Pediatric emergency care
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Pediatric emergency care · Jan 2006
Case ReportsSudden death in an infant revealing atypical Kawasaki disease.
We present a case of a 4-month-old girl referred to the emergency department with a provisional diagnosis of acute life-threatening event with a recent episode of heart block and a history of long-lasting fever. Soon after admission, the child suddenly deteriorated rapidly; she became pulseless with complete heart block and died despite intensive resuscitation efforts. ⋯ With this case presentation, we discuss the importance of early recognition and treatment of atypical and/or incomplete forms of Kawasaki disease, which are most common in young infants and may lead, if untreated, to coronary artery abnormalities with a potential for myocardial infarctions, aneurysm formation, and sudden death. In addition, the relevance of postmortem examination in a case of sudden and undiagnosed infant death is underlined.
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Pediatric emergency care · Jan 2006
Restraint use for psychiatric patients in the pediatric emergency department.
Restraint of children and adolescents with psychiatric problems has generated controversy. Restraint may be defined as methods used to restrict movement or normal access to one's body. Published data to guide restraint practice are limited. ⋯ Approximately 1 in 15 children undergoing psychiatric evaluation were restrained. This is the first study to elucidate correlates of restraint practice in the pediatric emergency department. Further studies examining indications for restraint and comparing methods of restraint are needed.
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Pediatric emergency care · Dec 2005
Unscheduled revisits to a pediatric emergency department: risk factors for children with fever or infection-related complaints.
Unscheduled revisits (URVs) may serve as markers of quality of care and may be costly both in financial terms as well as in limitations they place on primary care. We performed this study to examine the association between characteristics easily obtainable during an emergency department (ED) visit and URV to identify a subpopulation of children who may warrant interventions to decrease URV. ⋯ These factors may be used to identify children in the ED at greater risk for URV and may point to a need for improved discharge instructions and enhanced communication with primary care and systems to arrange follow-up. Results of this work may also identify at-risk populations for future qualitative research or intervention studies on URV to EDs.