Pediatric emergency care
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Pediatric emergency care · Jun 2011
Case ReportsLate migration of a foreign body in the foot 5 years after initial trauma.
An 11-year-old boy presented to our emergency department because of the extrusion of a small piece of glass through the plantar skin, 5 years after the initial trauma. Another foreign body was identified on ultrasounds and removed surgically. Ultrasound is an accurate test for detection of foreign bodies and to assess potential complications. ⋯ Migrations of foreign bodies are not uncommon. Ultrasounds could help for localization and removal as an intraoperative procedure. In case of suspicion of a foreign body after trauma, complementary examinations are required.
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Pediatric emergency care · Jun 2011
Case ReportsA case of autonomically mediated pain due to spinal epidural abscess in an adolescent female.
Spinal epidural abscess (SEA) is a rare disease in children without predisposing risk factors. Atypical presentations of SEA without the classic triad of fever, back pain, and neurological signs, have previously been described. We report an atypical presentation of an acute SEA in a previously healthy adolescent female. ⋯ Our experience adds to the literature a case that demonstrates the difficulty in diagnosis of atypical presentations of SEA in previously healthy children. In addition, referred or autonomically mediated pain should be considered in unusual pain presentations. Children with significant extremity or abdominal pain should be considered for the possibility of sympathetically mediated pain syndrome due to a thoracic-level spinal cord lesion such as a SEA.
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Pediatric emergency care · Jun 2011
Randomized Controlled Trial Comparative StudyParental health literacy and asthma education delivery during a visit to a community-based pediatric emergency department: a pilot study.
The objective of the study was to compare change in asthma knowledge among parents with low or adequate health literacy after video or written asthma education delivered during their child's asthma-related emergency department (ED) visit. ⋯ Asthma education materials distributed at the time of an ED visit increase parental knowledge about the disease. Video-based asthma education appears promising as a tool for increasing asthma knowledge in both low- and adequate-health-literacy parents.
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Peripherally inserted central catheters are increasingly used in the pediatric and adolescent population for long-term central access. This article reviews the indications, insertion techniques, and complications of peripherally inserted central catheter lines.
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Pediatric emergency care · Jun 2011
Comparative StudyPredictors of psychiatric boarding in the pediatric emergency department: implications for emergency care.
Patients who present to the emergency department (ED) and require psychiatric hospitalization may wait in the ED or be admitted to a medical service because there are no available inpatient psychiatric beds. These patients are psychiatric "boarders." This study describes the extent of the boarder problem in a large, urban pediatric ED, compares characteristics of psychiatrically hospitalized patients with boarders, and compares predictors of boarding in 2 ED patient cohorts. ⋯ Suicidal patients continue to board. Limits within the system, including timing of ED presentation and a dearth of specialized services, still exist, elevating the risk of boarding for some populations. Implications for pediatric ED psychiatric care delivery are discussed.