Articles: emergency-department.
-
Pediatric emergency care · Sep 2014
Case ReportsEncephalopathy from unintentional donepezil and memantine ingestion.
Donepezil and memantine are commonly prescribed antidementia drugs. There is a paucity of literature concerning pediatric ingestions of these drugs. We describe a case of a 2-year-old child who developed encephalopathy after an unintentional ingestion of donepezil and memantine. ⋯ She recovered with supportive care for 72 hours. Serum concentrations of donepezil and memantine measured on arrival were 470 ng/mL (therapeutic range, 25-50 ng/mL) and 32 ng/mL (therapeutic range, 70-150 ng/mL), respectively. This case demonstrates that unintentional ingestions of memantine and donepezil can potentially cause significant and prolonged neurological symptoms in pediatric patients.
-
Understanding differences between patients who accept and decline HIV testing is important for developing methods to reduce decliner rates among patients at risk for undiagnosed HIV. The objectives of this study were to determine the rates of acceptance and reasons for declining, and to determine if differences exist in patient or visit characteristics between those who accept and decline testing. ⋯ Acceptance of ED-based rapid HIV testing is not universal, and there are both patient and visit characteristics consistently associated with declining testing. This detracts from the goal of using the ED to screen a large number of at-risk patients who do not have access to testing elsewhere.
-
Pediatric emergency care · Sep 2014
A Computerized Child Passenger Safety Screening Program in the Emergency Department.
The emergency department (ED) can be an effective site for pediatric injury prevention initiatives, including child passenger safety. The objectives of this study were to evaluate the implementation of an ED child passenger safety program and to analyze the effectiveness of a computerized screening tool to identify car seat-related needs for children younger than 8 years. ⋯ A child passenger safety program can be successfully implemented in the ED. A computerized nursing screening tool increases compliance with screening and providing needed car seats.
-
The continuing shortfall of organs for transplantation has led to interest in Maastricht Category II (uncontrolled) Donation after Circulatory Death (DCD) organ donation. As preparation for a proposed pilot, this study aimed to explore the potential of uncontrolled DCD organ donation from patients presenting in cardiac arrest to the emergency department (ED) who are unsuccessfully resuscitated. ⋯ Identifying potential organ donors in the ED who are unsuccessfully resuscitated from cardiac arrest may contribute to reducing the shortfall of organs for transplantation, although numbers are likely to be small. If such a programme was to be introduced during weekday working hours, there may be around four donors a year. However, even one additional donor per year from hospitals across the UK with an ED and a transplantation service would add considerably to the overall organ donation rate.
-
It is often very challenging for clinicians to distinguish between accidental, intentional, and other causes of bruising such as underlying bleeding disorder in a child with extensive bruising. We present a case of a 17-month-old healthy male who presented to our emergency department with multiple unexplained bruises after an unwitnessed fall and was subsequently diagnosed with congenital vitamin K-dependent clotting factor deficiency. This case illustrates the importance of thorough assessment in evaluating a child with multiple bruises to differentiate accidental from intentional injuries as well as to recognize bleeding disorders, which warrant specific diagnostic workup.