Pediatric emergency care
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Pediatric emergency care · Dec 2019
Review Case ReportsSudden Onset of Severe Cervical Pain in an Adolescent Girl: Case Report and Review of Literature.
A previously healthy 13-year-old girl presented with a 9-day history of acute onset severe neck pain associated with limited range of movement. Medical evaluation at day 2 was suggestive of muscle contracture, and she was discharged home with diazepam, antiinflammatory agents, and rest; however, she returned because of progressive clinical worsening with left arm distal paresthesia and paralysis since day 3. There was no history of trauma or other systemic complaints, and her familial medical history was unremarkable. ⋯ It usually presents acutely with neurologic deficits, but the initial presentation may be atypical or insidious, delaying diagnosis and intervention. Definitive diagnosis is made by magnetic resonance imaging and implies a high index of suspicion. Surgical drainage of the hematoma is the mainstay of treatment with favorable prognosis even in cases with a delayed diagnosis.
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Spontaneous colon perforation is a known complication of vascular Ehlers-Danlos syndrome (vEDS) in the pediatric age group. The diagnosis of vEDS is often missed until the child presents to the pediatric emergency room with a complication like spontaneous arterial or colon rupture. These patients require immediate imaging and surgical attention to decrease morbidity and mortality. ⋯ An abdominal computed tomography revealed free air under the diaphragm, and surgical exploration showed perforation of the sigmoid colon. Ultimately, he was diagnosed with vEDS. We review the literature and discuss the clinical presentation, diagnosis, and life-threatening crises associated with vEDS.
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Pediatric emergency care · Dec 2019
Comparative StudyLower Extremity Fractures in Hospitalized Pediatric Patients Following Road Traffic Accidents.
Lower extremity fractures (LEFs) caused by road traffic accidents (RTAs) can result in significant morbidity and account for a substantial part of nonfatal injuries requiring hospitalization. This study investigated the epidemiology of RTA-associated LEFs in the pediatric population. Based on the National Trauma Registry, data of 28,924 RTA hospitalized pediatric patients were reviewed. ⋯ As patients were older, the greater the chance they required further treatment in the operating room (P < 0.0001). This large-scale study on the epidemiology of LEFs in the pediatric population following RTA provides unique information on epidemiological characteristics of LEF, pertinent both to medical care providers and to health policy makers allocating resources and formulating prevention strategies in the attempt to deal with the burden of road traffic accidents. Level of Evidence: Prognostic and epidemiologic study, level II.
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Pediatric emergency care · Dec 2019
Case ReportsBurns Due to Application of Raw Garlic to the Feet as a Home Remedy for Fever.
We present an illustrative case of unintentional burns to the feet of a 15-month-old child following the application of raw garlic as a home remedy for fever. We provide an overview of the historical medicinal uses of garlic as well as its unintended adverse effects. This case underscores the importance of clinicians' ability to recognize unusual presentations of injury due to culturally based practices that require care in emergency settings. This is particularly important in patient populations for whom abusive etiology would be considered.
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Pediatric emergency care · Dec 2019
Comparative StudyA Qualitative Analysis of General Emergency Medicine Providers' Perceptions on Pediatric Emergency Telemedicine.
Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers. ⋯ General ED providers identified 7 specific potential uses of pediatric emergency video telemedicine. However, they also identified several limitations of telemedicine in caring for pediatric emergency patients. Further studies after implementation of telemedicine program and comparing provider perceptions with actual practice may be helpful. Furthermore, studies on telemedicine's effect on patient-related outcomes and studies on cost-effectiveness might be necessary before the widespread implementation of a telemedicine program.