Pediatric emergency care
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Pediatric emergency care · Nov 2007
Resident exposure to critical patients in a pediatric emergency department.
We hypothesize that nonpediatric and pediatric residents are exposed to a very low percentage of critically ill patients in a high-volume children's hospital emergency department (ED). ⋯ Pediatric and nonpediatric residents who rotate through a high-volume children's hospital ED are exposed to a very low number of critically ill children. Other educational formats, such as mock resuscitations or standardized patient encounters, may be required to correct this deficit.
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Pediatric emergency care · Nov 2007
Case ReportsPott puffy tumor in a 4-year-old boy presenting in status epilepticus.
Pott puffy tumor is an osteomyelitis of the frontal bone with the development of a subperiosteal abscess manifesting as a puffy swelling of the forehead or scalp. It is believed to occur as a complication of frontal sinusitis. The modern antibiotic era has made it a rarely encountered entity. This case describes a 4-year-old boy who presented in status epilepticus secondary to Pott puffy tumor.
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Pediatric emergency care · Nov 2007
Case ReportsSerotonin syndrome in dextromethorphan ingestion responsive to propofol therapy.
An 18-year-old male developed a severe serotonin syndrome after recreational ingestion of Coricidin HBP (chlorpheniramine 4 mg and dextromethorphan hydrobromide 30 mg). Propofol infusion rapidly normalized his agitation, neuromuscular hyperactivity, and autonomic instability. Confirmatory analysis demonstrated a dextromethorphan serum concentration of 930 ng/mL. Dextromethorphan can produce serotonin syndrome in the absence of another serotonergic drug.
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Pediatric emergency care · Nov 2007
Multicenter StudySimulated pediatric trauma team management: assessment of an educational intervention.
Trauma is the leading cause of death in children. The quality of initial medical care received by injured children contributes to outcomes. Our objective was to assess effectiveness of an educational intervention on performance of emergency department (ED) teams during simulated pediatric trauma resuscitations. ⋯ This study demonstrated that an on-site educational intervention was effective in improving the performance of ED teams during simulated pediatric trauma resuscitations. Postintervention performance was more consistent with the Pediatric Advanced Life Support and Advanced Trauma Life Support guidelines. Further studies are needed to determine if improved performance in a simulated scenario leads to improved performance and better clinical outcomes of critically injured children.
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The study was undertaken to describe the presenting features of children with physeal separation of the distal humerus and review the radiographic features of the diagnosis. ⋯ Physeal separation of the distal humerus is an unusual injury but accounts for a significant number of elbow fractures in children 3 or younger. Attention to the radiographic relationship of the ulna and humerus and an appropriate index of suspicion are keys to diagnosis. Nonaccidental injury should be considered as an etiology.