Pediatric emergency care
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Pediatric emergency care · Oct 1999
Case ReportsBilateral localized tension pneumothoraces refractory to needle decompression.
We present the unusual case of a 12-year-old child with bilateral localized tension pneumothoraces that were initially both difficult to diagnose and refractory to needle decompression. This case illustrates several important variations in the diagnosis and treatment of tension pneumothorax. To the best of our knowledge, it also represents the only reported case of bilateral localized tension pneumothoraces presenting in the pediatric age group.
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Pediatric emergency care · Oct 1999
Comparative StudyCurrent income profile for academic pediatric emergency medicine faculty.
To survey academic pediatric emergency medicine (PEM) programs for information on financial compensation and patient care activities of PEM faculty and compare the results to the financial data published by the AAEM, AAAP, and MGMA. ⋯ Direct patient care responsibility of PEM academic faculty has not changed significantly in the past 13 years, despite the availability of clinical appointments within most of the surveyed programs. Our data indicate that the annual income for PEM faculty in academic institutions is significantly less than AEM faculty. No significant difference was observed between programs at the assistant, associate, or full professor level when stratified by size or geographic region. Bonus/incentive plans for exceptional patient care or scholarly activity were available in less than half of the surveyed programs.
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Pediatric emergency care · Oct 1999
Comparative StudyManagement of children with aseptic meningitis in the emergency department.
To review the emergency department management of children with aseptic meningitis and compare the clinical features, laboratory findings, and short-term follow-up of those who were hospitalized or discharged to determine guidelines for discharge. ⋯ It is feasible, clinically safe and less costly to treat a subgroup of children with aseptic meningitis in an ambulatory setting. Although absolute criteria for ambulatory follow-up could not be defined, age >1 year, a nontoxic clinical appearance, normal white blood cell count, mild cerebrospinal fluid pleocytosis (even with a high percentage of polymorphonuclear cells), negative CSF Gram stain, and a reliable family setting could serve as guidelines for decision-making regarding emergency department discharge. Further prospective research is needed to better specify these criteria.
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Pediatric emergency care · Oct 1999
Case ReportsSerous fluid leakage after a modified Blalock-Taussig shunt: a cause of hypercyanotic episodes.
We report a case of a 10-week-old girl, with tetralogy of Fallot and a Blalock-Taussig shunt, who presented with hypercyanotic episodes. She was found to have serous fluid leakage around her shunt, causing compression of her trachea. Hypercyanotic episodes resulting from shunt leakage have not previously been reported. An awareness of this possible complication of a Blalock-Taussig shunt will allow the emergency physician to consider it in the differential diagnosis of hypercyanotic episodes.