Pediatric emergency care
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Pediatric emergency care · Aug 2012
Comparative StudyAccuracy of ultrasonography versus computed tomography scan in detecting parapharyngeal abscess in children.
Significant morbidity and rarely mortality have been described in parapharyngeal space infections in children; hence, the decision on the timing of surgical intervention might be crucial. The aim of this study was to compare the accuracy of plain x-rays, ultrasonography (US), and contrast-enhanced computed tomography (CT) in demonstrating a parapharyngeal abscess. ⋯ Our study demonstrates good rates of accuracy of CT scan for diagnosing a parapharyngeal abscess. Our study suggest that it is appropriate to obtain a CT scan upon presentation in all children with suspected parapharyngeal abscess and that a CT scan is proven to be a useful diagnostic tool in establishing a treatment plan.
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Pediatric emergency care · Aug 2012
Postdischarge adverse events related to sedation for diagnostic imaging in children.
The objectives of this study were to describe the type and frequency of postdischarge adverse events related to sedation for elective diagnostic imaging in children and to determine if any patient or drug characteristics were associated with such adverse events. ⋯ Postdischarge adverse events related to sedation for diagnostic imaging are minor, mostly behavioral, but occur in a significant number of patients. Parents should be provided with detailed discharge instructions to anticipate such adverse events at home.
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Pediatric emergency care · Aug 2012
No longer a "nursemaid's" elbow: mechanisms, caregivers, and prevention.
We sought to identify specific mechanisms leading to radial head subluxation, as well as correlation with different caregivers, as a potential platform for education and injury prevention. ⋯ Radial head subluxation mechanisms can be classified into subcategories, which may be caregiver and even patient gender specific. Provider awareness regarding these mechanisms may help target education and prevention.
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Near drowning in the Dead Sea is associated with both respiratory manifestations and severe electrolyte abnormalities. It is often difficult to distinguish between the contributions of sea water aspiration or ingestion to clinical manifestations. ⋯ Forced diuresis with large amounts of intravenous fluids resulted in clinical and biochemical improvement. Full recovery was achieved after 2 days of treatment.
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Pediatric emergency care · Aug 2012
Case ReportsElemental mercury poisoning presenting as hypertension in a young child.
Mercury intoxication is an uncommon cause of hypertension in children and can mimic several other diseases, such as pheochromocytoma and vasculitis. Mercury intoxication can present as a diagnostic challenge because levels of catecholamines may be elevated, suggesting that the etiology is a catecholamine-secreting tumor. Once acrodynia is identified as a primary symptom, a 24-hour urine mercury level can confirm the diagnosis. ⋯ Chelation therapy successfully treated our patient's mercury intoxication. However, it was also necessary to concurrently treat her hypertension and the pain associated with her acrodynia. Because there were no known risk factors for mercury poisoning in this case, and because ritual use of mercury is common in much of the United States, we recommend high clinical suspicion and subsequent testing in all cases of acrodynia.