Pediatric emergency care
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Pediatric emergency care · Dec 2004
Case ReportsUnsuspected acetaminophen toxicity in a 58-day-old infant.
Acetaminophen is frequently used by both physicians and parents for the relief of pain and fever in infants and children of all age groups. It has an excellent safety profile in therapeutic doses, but hepatotoxicity can develop following both intentional or unintentional overdoses. ⋯ In addition, initial signs and symptoms are nonspecific and biochemical evidence of hepatic damage may not become evident for 24 to 36 hours. We report the case of an infant who received multiple doses of acetaminophen during an illness who developed hepatotoxicity.
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Pediatric emergency care · Dec 2004
Multicenter StudyThe effect of fasting practice on sedation with chloral hydrate.
Infants undergo various painless imaging procedures frequently. Mild sedation is required in such cases to reduce anxiety as well as to ensure optimal performance of the procedure. The most frequently used sedative as a single drug is chloral hydrate. The issue of preprocedural fasting is a subject of contention. The purpose of this study was to assess the effect of the American Academy of Pediatrics (AAP)/American Society of Anesthesiology (ASA) fasting practice guidelines on the efficacy and success of the sedation with chloral hydrate. ⋯ Fasting was associated with an increased failure rate of the initial sedation. As a consequence, an increased total dose of chloral hydrate was required inducing a prolonged sedation time. Presumably, this is a result of the fact that a hungry child is irritable and therefore more difficult to sedate.
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Pediatric emergency care · Dec 2004
Case Reports"I can't taste ice cream": an unusual case of tinnitus and dysgeusia.
Auricular foreign bodies are usually presented to the emergency department in an easily recognizable fashion. We report the case of a 16-year-old male who presented to the emergency department with complaints of unilateral tinnitus and dysgeusia. He denied any history of injury except for falling from his bike in the woods earlier that day. ⋯ On evaluation, the chorda tympani nerve was found to be severed along with disruption of the ossicles. This is an unusual presentation for an aural foreign body, and the resulting injury of the chorda tympani is not well published. One should consider the possibility of injury to the middle and inner ear and perform the necessary clinical evaluation before and after removal of aural foreign bodies.
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The American Academy of Pediatrics (AAP) has published simple guidelines for the first aid management of ill or injured children. We determined knowledge of these first aid practices in parents. ⋯ Many adults are unfamiliar with AAP first aid measures according to the AAP guidelines and most believe that wounds should be allowed to dry. Further education is required to improve knowledge of first aid practices.