Pediatric emergency care
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Pediatric emergency care · Oct 2005
Hyperventilation at referring hospitals is common before transport in intubated children with neurological diseases.
To assess if cardiopulmonary complications and abnormal carbon dioxide tension are more likely in intubated children with neurological diseases undergoing transport. ⋯ There is no cardiopulmonary disaster in the various modes of pediatric transport. When compared with ground transport, there is no significant increase in the risk for cardiopulmonary complications or abnormal CO2 tension in air transport of intubated children. DeltapH, in conjunction with clinical data and PCO2 values, may be a simple index for evaluation of cardiopulmonary management during transport.
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Pediatric emergency care · Oct 2005
Case ReportsSmall bowel obstruction caused by a congenital jejuno-jejuno band in a child.
A case of small bowel obstruction in a 4-year-old boy with pica is described. The child habitually chewed on his plastic toy action figures. Abdominal radiography and endoscopy confirmed the presence of chewed pieces of plastic within the digestive tract. ⋯ Intestinal obstruction caused by foreign bodies is extremely rare, and obstruction caused by congenital bands is even more uncommon. This particular variant of a congenital band has not been previously described. Physicians should be aware that congenital bands can cause small bowel obstruction in children and that surgical treatment is required.
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Observation units (OUs) serve patients who require more evaluation or treatment than possible during an emergency department visit and who are anticipated to stay in the hospital for a short defined period. Asthma is a common admission diagnosis in a pediatric OU. Our main objective was to identify clinical factors associated with failure to discharge a child with asthma from our OU within 24 hours. ⋯ Many children with asthma can be admitted to a pediatric OU and discharged safely within 24 hours. Prospective studies are needed to confirm our findings and to identify other factors predictive of unplanned inpatient admission.
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Pediatric emergency care · Oct 2005
Case ReportsEsophageal coin with an unusual radiographic appearance.
Esophageal coins are typically seen as radiopaque disks on anteroposterior chest radiographs. This radiographic finding is generally considered classic for identifying "swallowed" coins as being in the esophagus. ⋯ Clinicians should be wary of making the diagnosis of foreign body aspiration of coins by relying on single-view radiographic findings alone. When clinically reasonable, we suggest additional imaging to help further localize swallowed coins.