Pediatric emergency care
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Pediatric emergency care · Jan 2013
Review Case ReportsLong-term outcome after suicidal colchicine intoxication in a 14-year-old girl: case report and review of literature.
Colchicine is used as an anti-inflammatory drug in the treatment of gout, familial Mediterranean fever, and Behçet disease. However, because of its potent inhibition of mitosis, adverse effects and symptoms of intoxication are frequent. Clinical manifestations of colchicine intoxication include abdominal cramps, diarrhea, and multiorgan failure including cardiovascular collapse with fatal outcome. ⋯ Major complaints of this fully conscious patient at the time of presentation ∼2 hours after ingestion of colchicine were nausea and impaired vision. Apart from a colchicine serum concentration of 16.2 ng/mL, no abnormalities were seen in the physical examination and blood tests. Gastrointestinal decontamination by activated charcoal, repeated administrations of sodium sulfate (Glauber salt) and substitution of volume and electrolytes led to complete recovery.
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Pediatric emergency care · Jan 2013
Multicenter StudyHospitalized children with influenza A H1N1 (2009) infection: a Spanish multicenter study.
Even though the majority of cases of influenza A H1N1 (2009) in children are mild, severe complications have been reported. Our objective was to describe the Influenza A H1N1 (2009) complications in pediatric population in Spain. ⋯ Respiratory manifestations were the main complication described. Although the majority of patients had a favorable evolution, a remarkable morbidity and mortality were observed. Patients with confirmed bacterial coinfection were at high risk of severe illness.
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Pediatric emergency care · Jan 2013
ReviewPediatric scorpion envenomation in the United States: morbidity, mortality, and therapeutic innovations.
In the Southwestern United States, the venom of the scorpion Centruroides sculpturatus (common name bark scorpion) can cause serious and potentially fatal neurotoxicity, with young children most vulnerable to its effects. Historically, advances in the quality of supportive care have made significant improvements in morbidity and mortality. ⋯ This article reviews the background, pathophysiology, diagnosis, and treatment options for C. sculpturatus envenomation. Recent advances in immunotherapy and subsequent implications for pediatric emergency care providers are discussed.
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The Wong-Baker FACES pain rating scale (WBS) is preferred by parents and patients for reporting pain severity. However, it is speculated that the "no hurt" and "hurts worst" anchors confound pain measurement with nonnociceptive states. The objective of our study was to determine if fear confounds reporting of pain severity on the WBS. We hypothesized that the WBS would correlate with a psychometrically different pain severity scale (the visual analog scale [VAS]) and not correlate with a fear measure, the Child Medical Fear Scale (CMFS). ⋯ The WBS demonstrates moderate correlation with another measure of pain (VAS) and is not mistaken for fear among school-aged patients presenting to the ED with pain.
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Pediatric emergency care · Jan 2013
Does the use of bedside pelvic ultrasound decrease length of stay in the emergency department?
Diagnostic ultrasounds by emergency medicine (EM) and pediatric emergency medicine (PEM) physicians have increased because of ultrasonography training during residency and fellowship. The availability of ultrasound in radiology departments is limited or difficult to obtain especially during nighttime hours. Studies have shown that EM physicians can accurately perform goal-directed ultrasound after appropriate training. The goal of this study was to compare the length of stay for patients receiving an ultrasound to confirm intrauterine pregnancies. The hypothesis of this study is that a bedside ultrasound by a trained EM/PEM physician can reduce length of stay in the emergency department (ED) by 1 hour. ⋯ The use of ED bedside ultrasound by trained EM/PEM physicians produced a significant reduction in length of stay in the ED, regardless of radiology ultrasound technologist availability.