American journal of diseases of children (1960)
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Intracranial hemorrhage (ICH) in the newborn or young infant is an uncommon presenting manifestation of hemophilia. Its occurrence is almost always preceded by mild-to-moderate head trauma, unlike adult hemophiliacs in whom ICH occurs without prior head injury in 50% of cases. The bleeding event may follow a minor complication of labor or delivery (eg, prolonged second-stage labor or the use of forceps). ⋯ In one case, PTT prolongation was ascribed to tissue thromboplastin-induced intravascular coagulation. There was one death secondary to overwhelming intraventricular hemorrhage and iatrogenic bacterial ventriculitis. Some specific diagnostic and therapeutic recommendations are provided to assist the clinician in evaluating a child with ICH and a prolonged PTT who is in need of immediate neurosurgery.
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Performance of mask-bag ventilation was evaluated on an infant resuscitation mannequin to resolve uncertainty regarding the proficiency of pediatric resuscitation personnel in this technique and to determine whether the type of resuscitation bag used would affect performance. Performance using a self-inflatable resuscitation bag was generally adequate. ⋯ Wide variation with a tendency to hyperventilate and to use excessive pressures indicate the need for improved standard training methods. Technical difficulties with an anesthesia bag impaired performance, suggesting that only self-inflatable bags should be used for mask-bag ventilation during pediatric resuscitation, unless the staff's proficiency with anesthesia bags is clearly demonstrated.
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Comparative Study
Laryngotracheal foreign bodies in children. A comparison with bronchial foreign bodies.
Twenty cases of laryngotracheal foreign bodies were reviewed over an 11-year period to determine features that differentiate these from bronchial foreign bodies. A history of choking or aspiration was obtained in 18 patients (90%). The most common presenting symptoms were stridor, wheezing, sternal retractions, and cough. ⋯ The correct diagnosis was made within the first 24 hours of presentation in 11 patients (55%); 19 patients (95%) were correctly diagnosed within one week. The incidence of major complications was 45% (9/20); however, in patients with a delay in diagnosis of over 24 hours the complication rate was 67% (6/9). For this reason, in children with a diagnosis of croup or reactive airway disease who respond poorly or whose condition deteriorates despite appropriate medical therapy, early endoscopy should be considered.