Delaware medical journal
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Delaware medical journal · Nov 2004
Editorial Biography Historical ArticleGeneral George Washington and Dr. Davis G. Durham: a Delaware connection.
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Choking episodes and foreign body aspiration can be life threatening or result in significant morbidity. Choking continues to be a direct cause of death among children, most commonly occurring between the ages of one and four years. Various strategies have been used to decrease choking risks and prevent adverse outcomes. ⋯ Although education has been partially successful, primary care physicians can play a critical role in increasing education efforts during each well child office visit through anticipatory guidance of choking risks. Management of a choking child often involves collaborative efforts from the primary care physician, emergency room physician, otolaryngologist, pulmonologist, and radiologist. The purpose of this brief review is to provide an overview of the epidemiology and pathophysiology of choking and foreign body aspiration in children and to highlight important aspects of prevention and patient education.
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Delaware medical journal · May 2004
The use of bilevel positive airway pressure for the treatment of acute chest syndrome of sickle cell disease.
To assess the outcome of bilevel positive airway pressure (BPAP) use for pediatric patients with sickle cell disease and acute chest syndrome. ⋯ Data suggest that BPAP therapy can be used to improve oxygenation and decrease work of breathing among patients with acute chest syndrome. We believe that BPAP may prevent progression to acute hypoxic respiratory failure requiring intubation and ventilation. It may reduce costs, especially if intensive care unit admission can be avoided by beginning therapy early. This therapy may become a standard of care for children with acute chest syndrome. The study design (a retrospective chart review) was subject to limitations and bias. A multicenter, prospective, randomized trial is recommended.