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
Comparative StudyIs there a role for intravenous acetaminophen in pediatric emergency departments?
As a nonopioid parenteral analgesic intravenous (IV) acetaminophen is potentially attractive for emergency department (ED) use. However, there is little experience with its use in the pediatric ED setting. We introduced the agent into a pediatric ED with a preliminary restrictive prescribing regimen and describe its use. ⋯ In the setting of an initial restrictive prescribing regimen, IV acetaminophen was used in a small number of pediatric ED patients. In addition to use in patients at risk of opioid adverse events, the medication was also used in complex patients who were unable to tolerate an enteral formulation. Emergency department prescribing guidelines have been modified accordingly.
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Pediatric emergency care · Jun 2011
Case ReportsCase records of the Children's Mercy Hospital: A 12-year-old girl with a straddle injury.
Straddle injuries are common in children. At the end of this case presentation, you should be able to describe the approach to the evaluation and treatment of a straddle injury, list indications for gynecologic consultation and/or sedation, plan disposition, and discuss pitfalls to avoid in evaluating patients with straddle injuries.
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Pediatric emergency care · Jun 2011
Case ReportsDiaphragmatic avulsion with chance fracture: a rare association in the seat belt syndrome.
Traumatic diaphragmatic injuries are uncommon in children. Chance fractures are typical in adults who had motor vehicle accidents but infrequent in children. The seat belt syndrome is characterized by a spectrum of injuries caused by the compression of the abdomen by the seat belt. ⋯ We describe the case of a child who was involved in a car accident and who presented with multiple traumas; liver and lung injuries were first detected, and the patient was managed accordingly. During the hospital stay, a right diaphragmatic avulsion and a Chance fracture, which were initially missed, were diagnosed and treated successfully. The relevance of this case lies in the low incidence of the diaphragmatic rupture and the Chance fracture in children along with their exceptional association and in the diagnosis, which might be especially difficult in the acute setting.
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Pediatric emergency care · Jun 2011
Case ReportsGlobe rupture and nonaccidental trauma: two case reports.
The association of globe rupture and nonaccidental trauma is not established in the literature. We present 2 cases involving a 9-month-old infant girl and a 14-month-old girl who experienced inflicted traumatic globe rupture. ⋯ Despite isolated eye findings on physical examination, this toddler also had evidence of additional injury on skeletal survey. These cases illustrate the importance of considering nonaccidental trauma in infants and toddlers who present with globe rupture and performing a complete evaluation for child abuse if no history is given or if the history is inconsistent with the injury.