Pediatric emergency care
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Hereditary angioedema is a disorder characterized by decreased levels or function of complement C1 esterase inhibitor. Symptoms in children generally consist of recurrent episodes of soft tissue swelling. On rare occasion, it can cause airway edema which may lead to airway obstruction. ⋯ Initial management of this rare complication should be directed at establishing an adequate airway and ensuring good oxygenation and ventilation. In addition, prompt administration of C1 esterase inhibitor concentrate is the most effective means of stopping progression of laryngeal edema and other forms of swelling. Commonly used agents for airway edema such as glucocorticoids, antihistamines, H1-blockers, and epinephrine tend not to be effective for reducing swelling related to hereditary angioedema.
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Pediatric emergency care · Jan 2005
The impact of training and experience on EMS providers' feelings toward pediatric emergencies in a rural state.
To determine which factors of training and education influence emergency medical technicians' (EMTs) feelings toward pediatric emergencies in a rural state. ⋯ Level of EMT and hours of CE influence the level of comfort felt by EMTs when confronting a pediatric emergency. Specific CE requirements for topics in pediatric emergency medicine should be considered for all EMTs.
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Bispectral analysis (BIS) is a technology using EEG information from a forehead electrode to calculate an index (0-100; 0 = coma, 90-100 = awake). Our objective was to determine the degree of agreement between sedation scales and BIS values in pediatric patients undergoing sedation. ⋯ The OAA/S sedation scale predicts the BIS value for pediatric patients undergoing procedural sedation when sedated with certain medications, excluding ketamine.
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Pediatric emergency care · Jan 2005
Case ReportsA thyroglossal duct cyst causing apnea and cyanosis in a neonate.
This is a case of a 3-week-old male who presented to the emergency department with intermittent apnea and cyanosis. While in the emergency department, he had respiratory compromise with stress and required intubation. ⋯ Congenital lesions causing extrinsic airway compression should be considered in all neonates with apnea, cyanosis, and respiratory compromise. Knowledge of pediatric airway anatomy and physiology is important in all cases where obstructive apnea is suspected.
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Pediatric emergency care · Jan 2005
Case ReportsOcular irrigant alternatives in pediatric emergency medicine.
Minimizing pain and discomfort is an important consideration in pediatric ocular decontamination. The pH of an irrigant solution plays a significant role in its tolerability, because a solution with a pH that is too low or too high may cause edema and discomfort to the conjunctiva. We reviewed several available ocular irrigation solutions with respect to their chemical composition, pH, and cost efficiency. ⋯ Alternative ocular irrigant solutions available include Lactated Ringers solution (LR), which has a pH range between 6.2 and 7.5, buffered NS with pH adjusted to 7.4 with sodium bicarbonate, and Balanced Salt Solution Plus (BSS Plus), which has a pH of 7.4. Of these alternative solutions, all except BSS Plus are comparable in cost efficiency to NS. The use of more pH neutral solutions such as LR, NS with bicarbonate buffer, or BSS Plus may decrease ocular pain and irritation associated with copious irrigation, and may improve tolerance of ocular decontamination by a child.