Pediatric emergency care
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Pediatric emergency care · Aug 2017
Ketamine Abuse Syndrome: Hepatobiliary and Urinary Pathology Among Adolescents in Flushing, NY.
Ketamine is a recreational drug widely abused in East Asia and also in certain subpopulations of the United States. Many US clinicians are unaware of abuse symptoms, leading to misdiagnosis and missed opportunities for intervention. We will discuss clinical patterns that should alert a clinician to the possibility of ketamine abuse. ⋯ Ketamine abuse is associated with a distinctive pattern of symptoms involving the urinary and hepatobiliary systems.
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Pediatric emergency care · Aug 2017
Comparative Study Observational StudyComparative Performance of Pediatric Weight Estimation Techniques: A Human Factor Errors Analysis.
We compared performance characteristics of 7 weight estimation methods examining predictive performance and human factors errors. ⋯ Skill-based, perception, or judgment errors were observed in more than 1 of 20 cases. No singular strategy was used with 100% accuracy.
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Pediatric emergency care · Aug 2017
Observational StudyAfebrile Infants Evaluated in the Emergency Department for Serious Bacterial Infection.
Afebrile infants 0 to 60 days of age are sometimes evaluated for serious bacterial infection (SBI). Our objective was to describe the clinical and laboratory findings in this population and compare them to their febrile counterparts. ⋯ Afebrile infants make up a significant percentage of SBI evaluations in the emergency department. Respiratory symptoms, vomiting, and seizure-like activity are common presentations. Although rates of bacteremia and urinary tract infection are higher in the febrile group, this did not reach statistical significance, and therefore afebrile infants should still be considered at risk for SBI.
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Pediatric emergency care · Aug 2017
A New Paradigm for the Management of Thoracolumbar Pediatric Spine Traumas.
The transient breath holding sign (TBHS) is a clinical sign often associated with magnetic resonance imaging (MRI) spine traumatic lesions. The aims of this study were to prospectively evaluate the TBHS in the detection of thoracolumbar lesions in a large cohort of children and to establish a comprehensive strategy on the use of MRI in spine traumas in children. ⋯ This study confirms that the TBHS is a relevant clinical tool that should be added in the routine questionnaire after any trauma at admission. Magnetic resonance imaging should be restricted to patients with a TBHS positive at admission. A single T2 Short T1 Inversion Recovery (STIR) sagittal sequence seems sufficient to make the diagnosis and could replace the use of standard x-rays in pediatric spine traumas.