Pediatric emergency care
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Pediatric emergency care · Aug 2015
Case ReportsA Perplexing Case of Child Abuse: Oral Injuries in Abuse and Physician Reporting Responsibilities.
The following case presents a pediatric patient with an oral foreign body secondary to intentional injury. This patient had presented several previous times for medical care, first with thigh bruises, then mouth bleeding, and finally with the unusual finding of a sharp foreign body embedded in the tongue. This case illustrates the importance of considering physical abuse in the differential of orofacial injuries. ⋯ Bruising, as seen in this patient, is common in children, and the clinical team must determine if the pattern, location, and history are concerning for a nonaccidental injury. Physicians should strongly consider child abuse in the emergency department when patients present with concerning physical examination findings such as bruises or orofacial injures without corroborating history. Finally, this case reviews mandatory reporting requirements for physicians and other medical professionals and highlights the obligation to report suspected child abuse even when not working in the professional capacity at the time of recognition.
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Pediatric emergency care · Aug 2015
Empiric Antibiotics for Serious Bacterial Infection in Young Infants: Opportunities for Stewardship.
To evaluate the causative agents of serious bacterial infection (SBI) in young infants and the optimal approach to empiric antibiotic therapy for infants with SBI. ⋯ Ampicillin/gentamicin remains an effective empiric regimen for infants 60 days or younger with suspected SBI. Use of a third-generation cephalosporin for suspected meningitis is appropriate, but cerebrospinal fluid must be obtained promptly to guide appropriate therapy.
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Pediatric emergency care · Aug 2015
Observational StudyMental Health Utilization in a Pediatric Emergency Department.
Mental health complaints are frequent in the pediatric emergency department (PED). The objective of this study was to describe trends over time in PED utilization for mental health care at in a single pediatric tertiary care hospital. It is our hypothesis that the resources used by this patient population are high and that mental health-related visits have increased over the most recent decade. ⋯ In this single-center study, we found evidence that the resources required to care for pediatric patients with mental health complaints have increased significantly over time both by increased number of annual visits and an increasing LOS. Further research is necessary to determine if our data are consistent with national trends to further our understanding of the problem and improve resource allocation.
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Pediatric emergency care · Aug 2015
Case ReportsEczema Herpeticum: Would You Know It If You Saw It?
Eczema herpeticum is an easily missed entity most commonly seen in the pediatric population and carries the risk of systemic compromise and a 10% mortality rate. Clinicians should maintain high clinical suspicion when encountering children or young adults with a history of atopic dermatitis or other erosive dermatoses and who present with vesicular lesions, punched-out erosions, and systemic symptoms. We present 3 severe cases of eczema herpeticum that were potentially overlooked and demonstrate the need for elevated awareness to avoid potential pitfalls.