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
ReviewPediatric Life Support Update: 2015 American Heart Association Highlights.
Despite improving survival rates for pediatric cardiac arrest victims, they remain strikingly low. Evidence for pediatric cardiopulmonary resuscitation is limited with many areas of ongoing controversy. The American Heart Association provides updated guidelines for life support based on comprehensive reviews of evidence-based recommendations and expert opinions. This facilitates the translation of scientific discoveries into daily patient care, and familiarization with these guidelines by health care providers and educators will facilitate the widespread, consistent, and effective care for patients.
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Pediatric emergency care · Aug 2017
Ultrasound-Assisted Lumbar Puncture in Pediatric Emergency Department.
Lumbar puncture (LP) is one of the essential diagnostic tools in pediatric emergency services. Recently, ultrasound-assisted LP was reported to be beneficial in the emergency service by facilitating the procedure and improving the successful procedure rates. In addition, this method may be effective in reducing patient and parent anxiety due to the LP procedure. ⋯ Ultrasound-assisted LP reduced traumatic LP and the number of puncture attempts in pediatric patients; however, the results were not statistically significant.
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Pediatric emergency care · Aug 2017
Case ReportsLeukemoid Reaction in a Pediatric Patient With Diabetic Ketoacidosis.
Herein, we report a case of a 12-year-old girl who presented with diabetic ketoacidosis and a leukemoid reaction. Although this association has been described in a few adult patients, pediatric cases have not been reported. A leukemoid reaction is commonly defined as an elevation in the white blood cell count greater than 50,000/μL in response to severe illness or stress other than hematologic malignancy; it is considered to be mediated by various hormones, cytokines, and factors that are released in response to inciting triggers, such as acidosis. As highlighted in our report, distinguishing a benign leukemoid reaction from a hematologic malignancy and even tumor lysis syndrome, particularly in a setting of diabetic ketoacidosis, is crucial to ensuring safe and efficacious therapeutic interventions.