Pediatric emergency care
-
Pediatric emergency care · Feb 2017
Review Case ReportsPediatric Necrotizing Pneumonia: A Case Report and Review of the Literature.
Necrotizing pneumonias occur infrequently in children but may be associated with significant morbidity. If not adequately treated, necrotizing pneumonia may lead to complications including bronchopleural fistula, empyema, respiratory failure, and septic shock. Staphylococcus aureus is the most commonly implicated agent, followed by Streptococcus pneumoniae. ⋯ An initial plain radiograph of the chest demonstrated lobar pneumonia. Ultimately, computed tomography of the chest revealed a cavitary lesion in the left upper lobe of the lung. We review the literature and describe the clinical presentation, diagnosis, microbiological etiology, and management of necrotizing pneumonia in children.
-
Pediatric emergency care · Feb 2017
Multicenter StudyThe Utility of Bedside Lung Ultrasound Findings in Bronchiolitis.
Recent literature suggests that bedside lung ultrasound may have a role in the evaluation of infants with bronchiolitis. B lines, which are multiple and diffuse vertical artifacts spreading from the lung pleural interface to the edge of the ultrasound screen, have been associated with thickened interlobular septa, extravascular lung water, and diffuse parenchymal disease. The aims of this study were (1) to describe the prevalence of B lines in children younger than 24 months presenting to the emergency department with wheezing, (2) to determine the interrater reliability of lung ultrasound findings in this setting, and (3) to determine the association of B lines with atopy and other clinical findings. ⋯ In this small sample of patients with bronchiolitis, B lines were associated with older age and an absence of atopic features. Lung ultrasound interpretation had poor interrater reliability.
-
The seatbelt syndrome describes an injury pattern infrequently seen in restrained passengers in motor vehicle collisions. It occurs when sudden deceleration forces coupled with compression of the lap belt around the abdomen causes abdominal wall bruising, intra-abdominal injuries, and spinal fractures. ⋯ We also review the literature on the prevalence, risk factors, and types of injuries sustained by children with the seatbelt syndrome as well as discuss the indications for laboratory studies, abdominal imaging, surgical intervention, and further observation. Current recommendations for child seatbelt use and its effectiveness in preventing injury are also reviewed.
-
Pediatric emergency care · Feb 2017
Is Level of Serum Ischemia-Modified Albumin A Useful Biomarker in Carbon Monoxide Poisoning Cases?
Ischemia-modified albumin (IMA) is an emerging diagnostic biomarker for many ischemic conditions. The study was conducted to investigate whether there is a change in IMA levels in carbon monoxide poisoning and, if so, the clinical relevance of IMA levels. ⋯ Results from this preliminary study suggest that IMA might have diagnostic value in carbon monoxide poisoning and may be a parameter to be used clinically together with carboxyhemoglobin levels in terms of reflecting tissue hypoxia. In addition, IMA may be a criterion, especially in delayed cases where carboxyhemoglobin level may be normal in deciding hyperbaric oxygen treatment. To clarify this issue, further studies with larger population are needed.