Emergency medicine clinics of North America
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Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. ⋯ Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.
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Emerg. Med. Clin. North Am. · Feb 2002
ReviewHematologic emergencies in the pediatric emergency room.
The complete blood count (CBC) describes the three hematopoietic lineages (i.e., the erythrocytes, leukocytes, and platelets), and it is an essential diagnostic component in numerous clinical situations. The pediatric CBC and hematologic problems in children may significantly differ from that of adults. In this article, special features of pediatric hematologic emergencies are highlighted.
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Emerg. Med. Clin. North Am. · Feb 2002
ReviewContemporary trends in pediatric sedation and analgesia.
The ability to provide safe, effective procedural sedation and analgesia is a necessary skill for physicians caring for the acutely ill or injured pediatric patient. They physician should be familiar with the agent(s) chosen, including dosage, duration, adverse effects, and contraindications. The choice of agent and regimen should be individualized for the patient and situation. Successful outcomes depend on performing careful pre- and post-sedation evaluations, following appropriate monitoring and equipment guidelines, and having the knowledge and skills to manage any adverse cardiorespiratory event.
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Emerg. Med. Clin. North Am. · Feb 2002
ReviewNew approaches to respiratory infections in children. Bronchiolitis and croup.
Croup is a disease that is commonly seen in children younger than the age of 6 years. The cause is viral, with parainfluenza viruses and RSV being the two most common pathogens. Treatment consists primarily of supportive care, and parents usually have tried humidification and cool air exposure before the child presents to the ED. ⋯ Racemic or L-epinephrine, both of which are equally effective, can be used for symptomatic treatment in severe croup. After administration of racemic or L-epinephrine, hospitalization is not automatic and patients can be discharged safely from the ED after a 3-hour of observation period. There should be no respiratory distress, and the patient should have access to follow-up and emergency care if needed.
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This article updates research concerning the resuscitation of a pediatric patient. The topics discussed include the state of pediatric life support, the current guidelines, the management of those guidelines, and coping with death.