Pediatric emergency care
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Neonatal period is a peculiar life stage. This study aimed to characterize newborns' visits to the emergency department (ED) of a secondary care hospital. ⋯ The majority of ED visits is owing to insufficient caretaker knowledge or benign symptoms without necessity of immediate medical evaluation. These results emphasize the need for parents' education by health professionals.
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Pediatric emergency care · Dec 2018
Accuracy of Point-of-Care Ultrasonography for Pediatric Ankle Sprain Injuries.
In children with radiograph fracture-negative lateral ankle injuries, the main objective of this pilot study was to explore the accuracy, sensitivity, and specificity of point-of-care ultrasound (POCUS) performed by a pediatric emergency physician in diagnosing anterior talofibular ligament injuries, radiographically occult distal fibular fractures, and effusions compared with reference standard magnetic resonance imaging (MRI). ⋯ In this pilot study, we established that POCUS diagnosed the specific pathology of radiograph-negative lateral ankle injuries with poor sensitivity but good specificity. Thus, POCUS could act as a tool to exclude significant ligamentous and radiographically occult bony injury in these cases. A larger study is needed to validate the utility of POCUS for this common injury.
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Pediatric emergency care · Dec 2018
Case ReportsA Case of Wernicke Encephalopathy Developing After Ileal Bypass Surgery.
Wernicke encephalopathy is an acute neurological problem resulting from thiamine deficiency and manifesting with mental confusion, oculomotor dysfunction, and ataxia. It is associated with alcohol dependence in adults. Preparatory factors include hyperemesis gravidarum, prolonged diarrhea, prolonged parental nutrition without vitamin support, absorption disorders, anorexia, cancer, and chemotherapy. ⋯ The patient's clinical and cranial magnetic resonance findings were compatible with Wernicke encephalopathy. Although these are not widespread, typical ocular findings for Wernicke encephalopathy were present. Dramatic improvements were observed in clinical, ocular, and cranial magnetic resonance findings after treatment.
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Pediatric emergency care · Dec 2018
Emergency Medical Services Provider Pediatric Adverse Event Rate Varies by Call Origin Pediatric Emergency Care.
Emergency medical services providers may be called to a variety of sites to transport pediatric patients, whether it be a scene call for initial evaluation and care, a clinic for transportation of a patient who has been assessed by medical providers, or a hospital where assessment and stabilization have already begun. We hypothesize that there may be a direct relationship between adverse event rates and adverse event severity in transports from less medically stabilizing origins. ⋯ In conclusion, UNSEMs involving the emergency medical services care of children are more likely to occur when transport originates from a clinic or scene compared with a hospital.
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Pediatric emergency care · Dec 2018
Case ReportsFever and Hip Pain: Not Always Due to a Septic Hip.
Hip pain in febrile children always raises concern for septic arthritis. Pyomyositis is a rare cause of hip pain. ⋯ We report a child who presented with fever and hip pain and has pyomyositis of the obturator internus muscle. This case underscores the need to consider the possibility of alternative etiologies in a limping child.