Articles: emergency-department.
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The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED.
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Most literature regarding fireworks injuries are from outside the United States, whereas US-based reports focus primarily on children and are based on datasets which cannot provide accurate estimates for subgroups of the US population. ⋯ Emergency department visits for fireworks injuries are concentrated around major national holidays and are more prevalent in certain parts of the country and among young males. This suggests that targeted interventions may be effective in combating this public health problem.
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In emergency department patients with symptoms suggestive of acute myocardial infarction, is the absolute or relative change of cardiac troponin assays (either high sensitivity or ultrasenstive) more accurate in diagnosing acute myocardial infarction at 1 to 2 hours postpresentation? ⋯ To evaluate the accuracy of new troponin assays in diagnosing acute myocardial events.
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Pediatric emergency care · Jul 2014
Case ReportsOmental liposarcoma presenting as chronic constipation.
Constipation is a common cause of pediatric abdominal pain seen in pediatric emergency departments (EDs). We present the case of an 11-year-old boy with a 4-month history of chronic constipation and abdominal pain who presented to the children's ED. He was found to have a large abdominal mass that was determined to be a myxoid liposarcoma. An extensive review of the medical literature did not reveal any previous cases of this type of tumor presenting to the ED as chronic constipation.
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Pediatric emergency care · Jul 2014
Case ReportsAn atypical presentation of atypical kawasaki disease.
Kawasaki disease (KD) is a well-known inflammatory disorder that, despite its classic description, can pose a diagnostic challenge. We report a case of a 3-year-old girl who presented to the emergency department with a limp and urinary incontinence who was ultimately diagnosed with KD. She was found to have a large coronary artery aneurysm on echocardiogram. We discuss the challenges in diagnosing incomplete KD.