Pediatric emergency care
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Pediatric emergency care · Sep 2018
Performance of Bedside Lung Ultrasound by a Pediatric Resident: A Useful Diagnostic Tool in Children With Suspected Pneumonia.
Recent studies suggest that lung ultrasound is a good, radiation-free alternative to chest radiography in children with pneumonia. We investigated how bedside lung ultrasound performed by a pediatric resident compared with chest radiography in children with suspected pneumonia. ⋯ Bedside lung ultrasound is a useful tool, with a good specificity, to find lung consolidations in children even when the sonologist has minimal practical ultrasound experience and no access to supervision. We suggest the use of bedside lung ultrasound as a diagnostic tool in children with suspected pneumonia.
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A 9-year-old white girl with a history of constipation presented to the emergency department with a few weeks of intermittent stool incontinence without any reported changes in diet or difficulty tolerating food or fluids by mouth. On the day of presentation, she developed nausea and nonbloody, nonbilious emesis, as well as multiple, loose, nonbloody stools, after becoming acutely ill during lunch at school. There was no reported fever or suspicious food intake. ⋯ The imaging test identified a large fecaloma with surrounding colonic inflammation concerning for stercoral colitis. The child underwent urgent manual disimpaction and was hospitalized for supportive care with subsequent recovery and return to her normal state of health. Follow-up testing during her hospital stay did not reveal any other infectious or physiologic cause for her constipation and colitis.
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Pediatric emergency care · Sep 2018
Multicenter StudyAcute Outcomes of Isolated Pneumocephali in Children After Minor Blunt Head Trauma.
We aimed to determine the prevalence of and adverse outcomes caused by pneumocephali in children with minor blunt head trauma who had no other intracranial injuries (ie, isolated pneumocephali). ⋯ Children with isolated pneumocephali and GCS scores of 14 or 15 after minor blunt head trauma are unlikely to have adverse clinical outcomes.
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Pediatric emergency care · Sep 2018
Case ReportsAcute-Onset Flaccid Hemiparesis in a 9-Year-Old Boy With Presumed Enteroviral Infection.
In the summer and autumn of 2014, a cluster of cases of flaccid paralysis were seen in the United States related to patients infected with enterovirus D68 (EV-D68). We present here a case of acute-onset flaccid hemiparesis in a previously healthy boy with altered mental status, hypothermia, and bowel incontinence.
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Pediatric emergency care · Sep 2018
Review Case ReportsHeterogeneous Knee Effusions on Point-of-Care Ultrasound in a Toddler Diagnosed With Juvenile Idiopathic Arthritis.
Point-of-care musculoskeletal ultrasound can provide information about joint effusions and the quality of the effusion. This case report describes the findings of a previously healthy pediatric patient with acute onset of knee swelling and abnormal gait. After point-of-care ultrasound demonstrated bilateral knee effusions with complex, heterogeneous material, subsequent workup revealed a diagnosis of juvenile idiopathic arthritis (JIA). We review the ultrasound technique, sonographic findings, and literature regarding point-of-care ultrasound for knee effusions and JIA.