Pediatric emergency care
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Pediatric emergency care · Jan 2012
Impact of an emergency department pharmacy on medication omission and delay.
The objective of the study was to evaluate the impact of adding a clinical pharmacist within a pediatric emergency department (ED) on medication omissions and delays, as well as medication errors on patients with prolonged ED stays of 8 hours or greater. ⋯ Medication omissions and delays are common within the ED. Admitted patients boarded within the ED for 8 hours or greater are at an increased risk for medications omissions and delays. The addition of a clinical pharmacist within an ED may reduce the number of medication omissions and delays occurring.
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Pediatric emergency care · Jan 2012
Review Case ReportsCholelithiasis and its complications in children and adolescents: update and case discussion.
In recent years, gallbladder disease, primarily in the form of cholelithiasis, has been on the rise among infants and children. Although pediatric gallbladder disease is still less prevalent than adult gallbladder disease, physicians and other clinicians who care for children need to be aware of this underappreciated problem and understand the manifestations of biliary disease in the pediatric population. In this article, case discussions will serve as a platform for discussing the clinical spectrum of cholelithiasis and its complications in children as well as discussing the latest evidence related to diagnosis and treatment.
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Pediatric emergency care · Jan 2012
Case ReportsEmergency ultrasound diagnosis of deep venous thrombosis in the pediatric emergency department: a case series.
The diagnosis of deep venous thrombosis (DVT) in patients presenting to the emergency department (ED) has traditionally been limited to examinations by radiologists and ultrasound technicians. Although contrast venography is considered the criterion standard for diagnosis of DVT, time, personnel, cost, exposure to radiation, and the invasive nature of the study (need for venous access) potentially limit the ability to perform the study in an emergent setting. Ultrasonography is an alternative method for thrombus detection and is widely preferred. ⋯ Based on recent studies demonstrating accuracy in adult patients, emergency sonographic evaluation of DVT by emergency physicians is considered a core emergency ultrasound application and is recently recommended as standard training to all emergency medicine residents. The diagnosis of DVT in children by emergency ultrasound in the pediatric ED has not been previously described. We present 3 cases of DVT in adolescents identified by emergency ultrasound evaluation in the pediatric ED.
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Pediatric emergency care · Jan 2012
Reasons for nonurgent pediatric emergency department visits: perceptions of health care providers and caregivers.
This study aimed to determine the most important reasons for pediatric nonurgent (NU) emergency department (ED) visits as perceived by caregivers, primary care pediatricians (PCPs), and ED personnel and to assess the differences among these 3 groups in perceived reasons and solutions to NUED visits. ⋯ Misconceptions exist among caregivers, PCPs, and ED personnel on NUED visits. Our findings underscore the need to foster understanding and provide concrete areas for intervention.
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Pediatric emergency care · Jan 2012
Case ReportsIschemic electrocardiographic changes and elevated troponin from severe heatstroke in an adolescent.
Heatstroke can result in significant diffuse tissue derangement, which can result in multiple organ system dysfunction. The heart can equally be affected and ischemia and infarction may occur. ⋯ Heatstroke can lead to morbidity and mortality. Tissue damage during heatstroke is believed to result from uncoupling during oxidative phosphorylation. It is important to realize that heart damage can occur from heatstroke and that appropriate diagnostic and therapeutic measures are required for a good outcome.