Indian journal of pediatrics
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Every 5 years the American Heart Association (AHA) updates the Guidelines for CPR and Emergency Cardiovascular Care (ECC). The ECC Guidelines 2000 incorporates all the current consensus of experts, from not only a variety of disciplines, but also a variety of countries and cultures and is evidence based. The new Guidelines emphasize interventions to reduce the risk of sudden deaths, early identification of respiratory failure and shock and implementation of Advanced Life Support (ALS) to treat respiratory and cardiac arrest.
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Stroke is a thrombohemorrhagic disorder of the central nervous system, with a fairly good outcome in pediatric age group except for the infancy period. In children ischemic type is more common than hemorrhagic type. ⋯ The treatment of stroke is largely for stabilization of the patient, but it is very important to know the cause to prevent future strokes. Use of heparin in ischemic stroke is very promising and thrombolytic therapy is under trial.
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Treating the febrile infant strikes fear in all of us. The source of fever in a very young infant may be a serious bacterial infection. A thorough physical examination is just the beginning of a complete evaluation of a febrile infant. ⋯ Febrile neonates warrant thorough evaluation, complete diagnostic testing, and aggressive inpatient treatment with i.v. antibiotics. Management of infants between 1-3 months of age may be guided by clinical evaluation and laboratory investigations. In infants above 3 months of age, the clinical assessment can direct regarding laboratory testing and treatment in most of the cases.
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Shock is a syndrome arising from any of several initiating causes, resulting in inadequate tissue perfusion. Untreated shock due to any cause can lead to irreversible cellular damage. Early diagnosis and intervention are, therefore, key to improved outcomes. ⋯ Aggressive fluid therapy in the early stages is essential to recovery. Understanding the pathophysiology will help in judicious use of vasoactive drugs. Newer modalities of treatment for severe sepsis and septic shock still need evaluation in children.