Pediatric clinics of North America
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Pediatr. Clin. North Am. · Feb 2006
ReviewEmergency Medical Treatment and Labor Act: the basics and other medicolegal concerns.
The Emergency Medical Treatment and Labor Act (EMTALA) was enacted by Congress because of its concern with an increasing number of reports that hospital emergency rooms were refusing to accept or treat individuals with emergency conditions if the individuals did not have insurance. With increasingly crowded emergency departments and a decreasing number of emergency departments, a periodic review of the effect that EMTALA has on the emergency medical services will prevent unintended consequences of this well-intentioned act.
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The pediatric musculoskeletal system differs greatly from that of an adult. Although these differences diminish with age, they present unique injury patterns and challenges in the diagnosis and treatment of pediatric orthopedic problems.
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Abdominal pain and gastrointestinal symptoms such as vomiting or diarrhea are common chief complaints in young children who present in emergency departments. It is the emergency physician's role to differentiate between a self-limited process such as viral gastroenteritis or constipation and more life-threatening surgical emergencies. Considering the difficulties inherent in the pediatric examination, it is not surprising that appendicitis, intussusception, and malrotation with volvulus continue to be among the most elusive diagnoses. This article reviews both the self-limited and more life-threatening gastrointestinal conditions that may present in the emergency department.
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This article focuses on current practice in the diagnosis and management of the pediatric patient who is a potential victim of abuse. We will review diagnostic and management issues in the major manifestations of physical and sexual abuse are reviewed. This article serves as an aide to practitioners in the recognition of and response to child maltreatment.