Pediatric emergency care
-
Pediatric emergency care · Dec 2012
Case ReportsNeuroborreliosis presenting as acute disseminated encephalomyelitis.
We report a case of a 5-year-old boy with acute disseminated encephalomyelitis as the initial presentation of neuroborreliosis. Parents report an upper-airway infection a few days before the development of acute encephalopathy, mild facial palsy, and seizures. The patient needed mechanical ventilation for 10 days, and after extubation, he presented hypotonia, ataxia, dysarthria, as well as weak gag and cough reflexes. ⋯ Borrelia burgdorferi was identified in the plasma and cerebrospinal fluid by polymerase chain reaction and in the plasma by Western blotting. He was treated with ceftriaxone, methylprednisolone, and human immunoglobulin. Recovery was partial.
-
Pediatric emergency care · Dec 2012
Comparative StudyEmergency department poisoning visits in children younger than 6 years: comparing referrals by a regional poison control center to referrals by other sources.
The study purpose was to compare medical appropriateness and costs of regional poison control center (RPCC) versus non-RPCC referrals to children's hospital emergency department (ED) for acute poison exposure. ⋯ When compared with other referral sources, RPCC triage results in fewer unnecessary ED visits in this age group. Increasing prehospital use of poison centers would likely decrease unnecessary ED referrals and related costs.
-
Pediatric emergency care · Dec 2012
Comparative StudyCurrent variability of clinical practice management of pediatric diabetic ketoacidosis in Illinois pediatric emergency departments.
This study aimed to investigate the management of pediatric patients with diabetic ketoacidosis (DKA) presenting to emergency departments (EDs) participating in the Illinois Emergency Medical Services for Children (EMSC) Facility Recognition program. ⋯ Best ED practice management of pediatric DKA includes establishing a specific guideline/protocol and ensuring access to a pediatric endocrinologist. Both were identified as improvement areas in this project. Illinois EMSC has developed an educational module and provided direct feedback to all participating EDs, to improve their management of pediatric patients with DKA.
-
Information technology (IT) has profoundly changed the delivery of health care during the past decade. The pediatric emergency department (ED) represents a specific challenge for applying IT systems to the patient bedside. The rapid pace and unscheduled nature of the ED, the breadth of care delivered, and the range of medical, ethical, cultural, and process issues presented by pediatric patients make this a setting in particular need of thoughtfully designed and usable IT systems. ⋯ The authors propose a new section of this journal focused on the application of IT systems to Pediatric Emergency Care. The section will include original research articles and reviews focusing on the application of IT to improve care of acutely ill and injured children. Innovative approaches and articles by physicians in training are particularly encouraged to develop new expertise in informatics within this and related specialties.
-
Pediatric emergency care · Dec 2012
Sexually transmitted infection prevalence in symptomatic adolescent emergency department patients.
This study aimed to determine the prevalence of sexually transmitted infections (STIs) in symptomatic adolescent female patients presenting to a pediatric emergency department (ED). Secondary objectives included determining correlates of infection. ⋯ A large percentage of our study population had an STI, and therefore, STI testing should be considered in all symptomatic adolescent ED female patients. Future studies should focus on understanding barriers to STI testing and designing interventions to increase testing within an adolescent ED population.