Pediatric emergency care
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Pediatric emergency care · Feb 2019
Consensus Statement on Urgent Care Centers and Retail Clinics in Acute Care of Children.
This article provides recommendations for pediatric readiness, scope of services, competencies, staffing, emergency preparedness, and transfer of care coordination for urgent care centers (UCCs) and retail clinics that provide pediatric care. It also provides general recommendations for the use of telemedicine in these establishments. ⋯ As pediatric visits to these establishments increase, considerations should be made for the type of injury or illnesses that can be safely treated, the required level training and credentials of personnel needed, the proper equipment and resources to specifically care for children, and procedures for safe transfer to a higher level of care, when needed. When used appropriately, UCCs and retail clinics can be valuable and convenient patient care resources.
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Pediatric emergency care · Feb 2019
Case ReportsA Finding of Hepatic Abscess in a Teenager Presenting With Abdominal Pain.
Pyogenic hepatic abscess is a rare infection, but it is an important diagnosis to consider because the current mortality is approximately 5%. We present a case of abdominal pain in a 16-year-old male patient whose presentation was initially concerning for appendicitis but was later diagnosed as having a pyogenic hepatic abscess. It is important to direct the patient to the proper treatment including source control with drainage and antibiotics to decrease morbidity and mortality.
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Pediatric emergency care · Feb 2019
Fever as a Presenting Symptom in Children Evaluated for Ileocolic Intussusception: The Experience of a Large Tertiary Care Pediatric Hospital.
Intussusception is the most common cause of intestinal obstruction in young children, and delayed diagnosis may lead to bowel perforation. The objective of this study was to determine the prevalence of fever in patients with ileocolic intussusception and to determine its utility as a predictive symptom. ⋯ Traditional teaching is that intussusception presents as intermittent colicky abdominal pain, red currant jelly stool, vomiting, and a palpable abdominal mass, but it is important to remember that this classic triad is a very late finding and this condition should be recognized before the development of these findings. The concurrence of fever can help to rule out the possibility of intussusception and prompt the health care professional to search diligently for alternative infectious etiologies but cannot eliminate the possibility, especially when other findings suggestive of intussusception are present.
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Pediatric emergency care · Feb 2019
Case ReportsCongenital Clavicular Pseudoarthosis-How to Differentiate It From the More Common Clavicular Fractures.
Congenital pseudoarthrosis of the clavicle is a rare entity that can be confused for a traumatic injury. We present 4 cases of congenital clavicular pseudoarthrosis and discuss its imaging findings that can help differentiate it from the more common clavicular facture. We also reviewed its epidemiology, embryology, and management based on available and most recent literature.
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Pediatric emergency care · Feb 2019
Review Case ReportsRat Bite Fever: A Case Report and Review of the Literature.
Cases of rat-bite fever (RBF) were reported in the literature for more than 2000 years. Not until recently, however, were attempts made to differentiate between RBF and Streptobacillus moniliformis septic arthritis, 2 arguably different clinical entities. ⋯ We report a case of a 17-year-old girl who presented with S moniliformis bacteremia and symptoms that spanned both RBF and S moniliformis septic arthritis. This case emphasizes the difficulty in differentiating the 2 clinical entities and the importance of early diagnosis, proper clinical suspicion, and prompt treatment to achieve positive outcomes.