Pediatric emergency care
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Pediatric emergency care · Aug 2008
Dosing ketamine for pediatric procedural sedation in the emergency department.
To describe intravenous ketamine dosing regimens for children requiring brief procedural sedation. ⋯ Dosing increases with decreasing age. A large single dose is associated with deep sedation, possible adverse effects, and delayed recovery. Between-subjects variability is large, and dose should be tailored to clinical monitoring and requirement. Intermittent pain insult is better suited to a top-up technique, whereas continuous pain is better suited to an infusion technique.
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Adnexal torsion is an acute abdominal condition often confused with other diseases in children. The objective of this study is to evaluate the diagnosis and characteristics of adnexal torsion in children. ⋯ Ultrasound usually plays an important, but not definitive, role in diagnosis. Multiple radiographic studies with combined computed tomography and US did not provide a diagnostic advantage over US alone. Most pediatric adnexal torsion occurs in postmenarchal patients, but the potential exists for this diagnosis in premenarchal girls. Adnexal torsion should be considered in any girl with an abdominal mass and any degree of abdominal pain.
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Pediatric emergency care · Aug 2008
Case ReportsPosttraumatic internal jugular vein thrombosis presenting as a painful neck mass in a child.
An uncommon case of a pediatric traumatic internal jugular vein thrombosis is presented. A 7-year-old boy developed severe neck pain after falling from a bunk bed. Initially, the child was diagnosed and treated for a lymphadenitis with a possible abscess formation. ⋯ He had full resolution of his symptoms without the development of complications associated with this injury process. Internal jugular vein thrombosis is an uncommon and potentially life-threatening disorder caused by various conditions. This case illustrates the need for a systematic approach when evaluating neck masses, and internal jugular venous thrombosis should be included in the differential of anterior neck swelling.
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Pediatric emergency care · Aug 2008
Emergency department revisits for pediatric acute asthma exacerbations: association of factors identified in an emergency department asthma tracking system.
To identify clinical variables associated with a greater likelihood of emergency department (ED) revisit for acute asthma within 7 days after an initial ED visit for acute asthma exacerbation. ⋯ Although our design precludes drawing causal inference, our results suggest that children younger than 2 years or with persistent asthma or lower asthma quality-of-life scores are at greater risk for ED revisits after acute ED asthma care.