Pediatric emergency care
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Pediatric emergency care · Nov 2004
Multicenter StudyEmergency mental health care for youth in Washington State: qualitative research addressing hospital emergency departments' identification and referral of youth facing mental health issues.
The purpose of this formative research was to gain a better understanding of how Washington State hospital emergency departments (EDs) identify and refer children and adolescents with mental health concerns. Increased understanding of emergency mental healthcare for youth will lead to the development and implementation of strategies and policies that enhance the system of providing mental health services to children and adolescents. ⋯ Specific interventions should be developed, implemented, and evaluated to increase coordination between the ED and the larger mental health system. This should include methods for increasing ED staff knowledge of available and accessible mental health services for youth, perhaps through an online system. In addition, the role of the ED in identifying youth facing mental health issues should be clarified, and a brief, nonintrusive screening tool for identifying emergency mental health concerns should be developed.
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Pediatric emergency care · Nov 2004
Case ReportsAn intentional opiate intoxication of an infant: when medical toxicology and child maltreatment services merge.
We present an instructive case of a 5-week-old infant seen in the emergency department with acute inspiratory stridor and depressed level of consciousness. His emergency department course identified an acute opiate intoxication. The child also developed chest wall rigidity, a rare complication of narcotic use. We discuss the emergency department management, as well as the toxicologic and child protection investigations.
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Pediatric emergency care · Nov 2004
Case ReportsAn adolescent with chest pain-sequela of Kawasaki disease.
Kawasaki disease, is an acute vasculitis of unknown etiology characterized by mucocutaneous involvement occurring in infants and young children, predominantly younger than 5 years of age. We present a case of a 19-year-old female with a prior history of Kawasaki disease as an infant who was seen in the emergency department with chest pain in the midsternal region lasting for 20 minutes with radiation to the left arm. ⋯ There was a 90% eccentric and calcified single discrete stenosis of the proximal segment of the left anterior descending artery, and the patient underwent a successful percutaneous transluminal coronary angioplasty with stent insertion. Physicians working in the emergency department setting should remain cognescent of the rarer but significant cardiac causes of chest pain while evaluating children, adolescents, and young adults.
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Pediatric emergency care · Nov 2004
Case ReportsWood's lamp employed as a provocative technique to identify pseudoseizures.
We present a case of a 12-year-old female who presented to the emergency department with ictal phenomena suggestive of pseudoseizures. A Wood's lamp was successfully employed to induce the stereotypic phenomena and thereby identify the ictal events as nonepileptiform. Use of the Wood's lamp has not previously been reported as a provocative stimulus to induce pseudoseizures. Given its noninvasive nature and ready availability, the Wood's lamp should be considered for identification of pseudoseizures.
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Pediatric emergency care · Nov 2004
Effect of JumpSTART training on immediate and short-term pediatric triage performance.
The purpose of this study was to evaluate the effectiveness of JumpSTART training in changing prehospital care personnel and/or school nursing personnel performance in triaging pediatric patients involved in a multiple casualty incident immediately posttraining and at a 3- to 4-month follow-up interval. ⋯ Structured training results in triage performance improvement among prehospital and nursing personnel. This improvement is maintained for a period of at least 3 months. Additional research pertaining to the length of time between necessary retraining and/or refresher is warranted. Additionally, the relationship between staged scenario performance and responses to actual multiple casualty incidents needs to be established.