Pediatric emergency care
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Pediatric emergency care · Jul 2017
Case ReportsSevere Respiratory Distress in a Neonate due to Bilateral Dacryocystoceles.
Nasal passage contributes up to 50% of total resistance in normal breathing especially in neonates who are obligatory nose breathers. Any further increase in airway resistance may lead to severe respiratory distress. Dacryocystoceles are a rare cause of nasal obstruction in neonates. We present the case of a full-term 3-day-old female infant with progressive respiratory distress due to bilateral dacryocystoceles.
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Pediatric emergency care · Jul 2017
Case ReportsDRESS Syndrome or Hematologic Malignancy?: A Case Report of a 4-Year-Old Boy.
Drug reaction with eosinophilia and systemic symptom (DRESS) is a serious idiosyncratic drug reaction. It is characterized by skin eruption, fever, hematologic abnormalities, and multi-organ involvement. Diagnosis is challenging because of the wide clinical spectrum. ⋯ The DRESS syndrome is a challenging entity and probably underdiagnosed because many of its clinical findings can mimic those of other serious systemic disorders such as infections and hematologic disorders. Virus reactivation and use of some drugs together with suspected drugs, such as amoxicillin, can trigger the symptoms of DRESS syndrome. This is a case report of a 4-year-old boy with oxcarbazepine-induced DRESS syndrome possibly triggered by amoxicillin; hematologic malignancy was included in the differential diagnosis.
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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
ReviewAn Ethical Justification for Termination of Resuscitation Protocols for Pediatric Patients.
The aim of this article was to compare specific characteristics and outcomes among adult and pediatric out-of-hospital cardiac arrest (OHCA) patients to show that the existing literature warrants the design and implementation of pediatric studies that would specifically evaluate termination of resuscitation protocols. We also address the emotional and practical concerns associated with ceasing resuscitation efforts on scene when treating pediatric patients. ⋯ The data compared demonstrate that characteristics and outcomes are virtually identical between adult and pediatric OHCA patients. We also found the 3 chief barriers hindering further research to be invalid impediments to moving forward. This review warrants designing pediatric studies that would specifically correlate termination of resuscitation protocols with patient survival and include predictive values.