Pediatric clinics of North America
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Children often present with painful conditions that require painful interventions. Procedural sedation and analgesia refers to the pharmacologic technique of managing a child's pain and anxiety. ⋯ Different medications and combinations of medications can be used to achieve the desired effect. It is also important to keep in mind the possible adverse reactions and side effects associated with each medication when choosing the sedation cocktail.
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Upper and lower respiratory infections are encountered commonly in the emergency department. Visits resulting from occurrences of respiratory disease account for 10% of all pediatric emergency department visits and 20% of all pediatric hospital admissions. ⋯ Signs and symptoms of upper and lower airway infections overlap, but the differentiation is important for appropriate treatment of these conditions. This article reviews the varied clinical characteristics of upper and lower airway infections.
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Although fever in the young child (0-36 months) is a common clinical problem, the evaluation and treatment of febrile children remain controversial. Furthermore, universal vaccination with the heptavalent pneumococcal conjugate vaccine (PCV7) has changed the epidemiology of invasive bacterial disease in young children. This article addresses the approach to febrile neonates (0-28 days old), young infants (1-3 months old), and older infants and toddlers (3-36 months old) in the PCV7 era.
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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.