Pediatric emergency care
-
The clinical spectrum of infectious causes of upper airway obstruction has changed dramatically in the last few decades, especially after the introduction of vaccines against diphtheria and Haemophilus influenzae. Nevertheless, infectious causes of upper airway obstruction remain an important source of morbidity and potential mortality in the pediatric age group. ⋯ Despite the virtual elimination of invasive H. influenzae type B infection, it is important for physicians caring for children to understand the management issues surrounding patients with supraglottitis to avoid disastrous outcomes. As illustrated in the following case, these children may not always present with classic features of supraglottitis.
-
Pediatric emergency care · Jan 2008
Case ReportsA child with abdominal pain and hyperglycemia: is it diabetic ketoacidosis?
Hyperglycemia, abdominal pain, and vomiting are the most common manifestations of diabetic ketoacidosis in pediatric patients. The absence of ketonemia in these patients should prompt a consideration of acute pancreatitis. We report a case of an 11-year-old girl with acute necrotizing pancreatitis, who was initially diagnosed as having new onset diabetes with nonketotic hyperglycemia.
-
The objectives of this study were: (1) to determine the incidence of embedded earrings as a chief complaint among children presenting to a pediatric emergency department (ED), (2) to describe the age distribution of children presenting to the ED with embedded earrings, and (3) to describe local experience with the evaluation and treatment of these children. ⋯ Embedded earring is an uncommon complaint among children presenting to a pediatric ED. Young children are likely overrepresented in the occurrence of this problem, which supports the American Academy of Pediatrics recommendation to postpone ear piercing until self-care is achievable.
-
Pediatric emergency care · Jan 2008
A consensus-established set of important indicators of pediatric emergency department performance.
Quality assurance is a new and important area of research in pediatric emergency medicine (PEM). There are few studies that describe which performance indicators best represent the PEM practice. The primary study objective is to construct a set of performance indicators that have been selected by current and former pediatric emergency department (PED) medical directors as most useful in assessing PED performance. The secondary objective is to assess which indicators are currently measured to assess performance in PEDs. ⋯ The top quartile of performance indicators considered most useful by participants included indicators that reflected clinical outcomes, LOS, and waiting times. A dichotomy may exist between those performance indicators that PED directors considered more useful and those indicators that are currently measured.