Pediatric emergency care
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Pulmonary embolism is an uncommon but potentially life-threatening event in children. There has been increasing awareness of pulmonary embolism in children with improved survival in children with systemic disease and advancements in diagnostic modalities. However, literature regarding pulmonary embolism in children is sparse, and thus current guidelines for management of pulmonary embolism in children are extrapolated from adult literature and remain controversial. This article reviews the background and pathophysiology of venous thromboembolism, as well as current diagnostic approach and recommended management of pulmonary embolism in children.
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Pediatric emergency care · Feb 2019
Observational StudyA Reexamination of the Accuracy of the Broselow Tape as an Instrument for Weight Estimation.
Accurate weight estimation is important for calculating appropriate medication dosages, determining rates of fluid replacement, and selecting correct equipment sizes in critically ill children requiring resuscitation. The actual measurement of the weight of a critically ill or injured child is often not possible. The Broselow Pediatric Emergency Tape (BT) is an important tool for predicting a child's weight based on his/her height. Although BT has previously been validated, given the increasing prevalence of obesity in today's society, it behooves clinicians relying on this resuscitation aid to revisit the issue. ⋯ In our population, BT was inaccurate in predicting weight in 42% of children (underestimation in 158 children [29.4%] and overestimation weight in 68 children [12.6%]). However, the majority of discrepancies involved only 1 BT color zone. Emergency physicians should be aware of this discrepancy until more accurate methods become available.
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Pediatric emergency care · Feb 2019
Case ReportsAcute Focal Dystonia After a Single Dose of Oral Cetirizine in a 9-Year-Old Boy.
Common cold is an acute illness affecting pediatric population in particular. The use of antihistamines is a common practice, with cetirizine being a frequently used drug with a good safety profile. ⋯ In our present case, dystonia due to the intake of cetirizine was observed, which the patient responded well to the use of benzodiazapines, namely, clonazepam. We report this case to highlight the occurrence of this adverse event with the use of cetirizine.
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Pediatric emergency care · Feb 2019
Randomized Controlled Trial Comparative StudyA Comparison of Nonpharmacologic Interventions on the Emotional State of Children in the Emergency Department.
The majority of children and adolescents presenting to the emergency department are in pain and require painful procedures. This randomized study was to investigate the efficacy of 3 different nonpharmacologic interventions (clowns, dogs, and musicians) to reduce pain and analyze the perception of positive and negative affects after the presence of these activities in a short-stay observation unit (SSOU). ⋯ The presence of different nonpharmacologic interventions (clowns, dogs, and musicians) seemed to empower positive affect in children but did not influence the self-reported pain.