Pediatric emergency care
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Pediatric emergency care · May 2005
ReviewEnd-tidal carbon dioxide monitoring in pediatric emergencies.
End-tidal carbon dioxide (CO2) monitoring is useful in the prehospital setting, emergency department, intensive care unit, and operating room. Capnography provides valuable, timely information about the function of both the cardiovascular and respiratory systems. ⋯ A thorough understanding of cardiopulmonary physiology and the technical nuances of capnometry is required for its optimal use in children. This review examines the basic physiology pertinent to end-tidal CO2 monitoring, its clinical applications, and evidence supporting its use in infants and children.
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Pediatric emergency care · May 2005
Review Case ReportsAbnormal gait in a child with fever: diagnosing septic arthritis of the hip.
The diagnosis of septic arthritis should be considered in all children with hip pain. We review the evaluation of children who present with fever and hip pain, emphasizing features that may assist in distinguishing septic arthritis of the hip from transient synovitis. We also discuss the impact of the increased prevalence of methicillin-resistant Staphylococcus aureus on the management of septic arthritis of the hip.
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Pediatric emergency care · May 2005
Case ReportsThe protean manifestations of blunt cardiac trauma in children.
We present a case series of pediatric blunt cardiac trauma with a variety of cardiac abnormalities, occurring immediately and after the initial insult. The range of complications and importance of serial evaluations are emphasized.
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Pediatric emergency care · May 2005
Case ReportsIdiopathic thrombocytopenic purpura complicated by an intracranial hemorrhage secondary to an arteriovenous malformation.
To report a case of idiopathic thrombocytopenic purpura (ITP) complicated by an intracranial hemorrhage (ICH) in a child with a previously undiagnosed arteriovenous malformation. ⋯ ICH is a rare but life-threatening complication of ITP. Neurologic symptoms in a child with ITP should be quickly evaluated by CT scan. Most experts suggest careful observation for most cases of ITP. However, when neurologic symptoms occur, more aggressive treatment options must be used. Care of this child included an emergency splenectomy prior to her craniotomy. Pediatric emergency medicine practitioners must be aware of these neurologic symptoms and must not hesitate to involve pediatric surgeons and neurosurgeons in the care of the child. Prompt recognition and early intervention are the keys to improving outcomes when ICH complicates ITP.
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Pediatric emergency care · May 2005
Self-reported pain intensity and associated distress in children aged 4-18 years on admission, discharge, and one-week follow up to emergency department.
Pain is the most common complaint among children presenting to the Emergency Department (ED), yet it is poorly managed. Although the poor management of pain has been documented, no studies have simultaneously determined the distress caused by the presenting pain nor have children been followed after the ED visit to determine whether the pain and distress have resolved. The purpose of this study was to describe pain intensity, distress from pain, and treatment of pain in children presenting to the ED and to follow them 1 week later to describe resolution of their pain. ⋯ A greater proportion of children report high intensity of distress from pain than of pain intensity itself when in the ED. Only a small proportion of children received analgesics during the visit to the ED and only slightly more on discharge. Although pain seems to resolve by 1 week, distress is less likely to have resolved. More attention needs to be paid both to pain children are experiencing in the ED and equally to the accompanying distress.