Pediatric emergency care
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Pediatric emergency care · Jun 2007
ReviewVenous access in the critically ill child: when the peripheral intravenous fails!
Emergent venous access is now achievable by intraosseous needle in patients of all ages and sizes. The review outlines the limitations of other more "traditional" forms of emergent venous access in children (when the peripheral intravenous fails) and briefly discusses the intraosseous devices that have been recently marketed that allow for rapid and effective intraosseous access in older children and adults.
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Pediatric emergency care · Jun 2007
Parental perception of the passage of time during a stressful event.
The duration of a specific event during an emergency and the duration of time from the event until medical evaluation are important components of a detailed history and may influence management decisions. We sought to determine whether a caregiver is accurate in their recollection of the passage of time related to a stressful event. ⋯ Caregivers recollection of the ambulance time intervals during their child's illness was generally unreliable. If used as a marker for the caregiver's perception of the passage of time during a stressful event, these data suggest that interval estimates alone should not be used to guide management.
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Pediatric emergency care · Jun 2007
ReviewPediatric patient safety in the prehospital/emergency department setting.
The unique characteristics of the pediatric population expose them to errors in the emergency department (ED) with few standard practices for the safety of care. Young children and high-acuity patients are at increased risk of adverse events both in the prehospital and ED settings. ⋯ Medication errors can be reduced by using organizational systems, and manufacturing and regulatory systems, by educating health care providers, and by providing caregivers tools to monitor prescribing. The consensus is that a safe environment with a high quality of care will reduce morbidity and mortality in ED pediatric patients.
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Pediatric emergency care · Jun 2007
Case ReportsDelayed intracerebral hemorrhage from an extracranial ball bullet pellet.
The evaluation of superficial penetrating injuries to the face and scalp is common in the emergency department. We present a patient who presented with a ball bullet pellet to the forehead with an initially negative computerized tomographic (CT) scan of the head, who represented 18 hours later with nausea, vomiting, and mental status changes. ⋯ Upon review, the initial CT scan was limited by scatter artifact. In this case report, we discuss the potential for significant injury with compressed air-driven arms, the limitation of CT in the presence of metallic foreign bodies, and the significant risks associated with pediatric radiation exposure.