Pediatric emergency care
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Visual disturbances resulting from acute nerve paralysis of the muscles controlling eye movements can be challenging to evaluate in the pediatric population. Children may not be capable of describing symptoms or providing an adequate history. Therefore, it is important to have an understanding of the anatomical course of the extraocular cranial nerves and clinical manifestations of their dysfunction. We report 2 cases of extraocular cranial nerve palsies and, in addition to an anatomical review, discuss the common etiologies of paralysis and the importance of ophthalmological and neurological follow-up to ensure optimal long-term visual function.
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Pediatric emergency care · May 2015
ReviewManagement of a patient with diabetic ketoacidosis in the emergency department.
Diabetic ketoacidosis is a common problem among known and newly diagnosed diabetic children and adolescents for which they will often seek care in the emergency department (ED). Technological advances are leading to changes in outpatient management of diabetes. The ED physician needs to be aware of the new technologies in the care of diabetic children and comfortable managing patients using continuous subcutaneous insulin infusions. This article reviews the ED management of diabetic ketoacidosis and its associated complications, as well as the specific recommendations in caring for patients using the continuous subcutaneous insulin infusion, serum ketone monitoring, and continuous glucose monitoring.