific gastrointestinal symptoms and generalized edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. Distinct from its adult counterpart, Ménétrier disease of childhood usually remits spontaneously and has a very good prognosis. We present a case report of Ménétrier disease in an edematous toddler and a brief review.
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Pediatric emergency care · Oct 2008
Randomized Controlled Trial Comparative StudyA prospective randomized controlled study of two fluid regimens in the initial management of septic shock in the emergency department.
To compare the impact of 40 mL/kg of fluid over 15 minutes followed by dopamine and further titration of therapy to achieve therapeutic goals (study protocol) versus 20 mL/kg over 20 minutes up to a maximum of 60 mL/kg over 1 hour followed by dopamine (control protocol) in septic shock. ⋯ There was no difference in the overall mortality, rapidity of shock resolution, or incidence of complications between the groups. The occurrence of hepatomegaly at 20 minutes following 40 mL/kg is of concern in settings with limited access to post-resuscitation ventilator care.