Pediatric emergency care
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Pediatric emergency care · May 2013
Case ReportsStatus epilepticus in a child secondary to ingestion of skin-lightening cream.
The popularity of the Internet and online media has led to the increased availability of prescription-strength, skin-lightening products contributing to a rise in their use among people with various skin pigment disorders. These products may contain a wide variety of active ingredients such as heavy metals, hydroquinone, and corticosteroids that can be highly toxic, especially after prolonged application. ⋯ We report a case of a child who developed status epilepticus after ingesting a skin-lightening solution containing 2% hydroquinone. The toxicodynamics of hydroquinone and its effects on the central nervous system are discussed.
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Pediatric emergency care · May 2013
Clinical TrialValue of rapid antigen test for pandemic influenza A (H1N1) 2009 in the pediatric emergency department.
Pandemic H1N1 influenza is the predominant influenza virus circulating in Turkey in 2009. Because of the clinical manifestations of influenza overlap with those attributable to other common respiratory illnesses of childhood, establishing a diagnosis of influenza requires confirmatory testing. The aim of our study was to define the predictive value of rapid influenza antigen detection test in children presenting to a pediatric emergency care department with influenza-like illness and to compare with clinical signs and symptoms. ⋯ We found that if the patients have high fever (≥39 °C), myalgia, and vomiting-diarrhea together, the likelihood of rapid antigen test positivity rate increases in patients, who presented with influenza-like illness.
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Pediatric emergency care · May 2013
Clinical practice guidelines for pediatric appendicitis evaluation can decrease computed tomography utilization while maintaining diagnostic accuracy.
The objective of this study was to compare usage of computed tomography (CT) scan for evaluation of appendicitis in a children's hospital emergency department before and after implementation of a clinical practice guideline focused on early surgical consultation before obtaining advanced imaging. ⋯ Implementation of a clinical evaluation pathway emphasizing examination, early surgeon involvement, and utilization of ultrasound as the initial imaging modality for evaluation of abdominal pain concerning for appendicitis resulted in a marked decrease in the reliance on CT scanning without loss of diagnostic accuracy.
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Pediatric emergency care · May 2013
Case ReportsAn interesting case of a unilaterally dilated pupil.
Facial lacerations from minor trauma are a common presenting complaint to the emergency department. With the increasing availability of topical anesthetics, there is a decrease in the need for injectable local anesthetic and sedation services, facilitating the ease of facial laceration repairs for young children. ⋯ Although the use of LET has decreased the need for injectable lidocaine and sedation for facial lacerations, both of which can be unpleasant for children with potentially life-threatening adverse events, it may still lead to unexpected and untoward adverse events. We explore here a little-known adverse effect of LET in a child who presented to a pediatric emergency department with an eyelid laceration after minor head trauma.
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Pediatric emergency care · May 2013
Case ReportsOrganophosphate poisoning-induced acute renal failure.
Acute kidney injury as a direct complication of organophosphate poisoning has rarely been described and its etiology is unclear. ⋯ Organophosphate poisoning can lead to renal failure, which, with proper treatment, may be reversible but, if left unattended, might aggravate the clinical course of the disease. Physicians should be aware of this rare complication.