Pediatric emergency care
-
Pediatric emergency care · Feb 2012
Comparative StudyChanges in community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections presenting to the pediatric emergency department: comparing 2003 to 2008.
This study aimed to compare the differences in the type and location of skin infections, organisms cultured, and antibiotic resistance patterns presenting to the same pediatric emergency department from 2003 to 2008 with specific focus on community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections. ⋯ The prevalence of CA-MRSA skin infections, specifically abscesses, has significantly increased at our institution from 2003 to 2008. The antibiotic resistance patterns have not significantly changed. The most common anatomic location for CA-MRSA abscesses continues to be the buttocks, but more children are presenting with multiple abscesses in a wider variety of anatomic locations.
-
Pediatric emergency care · Feb 2012
Review Meta AnalysisIntraosseous vascular access for in-hospital emergency use: a systematic clinical review of the literature and analysis.
Intraosseous (IO) vascular access is a viable primary alternative in patients requiring emergent vascular access in the hospital emergency department (ED) (eg, resuscitation, shock/septic shock) but is underutilized. ⋯ Recommendations/guidelines from physician specialty societies involved in the ED setting are also lacking. Underutilization exists despite recommendations for IO access use from a number of important medical associations peripherally involved in the ED such as the American Academy of Pediatrics. To encourage the IO approach, IO product champions (as both supporter and user) in the ED are needed for prioritizing and assigning IO access use when warranted. In addition, specialty societies directly involved in emergent hospital care should develop clinical guidelines for IO use.
-
Pediatric emergency care · Feb 2012
Case ReportsUltrasound-guided femoral nerve block for pain control in an infant with a femur fracture due to nonaccidental trauma.
A 3-month-old infant girl was transferred to our emergency department (ED) with a subtrochanteric femoral neck fracture due to nonaccidental trauma. She received multiple doses of parenteral analgesics both before arrival and in our ED. ⋯ The patient required only a single dose of parenteral narcotics during the ensuing 18 hours. To our knowledge, this is the first report of an ultrasound-guided femoral nerve block used in the ED for pain control in a pediatric patient.
-
Pediatric emergency care · Feb 2012
Case ReportsAnorexia nervosa: a case report of a teenager presenting with bradycardia, general fatigue, and weakness.
Anorexia nervosa is a disease with high prevalence in adolescents and carries the highest mortality of any psychiatric disorder. ⋯ Patients with anorexia may present with multiple medical complaints, and it is imperative that the emergency physician be familiar with the syndrome so as to correctly identify and treat patients with this disease.
-
Pediatric emergency care · Feb 2012
Ability of pediatric physicians to judge the likelihood of intussusception.
Intussusception is the most common cause of intestinal obstruction in infants and children. To date, no study has evaluated the ability of physicians to predict the likelihood of intussusception. ⋯ Pediatric physicians can accurately predict the likelihood of intussusception. This ability to properly judge the risk of intussusception can be incorporated into management strategies.