Pediatric emergency care
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Pediatric emergency care · Oct 2014
Randomized Controlled TrialEfficacy of vibration on venipuncture pain scores in a pediatric emergency department.
Venipuncture is a frequent source of painful procedures for infants. It has been well documented that infants react to pain with a combination of physiologic and behavioral responses. Infants are unable to describe pain and at particularly high risk for inadequate pain management. The Vibration Anesthesia Device is a specifically designed device for management of pain from minor procedures. It has been shown to reduce venipuncture pain in older children but has not been studied in infants. The mechanism of its effects has been described by a gate control theory, which states that vibration stimulates the dorsal horn neurons where the pain signal is being modulated. The objective of this study was to investigate the efficacy of this device on pain during and after venipuncture procedures in infants. ⋯ We assessed the efficacy of a vibration anesthesia device, and our results suggested that this device did not reduce pain scores in infants during and after venipuncture procedure.
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Pediatric emergency care · Oct 2014
Comparative StudyInfant head injury in falls and nonaccidental trauma: does injury pattern correlate with mechanism?
Nonaccidental trauma (NAT) is most common and most lethal in infants. Falls are the most frequently given explanation for NAT, and head injuries can result from both mechanisms. We hypothesized that infant head injuries from NAT have a distinct injury profile compared to falls. ⋯ We recommend that all children younger than 1 year, with an isolated intracranial hemorrhage, have a full NAT work-up. Injury severity score greater than 20, Glasgow Coma Scale less than 13, and extracranial injuries should also increase suspicion of NAT.
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Pediatric emergency care · Oct 2014
Case ReportsEpiglottitis as a presentation of leukemia in an adolescent.
Epiglottitis is a life-threatening entity that can present in children or adults. Although the incidence has declined since the introduction of the Haemophilus influenzae type B vaccine in 1985, cases continue to be identified in high-risk populations. In pediatric oncology patients specifically, epiglottitis has been reported after initiation of chemotherapy. We report the first case of epiglottits as the initial presentation of leukemia in a pediatric patient.
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Pediatric emergency care · Oct 2014
Case ReportsSplenic injury after blunt abdominal trauma during a soccer (football) game.
The spleen is the most commonly injured abdominal organ in children who sustain blunt abdominal trauma, and pediatric splenic injury may result from minor mechanisms of injury, including sports participation. We present 2 cases of splenic injury in soccer goalies because of blunt abdominal trauma sustained during game play. Although abdominal organ injuries are uncommon in soccer, emergency medicine and primary care physicians must be aware of the possibility. A high index of suspicion and careful physical examination are key in making the diagnosis.
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Pediatric emergency care · Oct 2014
Case ReportsVentricular tachycardia after ketamine sedation for fracture reduction.
This case report describes a 10-year-old female patient who underwent ketamine sedation for fracture reduction and experienced asymptomatic ventricular tachycardia after the sedation. She had no history of syncope, chest pain, palpations, or light-headedness and had a normal physical examination. This is the first reported case of a patient experiencing ventricular tachycardia after ketamine use for sedation. This case demonstrates a serious and potentially harmful possible adverse effect of ketamine administration.