Pediatric emergency care
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Hirudin is a potent anticoagulant found in the salivary glands of several species of leeches. We report a case of direct hirudin exposure after suspected leech bite causing significant penile ecchymosis. Diagnosis was not apparent on initial evaluation but made after a thorough history was obtained and the leech was found in the lining of his swim trunks, which he left at home. Although this presentation mimics several other potentially serious conditions, treatment is largely observational with anticipated rapid improvement over the course of hours without intervention.
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Pediatric emergency care · Mar 2019
Review Case ReportsA Mild Laryngeal Cleft Causes Severe Symptoms.
Diagnosis and treatment of laryngeal clefts (LCs) particularly type I pose a challenge. Although rare, type I LCs are becoming increasingly identified in recent years, and this is perhaps due to both an increased awareness and better diagnostic modalities. We report a young infant presenting with feeding difficulty and respiratory distress related to LC. The pertinent literature is also reviewed.
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Pediatric emergency care · Mar 2019
Multicenter StudyOutcomes From Referrals and Unscheduled Visits From Community Emergency Departments to a Regional Pediatric Emergency Department in Canada.
Existing pediatric literature describing repeat visits to the emergency department (ED) for the same medical complaint has yet to report on patient flow patterns from general EDs (GEDs) to a pediatric ED (PED). We sought to characterize the population of patients who are treated in a GED and subsequently present to a PED for further care. ⋯ Knowing the proportion, management, and outcomes of children who are treated in a GED and subsequently at a PED may provide an important quality measure and opportunities to improve the management of common pediatric emergencies in the community.
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Pediatric emergency care · Mar 2019
Computed Tomography Use Plateaus Among Children With Emergency Visits for Abdominal Pain.
Abdominal pain is a common pediatric complaint to emergency departments (EDs), and clinicians often rely on imaging for diagnosis. Studies have demonstrated an increase in computed tomography (CT) in this population. Following emphasis on radiation reduction by researchers and organizations, this study evaluates recent national trends in CT use among pediatric patients presenting to EDs with abdominal pain. ⋯ In contrast to the earlier dramatic increase in CT use for pediatric patients with abdominal pain, CT remained constant between 2008 and 2011. There was no associated change in the rate of diagnosis of appendicitis or hospitalization; however, ultrasound is increasing.
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Pediatric emergency care · Mar 2019
An Innovative Model to Predict Pediatric Emergency Department Return Visits.
Return visit (RV) to the emergency department (ED) is considered a benchmarking clinical indicator for health care quality. The purpose of this study was to develop a predictive model for early readmission risk in pediatric EDs comparing the performances of 2 learning machine algorithms. ⋯ These models provide a promising predictive tool for supporting the ED staff in preventing unnecessary RVs.