Pediatric clinics of North America
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Pediatr. Clin. North Am. · Dec 2018
ReviewRecognition, Diagnostics, and Management of Pediatric Severe Sepsis and Septic Shock in the Emergency Department.
Several new studies have emerged in recent years that have attempted to aid emergency department providers in recognizing and treating pediatric patients with severe sepsis and septic shock. National guidelines and supporting literature are unanimous in recommendations that early recognition and timely therapeutics are necessary for improved survival and decreased morbidity. The literature is less concrete in defining how emerging advances in the field can aid in time-sensitive care of these patients. This article summarizes the recent literature as it pertains to the initial presentation of severe sepsis and septic shock in the pediatric patient within the emergency department.
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Pediatr. Clin. North Am. · Dec 2018
ReviewManagement of Adult Patients in the Pediatric Emergency Department.
Adult patients often present to the pediatric emergency department (ED) for treatment of a wide variety of diseases. However, pediatric emergency medicine physicians are primarily trained to provide specialized care for children. ⋯ This article discusses the management of common adult complaints presenting to the pediatric ED. The focus is on stabilization in the pediatric ED and safe transfer to a more appropriate facility.
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In caring for critically ill children, recognition and management often begins in the pediatric emergency department. A seamless transition in care is needed to ensure appropriate care to the sickest of children. This review covers the management of critically ill children in the pediatric emergency department beyond the initial stabilization for conditions such as acute respiratory failure and pediatric acute respiratory distress syndrome, traumatic brain injury, status epilepticus, congenital heart disease, and metabolic emergencies.
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Emergency medicine requires diagnosing unfamiliar patients with undifferentiated acute presentations. This requires hypothesis generation and questioning, examination, and testing. ⋯ Diagnostic error is the failure to establish an accurate and timely explanation of the problem or communicate that to the patient, often contributing to physical, emotional, or financial harm. Methods for monitoring diagnostic error in the emergency department are needed to establish frequency and serve as a foundation for future interventions.