Pediatric emergency care
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Pediatric emergency care · Dec 2017
Case ReportsUnder the Sea: Superficial Skin Infection With an Atypical Cause.
Traumatic abrasions on human extremities as a result of direct contact with sea, lake, river, or aquarium animals or from traumatic injuries sustained in seawater may develop into solitary or linear granulomatous lesions. One of the more common microbial etiologies for such infections is Mycobacterium marinum. An astute pediatrician, family physician, or nurse practitioner should have a high index of suspicion and obtain specific cultures to support the growth of Mycobacterium species. ⋯ After several failed antibiotic trials, M. marinum was eventually identified from the depth of her lesions. The patient improved after a 3-month course of clarithromycin. This case report is the first to include pictures demonstrating the clinical progression and resolution of M. marinum infection.
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Pediatric emergency care · Dec 2017
Case ReportsTrauma Arrest and Spinal Injury in a 3-Year-Old Girl.
Management of an acutely injured pediatric patient with multiple traumas is a common challenge facing clinicians in pediatric emergency care. Blunt trauma is more common in the pediatric population with motor vehicle accidents being the most common cause of injury. Spinal injury, especially in young children, is only seen in 1% to 2% of cases and can be lethal. ⋯ This case presents a child in trauma arrest after a motor vehicle crash requiring advanced interventions, diagnostics, and support. Her clinical course is described and reveals a complete distraction of the cervical and thoracic spine. This case illustrates pathology and management along with the importance of proper management and interventions by pediatric emergency clinicians to manage the patient and attempt to maximize the patient's outcome.
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Pediatric emergency care · Dec 2017
Children Covered by Medicaid/State Children's Health Insurance Program More Likely to Use Emergency Departments for Food Allergies.
Food allergies (FAs) occur in 4% to 8% of children in the United States, and emergency department (ED) visits account for up to 20% of their costs. In 2010, the National Institute of Allergy and Infectious Diseases established diagnostic criteria and management practices for FAs, and recognition and treatment of FAs for pediatric ED practitioners has been described. ⋯ Medicaid/State Children's Health Insurance Program-insured pediatric patients had higher odds of visiting ED for recognized FAs and nonspecific allergic reactions and higher odds of receiving epinephrine than privately insured children.
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To determine the proportion of true-positive blood culture results in children presenting to the ED with suspected appendicitis. To describe the current practice of obtaining blood cultures in children with suspected appendicitis. ⋯ True-positive blood cultures are very rare in children presenting to the ED with suspected appendicitis. Given the potential for false-positive cultures and the social/economic implications of initial testing/retesting of false positives, the use of routine blood cultures for children with suspected appendicitis is not supported.
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Pediatric emergency care · Dec 2017
Review Case ReportsUltrasound-Guided Popliteal Sciatic Nerve Block for an Ankle Laceration in a Pediatric Emergency Department.
Although ultrasound-guided peripheral nerve block has recently been introduced into pediatric emergency departments, knowledge of its use is limited. We present here a case demonstrating the safety and effectiveness of ultrasound-guided popliteal sciatic nerve block for a pediatric spoke injury in a pediatric emergency department setting.