Pediatric emergency care
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Pediatric emergency care · Feb 2020
ReviewConfronting Subconscious Bias: Ethics in the Pediatric Emergency Department.
Physicians are only human. Upon graduating from medical school, physicians take an oath declaring veracity and fidelity toward our patients. We are told to lay aside negative feelings toward patients in exchange for integrity, truth, honor, and compassion. ⋯ Recognition of these reactions and emotions will help physicians understand more about themselves, and assist in interacting more favorably with challenging patients. It is common for doctors to attempt to suppress their human reactions to maintain clinical objectivity, yet these reactions facilitate a better doctor-patient relationship. Allowing ourselves to yield to our emotions help the patient realize that the physician is a human being.
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Pediatric emergency care · Feb 2020
ReviewEarly Recognition and Emergency Treatment of Sepsis and Septic Shock in Children.
Early diagnosis and treatment of sepsis and septic shock in children results in improved outcomes. However, diagnosis is hampered by lack of specific diagnostic tests and relies on the recognition of the alterations of vital signs and protean systemic manifestations associated with infections, signs that mimic many critical illnesses. As a result, the early diagnosis of sepsis is usually presumptive and is based on the suspicion or presence of an infection in combination with the systemic changes. ⋯ To best accomplish these tasks, contemporary guidelines suggest that the use of a "recognition bundle" containing a trigger tool for rapid identification, a "resuscitation and stabilization bundle" to enable adherence to best practice, and a "performance bundle" to identify and overcome barriers to best practice be used. Although there are no universally acceptable tools to accomplish these tasks, the various iterations used in quality improvement initiatives have consistently demonstrated better care processes and outcomes. In this article, we outline the contemporary approach to sepsis in the first hours after presentation.