Pediatric emergency care
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Pediatric emergency care · Sep 2019
Emergency Provider Use of Plain Radiographs in the Evaluation of Pediatric Constipation.
More than half of children evaluated as outpatients for abdominal pain are diagnosed with constipation. X-ray use in this scenario is variable: less than 5% in clinic settings, greater than 70% in emergency departments. X-rays increase misdiagnosis rate, remain costly, and involve radiation exposure. ⋯ This survey suggests that many PEM providers obtain radiographs to convince families of the diagnosis of constipation. This is not a viable management plan given the risks of radiation as well as costs. There remains room for improvement as we attempt to reduce use of radiation in the evaluation of common pediatric illnesses.
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Complete heart block is rare in children and is usually owing to congenital abnormalities. These children are often pacemaker dependent. However, pacemaker complications can require emergency interventions, including external pacing. This case presents a child in complete heart block requiring external pacing and then discusses some of the literature behind such interventions.
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Pediatric emergency care · Sep 2019
Case ReportsAmitraz: A Perpetual Silent Menace Among Children in Developing Countries-A Case Report.
Amitraz is an acaricide and insecticide used to treat ticks, which infest domestic animals in developing countries. Because of its widespread use, it is one of the common poisons unintentionally consumed by infants and children when left unsupervised. A 3-year-old boy was brought with unintentional consumption of Amitraz. ⋯ Amitraz is an unusual but deadly poison unintentionally consumed by children. It can be suspected in the setting of rural households in developing countries having pets. There is no antidote available, and treatment is mainly supportive.
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Pediatric emergency care · Sep 2019
Case ReportsThe Visualization of a Foreign Body in a Patient's Subglottic Region Using Point-of-Care Ultrasonography.
Point-of-care ultrasonography is a real-time dynamic examination that is useful for evaluating the location of foreign bodies in a patient's gastrointestinal tract and soft tissue. In particular, it is useful for identifying radiolucent foreign bodies that are difficult to visualize using routine x-ray examinations. This case study describes the visualization of a radiolucent foreign body in a patient's subglottic region using point-of-care ultrasonography.
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Pediatric emergency care · Sep 2019
Case ReportsVentricular Tachycardia Induced by Propafenone Intoxication in a Pediatric Patient.
Unintentional poisonings are a global health problem frequently resulting in hospital admissions. Propafenone is a class 1C antiarrhythmic drug used in the second-line management of supraventricular and ventricular arrhythmias and, when unintentionally ingested, can lead to severe and life-threatening poisoning. ⋯ Two boli of intravenous hypertonic sodium bicarbonate (total amount of 3 mEq/kg), followed by 3-hours continuous infusion of 1 mEq kg h sodium bicarbonate, were able to restore the clinical conditions of the patient. With this case report, we aim to highlight the existing challenge in the therapeutic management of propafenone intoxication that finds intravenous hypertonic bicarbonate to be a useful tool also in pediatric population.