Pediatric emergency care
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Pediatric emergency care · Jul 2017
Observational StudyDrug Misuse in Adolescents Presenting to the Emergency Department.
Drug misuse is a disturbing, common practice among youth. One in 4 American adolescents reports consuming prescription medications without a clinical indication. We sought to explore current trends of drug misuse in adolescents. ⋯ Adolescents presenting with drug misuse may be exposed to a wide range and combinations of therapeutics or illicit substances and frequently display central nervous system abnormalities, compromising the ability to obtain a reliable history. Frontline clinicians should maintain a high index of suspicion, as routine toxicology screenings fail to detect most contemporary misused legal and designer drugs.
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Pediatric emergency care · Jul 2017
Review Case ReportsPediatric Disseminated Lemierre Syndrome in 2 Infants: Not Too Young for an Ancient Disease.
The Lemierre syndrome is characterized by an oropharyngeal infection, thrombosis of the internal jugular vein, and multiple septic metastases. Fusobacterium necrophorum is a common cause of it. The incidence is 0.6 to 2.3 cases per million with a mortality rate of 4% to 18%. ⋯ The younger case, a 6-month-old infant, was fully recovered. In the other side, and despite an aggressive therapy, an 18-month-old infant developed cerebral palsy. We also provide a short literature review with a focus on clinical presentation and differential diagnosis in order to initiate an early and adequate therapy.
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Pediatric emergency care · Jul 2017
Review Case ReportsA Case of Testicular Rupture Diagnosed by Point-of-Care-Ultrasound.
Point-of-care ultrasound is an expanding diagnostic tool in the pediatric emergency department. We describe a case of testicular rupture diagnosed by ultrasound at the bedside, which led to prompt surgical intervention and repair.
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Pediatric emergency care · Jul 2017
Randomized Controlled TrialCan Telemedicine Improve Adherence to Resuscitation Guidelines for Critically Ill Children at Community Hospitals? A Randomized Controlled Trial Using High-Fidelity Simulation.
Children transferred from community hospitals lacking specialized pediatric care are more seriously ill than those presenting to pediatric centers. Pediatric consultation and adherence to management guidelines improve outcomes. The aims of the study were (1) to assess whether telemedicine consultation in critical situations is feasible and (2) to compare the impact of pediatric critical care medicine (PCCM) consultation via telemedicine versus telephone on community hospital adherence to resuscitation guidelines through a randomized controlled telemedicine trial. ⋯ This study demonstrates the feasibility of using telemedicine to support acute management of children who present to community hospitals. Neither study arm adhered to current resuscitation guidelines and telemedicine consultation with PCCM experts was not associated with improvement. However, further research on optimizing telemedicine impact on the quality of pediatric care at community hospitals is warranted.
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Pediatric emergency care · Jul 2017
Review Case ReportsDiagnosis of a Posterior Fracture Dislocation of the Medial Clavicle in an Adolescent With Point-of-Care Ultrasound.
We report a case of an adolescent patient with medial clavicular tenderness after a fall on the lateral left shoulder. Initial radiographs did not reveal a fracture or dislocation. Point-of-care ultrasound was used to diagnose a posterior clavicular fracture dislocation.