Pediatric emergency care
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Pediatric emergency care · Sep 2016
Case ReportsNausea, Vomiting, and Weight Loss in a Young Adult Patient With a History of a Gunshot Wound.
Assessing victims of gunshot wounds with retained bullets/bullet fragments for lead toxicity is not always considered until the patient develops signs and symptoms of toxicity. We discuss the case of a 19-year-old young man who received a diagnosis of chronic lead toxicity (serum lead concentration 51 μg/dL) 5 weeks after a hunting accident. Extensive wound debridement occurred following the accident; however, lead toxicity was not diagnosed until after his fourth emergency department visit. Oral chelation therapy was required for the management of his lead toxicity.
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Pediatric emergency care · Sep 2016
Case ReportsPoint-of-Care Ultrasound Diagnosis of Bilateral Retinal Detachment Associated With Vogt-Koyanagi-Harada Disease in the Pediatric Emergency Department.
We report a case of a 16-year-old girl with acute visual complaints who was diagnosed with bilateral retinal detachment using point-of-case ultrasound and ultimately was diagnosed with Vogt-Koyanagi-Harada disease. This case illustrates the use of point-of-care ultrasound by the pediatric emergency physician to recognize the ocular abnormality associated with this rare disease.
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Pediatric emergency care · Sep 2016
Procalcitonin as a Marker of Bacteremia in Patients With Fever and Acute Lymphoblastic Leukemia.
Children undergoing treatment for acute lymphoblastic leukemia (ALL) often present to the emergency department (ED) with a fever. They are at high risk of bacteremia secondary to being immunocompromised. Recent reports indicate that procalcitonin (PCT) is a useful marker of bacteremia in children. ⋯ Procalcitonin value was significantly associated with positive BC (P < 0.0001). The diagnostic performance of PCT was better than the other markers of inflammation. Its use in the ED in a select population of patients may be of significant value in identifying bacteremia. This has the potential to lead to a decrease in unwarranted use of antibiotics, hospital length of stay, and health care expenditures.
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Pediatric emergency care · Sep 2016
Case ReportsPelvic Fracture Urethral Injuries in Children: A Case Report and Appraisal of Their Emergency Management.
Pelvic fracture urethral injuries are uncommon injuries that are frequently overlooked in the emergency department. We present a case of a 2-year-old girl whose urethral trauma was initially missed and potentially worsened by the placement of a urinary catheter. The clinical and diagnostic features of these rare injuries are discussed along with the controversies surrounding urinary catheter placement and retrograde urethrography.
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Pediatric emergency care · Sep 2016
Case ReportsEvaluation and Monitoring of a Child With Hydrocarbon Pneumonitis Using Point-of-Care Lung Ultrasound in the Pediatric Emergency Department.
A well-appearing 3-year-old boy presented to the pediatric emergency department 2 hours after a presumed hydrocarbon ingestion. He was referred to the emergency department by his pediatrician after consultation with the local poison control center after possibly ingesting ylang ylang (Cananga odorata) fragrance oil. ⋯ Point-of-care lung ultrasound identified focal hydrocarbon pneumonitis in the right lung and demonstrated resolution of these findings. Utilization of point-of-care ultrasound resulted in a shorter emergency department length of stay and the avoidance of radiation exposure from serial chest x-rays.