Pediatric emergency care
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Pediatric emergency care · Nov 2021
Clinical Indicators of Pediatric Shunt Malfunction: A Population-Based Study From the Nationwide Emergency Department Sample.
The majority of the previous literature on clinical predictors of shunt malfunction is from the neurosurgical data, looking at the symptoms of patients who had surgery. Because common childhood illnesses are filtered from these samples, the prevalence of shunt malfunction is markedly higher than it would be for the pediatrician's office or emergency department (ED). Clinical predictive values obtained from a representative population can better inform clinical judgment in these environments. ⋯ We identified peritonitis, papilledema, and oculomotor palsies as the strongest clinical indicators for shunt malfunction in pediatric ED visits with a CSF shunt. We found that patients presenting with headache, nausea/vomiting, convulsions, or fever were more likely to have an etiology other than shunt malfunction. Thus, after an appropriate shunt evaluation, other sources of symptoms should be investigated.
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There are many tick-borne infections that affect children and adolescents in the United States. These illnesses often begin with non-specific flulike symptoms such as fever, chills, headache, and myalgia, so obtaining a good travel history is important. ⋯ Often, treatment should commence before formal illness identification, as delays may cause more severe disease, and rapid laboratory confirmation is difficult. One of the most important issues is prevention of tick bites with insect repellents, accompanied by thorough tick checks after being outdoors in a tick-infested region.
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Pediatric emergency care · Nov 2021
ReviewAcute Movement Disorders in Childhood: A Cohort Study and Review of the Literature.
Acute movement disorders (AMD) are frequent in neurological and pediatric emergencies. Few studies analyzed AMD in children, none in Tunisia or other African country. The purpose of this study was to describe the peculiarities of AMD in a Tunisian pediatric population with a literature review. ⋯ Our study illustrated the broad range of AMD in children and the wide spectrum of their etiologies. In our series, we described some exceptional findings and etiologies of AMD in children. These findings may denote a specific profile in of AMD in our country with predominant infectious, postinfectious, and IMD.