Pediatric emergency care
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Pediatric emergency care · Sep 2013
Case ReportsCocaine-induced dystonic reaction: an unlikely presentation of child neglect.
Child neglect can be difficult to recognize. Parental substance abuse may place a child at increased risk of neglect. ⋯ Pediatric emergency physicians should consider cocaine exposure when a child of any age presents with abnormal movements. Dystonic reaction is an uncommon, but reported, complication of cocaine exposure in the absence of other risk factors and may be the first presentation of child neglect.
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Pediatric emergency care · Sep 2013
Observational StudyParental Language and Dosing Errors After Discharge From the Pediatric Emergency Department.
Safe and effective care after discharge requires parental education in the pediatric emergency department (ED). Parent-provider communication may be more difficult with parents who have limited health literacy or English-language fluency. This study examined the relationship between language and discharge comprehension regarding medication dosing. ⋯ Current ED discharge communication results in a significant disparity between English- and Spanish-speaking parents' comprehension of a crucial aspect of medication safety. These differences were not explained purely by interpretation, suggesting that interventions to improve comprehension must address factors beyond language alone.
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Pediatric emergency care · Sep 2013
Initiating Inhaled Steroid Treatment for Children With Asthma in the Emergency Room: Current Reported Prescribing Rates and Frequently Cited Barriers.
The objective of this study was to determine how frequently emergency department (ED) physicians prescribe inhaled corticosteroids (ICSs) and describe commonly cited barriers. ⋯ Emergency department physicians report low rates of ICS prescribing. Commonly cited barriers include unclear guidelines, believing that long-term medication prescribing is not within their role, and inability to see patients in follow-up. Addressing guideline discrepancies may improve preventive care delivery in the ED.
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Pediatric emergency care · Sep 2013
Violating Traditional NPO Guidelines With PO Contrast Before Sedation for Computed Tomography.
Administration of PO contrast within 2 hours before sedation for abdominal computed tomography (CT) is controversial because it violates American Society of Anesthesiologists guidelines that recommend 2 hours of fasting for clear fluids before sedation. ⋯ Administering oral contrast material within 2 hours of propofol sedation for abdominal CT in children seems to be relatively safe compared with those sedated after traditional NPO time frames.
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Pediatric emergency care · Sep 2013
Case ReportsSodium Channel Blockade With QRS Widening After an Escitalopram Overdose.
Escitalopram is rarely associated with prolongation of the QTc interval; however, there are no reported cases of QRS complex widening associated with escitalopram overdose. We report a case of a patient who presented with both QRS complex widening and QTc interval prolongation after an escitalopram overdose. ⋯ Both QRS complex widening and QTc interval prolongation should be monitored in cases of escitalopram and citalopram overdoses.