Pediatric emergency care
-
Pediatric emergency care · Dec 2017
Case ReportsThe Pseudosubarachnoid Sign: Clinical Implications of Subarachnoid Hemorrhage Misdiagnosis.
Several radiographic mimics of subarachnoid hemorrhage (SAH) have been reported. The pseudosubarachnoid sign may be seen in patients with marked hypoxic-ischemic injury. Our case was a 12-year-old boy with a known history of autism spectrum disorder. ⋯ In this case, the misdiagnosis of SAH had several clinical implications for the management of the patient. This could have clinical implications if a patient with the Glasgow Coma Score greater than 3 were inappropriately treated for SAH. Furthermore, there are possible medical-legal implications regarding child abuse with SAH misdiagnosis.
-
Pediatric emergency care · Dec 2017
Bloodstream Infections in Patients With Intestinal Failure Presenting to a Pediatric Emergency Department With Fever and a Central Line.
Previous small studies have found a high occurrence of bloodstream infections (BSIs) in patients with intestinal failure, and these rates are higher than reported rates in other pediatric populations with central lines. The primary study objective was to describe the occurrence of BSIs in patients with intestinal failure who present to the pediatric emergency department (ED) with fever. ⋯ Pediatric patients with intestinal failure and central lines have a high occurrence of BSIs with 69% of cultures positive in this study of ED febrile episodes. In contrast to reports in other populations with central lines, BSI occurrence in patients with intestinal failure and fever is higher and larger proportions are gram-negative and enteric organisms. For these patients, we recommend central and peripheral blood cultures, empiric broad spectrum antibiotics targeting gram-negative and enteric organisms, and hospital admission.
-
Pediatric emergency care · Dec 2017
Case ReportsAn Unanticipated Complication of Atopic Dermatitis.
An infant with a history of atopic dermatitis presented to the emergency department on 5 occasions with flulike symptoms. Eventually, this child presented with signs of infection and increased intracranial pressure: fever, bulging anterior fontanel, and leukocytosis. ⋯ The initial source of the infected brain abscess was explored. Ultimately, it was thought to be secondary to impetiginized atopic dermatitis, an unusual but serious consequence of a common skin condition.
-
Pediatric emergency care · Dec 2017
Barriers and Facilitators to Implementing the HEADS-ED: A Rapid Screening Tool for Pediatric Patients in Emergency Departments.
This study sought to identify barriers and facilitators to the implementation of the HEADS-ED, a screening tool appropriate for use in the emergency department (ED) that facilitates standardized assessments, discharge planning, charting, and linking pediatric mental health patients to appropriate community resources. ⋯ The HEADS-ED has the potential to address the need for better discharge planning, complete charting, and standardized assessments for the increasing population of pediatric mental health patients who present to EDs. This study has identified potential barriers and facilitators, which should be considered when developing an implementation plan for adopting the HEADS-ED tool into practice within EDs.