Pediatric emergency care
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Pediatric emergency care · Sep 2012
Survey in the emergency department of parents' understanding of cough and cold medication use in children younger than 2 years.
In August 2007, the Food and Drug Administration (FDA) released a public health advisory recommending that over-the-counter cough and cold medications (CCMs) not be used in children younger than 2 years. Our objective was to assess parents' awareness and understanding of the guidelines. ⋯ The majority of caregivers were not aware of the FDA guidelines on CCM use in children younger than 2 years. Most thought CCMs were safe and effective.
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Pediatric emergency care · Sep 2012
Factors associated with the interfacility transfer of the pediatric trauma patient: implications for prehospital triage.
The goal of this study was to identify prehospital factors associated with increased likelihood of interfacility transfer of pediatric trauma patients. Such factors might serve as a basis for improvements in future field pediatric trauma triage guidelines. ⋯ Factors highly associated with transfer of an injured child from a non-PTC to a PTC included younger age, burns, non-accidental trauma, head/neck injury, and multiple injuries in younger children. Further investigation is warranted to determine whether these factors may have applicability in future improvements in field pediatric trauma patient triage guidelines.
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Pediatric emergency care · Sep 2012
Case ReportsComplicated and dislodged airway foreign body in an intubated child: case report.
We report a case of missed foreign body aspiration in a child presenting with status epilepticus. On admission, the patient was found to have pneumonia, which progressed to respiratory failure and acute respiratory distress syndrome. While the patient was intubated and mechanically ventilated, the patient experienced acute respiratory deterioration. Subsequently, it was determined that a previously undetected foreign body had dislodged from the right main to the left main bronchus and was the underlying cause for the child's illness. ⋯ A combination of sudden change of physical and radiographic findings with unilateral lung hyperinflation is highly suspicious for an obstructing airway foreign body. This case demonstrates that foreign body aspiration can lead to significant morbidity. It should be in the differential diagnosis for any acute pulmonary process in an otherwise well child because there is no specific clinical or radiographic finding to rule it out.
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Pediatric emergency care · Sep 2012
The use of a modified pediatric early warning score to assess stability of pediatric patients during transport.
Pediatric early warning scores (PEWSs) have been used effectively in limited patient care areas. Children's Transport, at Children's Healthcare of Atlanta, transports approximately 5000 children annually. In an effort to consistently assess patient acuity and the impact of our team's interventions, we instituted a modified "transport PEWS" (TPEWS). ⋯ In this cohort of pediatric transport patients, TPEWS appears to be a helpful additional assessment tool. Transport PEWS may function as a tool for assessing severity of illness, hence optimizing transport dispatch and patient disposition.
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Pediatric emergency care · Sep 2012
Case ReportsSurfactant replacement therapy in a pediatric near-drowning case in manure.
Drowning is defined as suffocation by submersion especially in water and is a leading cause of injury-related death in children. Age groups at greatest risk are toddlers and male adolescents. ⋯ The use of surfactant after near-drowning in water is reported in the literature in few case reports. We report here a boy whose condition did not get better with conventional treatment, but dramatically improved after surfactant treatment after near-drowning in a fluid with manure.