Pediatric emergency care
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Pediatric emergency care · Feb 2019
Review Case ReportsAnother Useful Application of Point-of-Care Ultrasound: Detection of Esophageal Foreign Bodies in Pediatric Patients.
Foreign body ingestion is a common pediatric complaint. Esophageal foreign body (EFB) requires early diagnosis and emergency removal of the object. We report 3 cases of EFB detected by point-of-care ultrasound demonstrating characteristic sonographic findings. Point-of-care ultrasound can be a potentially useful modality for identifying EFB.
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Pediatric emergency care · Feb 2019
Characterizing the Toxicity and Dose-Effect Profile of Tramadol Ingestions in Children.
Tramadol can cause life-threatening toxicity in overdose; however, data on its toxicity in children are lacking. This study investigates toxicity associated with tramadol ingestions in children. The hypothesis is that children will experience dose-related central nervous system and respiratory depression and seizures. ⋯ Seizure and respiratory depression are uncommon in pediatric tramadol ingestions. Given the small number of patients with dose data and lack of laboratory confirmation of dose, more studies are needed to determine the minimum dose at which medical management is recommended.
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Pneumatosis intestinalis (PI) and the presence of portal venous gas (PVG) are commonly considered pathognomonic for necrotizing enterocolitis in the neonatal period; however, these 2 radiographic findings have been documented in all age groups in a variety of clinical settings and medical conditions including respiratory, cardiac, rheumatologic, gastrointestinal disorders, and traumatic injury. In children, intramural dissection of intestinal gas in the absence of clinical symptoms suggestive of necrotizing enterocolitis should raise concern for a traumatic etiology, including injuries sustained from child physical abuse. Several pediatric cases of traumatic PI and PVG have been reported; however, these cases described additional, associated abdominal injury or featured toddlers - a single case report of accidental abdominal trauma resulted in PVG in a preterm infant. We report the case of a neonatal victim of child physical abuse presenting with PI and PVG in the absence of other evidence of abdominal trauma.
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Pediatric emergency care · Feb 2019
Provider Prediction of Disposition for Children With an Acute Exacerbation of Asthma Presenting to the Pediatric Emergency Department.
The aim of this study was to evaluate the accuracy of the initial impression of emergency department providers on the disposition of children with asthma exacerbation. ⋯ Emergency department providers correctly predicted disposition 80% of the time. Providers were particularly likely to correctly predict admission. A VAS score of 7 or greater is nearly 90% specific for admission, with specificity increasing at higher values.