Pediatric emergency care
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Pediatric emergency care · Nov 2016
An Anaphylactoid Reaction to Rattlesnake Envenomation in a Pediatric Patient.
Rattlesnake envenomation causes a spectrum of symptoms and signs, many of which closely resemble an anaphylactic reaction. Development of airway compromise after a snake bite to an extremity is unusual, but has been previously reported. ⋯ Few reports exist without such previous contact; no reports are of pediatric cases. Here we present a 14-year-old boy with no history of prior snake exposure who presents with an anaphylactoid reaction after a rattlesnake bite.
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Pediatric emergency care · Nov 2016
Case ReportsStatus Epilepticus Due to Cat Scratch Disease: Recognition, Diagnosis, and Thoughts on Pathogenesis.
Despite the publication of a number of case reports since the 1950s, physician awareness of the unique relationship between cat scratch disease (CSD) and acute encephalopathy remains limited. This report alerts emergency medicine physicians to include CSD encephalopathy (CSDE) in the differential diagnosis when a previously healthy child presents with status epilepticus. Prompt recognition of this relationship impacts the selection of initial diagnostic studies and antibiotic choices and permits reliable insight into prognosis. ⋯ Both children were treated with antibiotics, and both had resolution of all neurological symptoms. However, the role of antibiotics in the treatment and outcome of CSDE remains speculative. Lastly, the report suggests potential areas of investigation to address immune-mediated mechanisms in the pathogenesis of CSDE.
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Pediatric emergency care · Nov 2016
Outcome of Pediatric Gastroenterology Outpatients With Fever and Central Line.
Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols. The aim of the study was to assess outcomes for pediatric outpatients with gastrointestinal disorders presenting with fever and CVC. ⋯ Pediatric gastroenterology outpatients with fever and a CVC have a high prevalence of bloodstream infection. Algorithms for management need to be subspecialty specific. Pediatric gastroenterology patients presenting to emergency departments or clinics with fever and CVC require admission for monitoring and management.
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Pediatric emergency care · Nov 2016
Review Meta Analysis Comparative StudyManagement of Pediatric Forearm Torus Fractures: A Systematic Review and Meta-Analysis.
Pediatric forearm torus fracture, a frequent reason for emergency department visits, can be immobilized by both rigid cast and nonrigid methods. However, controversy still exists regarding the optimal treatment of the disease. The aim of this study was to compare, in a systematic review, clinical efficacy of rigid cast with nonrigid methods for immobilization of the pediatric forearm torus fractures. ⋯ The current study suggests that the nonrigid immobilization methods have more advantages than rigid cast for immobilization of pediatric forearm torus fracture. The former strategies are also safe enough for clinical therapy.
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Pediatric emergency care · Nov 2016
ReviewCimex lectularius ("Bed Bugs"): Recognition, Management, and Eradication.
Reports of bed bug infestations in major cities in the United States and abroad have been in the public press. Physicians and other clinicians who care for children need to be able to recognize bed bug bites and understand the social, psychological, and medical implications that this diagnosis will have on patients and their families. In this article, a case presentation serves to guide discussion regarding establishing the diagnosis, differential diagnosis, and the management of bed bug bites and their complications. Integrated pest management programs involving housing managers, residents, and professional pest exterminators provide both chemical and nonchemical solutions for eradication of bed bug infestations.