Pediatric emergency care
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Pediatric emergency care · Dec 2021
Case ReportsMassive Iatrogenic Pediatric Ketamine Overdose With Serial Levels and Minimal Morbidity.
Ketamine is a dissociative anesthetic commonly used for procedural sedation owing to its perceived favorable safety profile. Despite its frequent use, overdoses of ketamine are rarely reported, and no cases with serum levels of ketamine or its metabolite have previously been reported. We report a case of an iatrogenic pediatric ketamine 20 mg/kg intramuscular overdose with serial ketamine and norketamine levels that resulted in minimal toxicity.
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Pediatric emergency care · Dec 2021
Case ReportsCoarctation of the Aorta in Adolescence: Significance of Detailed Cardiac Examination in Pediatric Hypertension.
Although coarctation of the aorta (CoAo) is a congenital anomaly, it can pose a diagnostic challenge in those presenting beyond neonatal period, as some patients can remain asymptomatic until complications of hypertension develop later in life. Careful physical examination can play an important role in timely diagnosis and prevention of complications. We present 2 cases of adolescents with undiagnosed CoAo who both presented with nonspecific headaches and hypertension. ⋯ These findings raised the clinical suspicion of CoAo, which was confirmed on further investigations. Our cases highlight the importance of considering CoAo in the differential diagnosis of hypertension in adolescents. These cases also stress the significance of detailed cardiac examination including 4-limb blood pressure and femoral pulses in a patient presenting to the emergency department with high blood pressure irrespective of the primary complaint.
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Pediatric emergency care · Dec 2021
Identifying Predictors of Physical Abuse Evaluation of Injured Infants: Opportunities to Improve Recognition.
To identify predictors of physical abuse evaluation in infants younger than 6 months with visible injury and to determine the prevalence of occult fracture and intracranial hemorrhage in those evaluated. ⋯ About half of preambulatory infants with visible injury were not evaluated for physical abuse. Targeted education is recommended as provider experience and training influenced the likelihood of physical abuse evaluation. Occult fractures and intracranial hemorrhage were often found in infants presenting with seemingly isolated "minor" injuries. Physical abuse should be considered when any injury is identified in an infant younger than 6 months.
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Pediatric emergency care · Dec 2021
ReviewEvaluating the Necessity of Antibiotics in the Treatment of Acute Epididymitis in Pediatric Patients: A Literature Review of Retrospective Studies and Data Analysis.
This literature review and data analysis aims to evaluate the percentage of pediatric patients with acute epididymitis found to have bacterial etiology and the percentage of patients in these studies that were treated with antibiotic therapy versus conservative therapy. ⋯ Practitioners should consider only prescribing antibiotics to patients with acute epididymitis if there is an abnormal urinalysis or urine culture.
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Pediatric emergency care · Dec 2021
Point-of-Care Ultrasound Training Programs Across Italian Pediatric Residency Schools: A National Survey.
The role of point-of-care ultrasound (POCUS) in routine clinical practice is rapidly growing, whereas adult specialties have already included training programs regarding this topic; pediatric residency schools are still late on this topic, particularly in Italy. ⋯ Our results demonstrate that POCUS training is still missing in Italy. Given the growing number of evidences of the benefits from including POCUS in clinical practice and patient evaluation, efforts are needed to fill this gap, in Italy and, probably, in most European countries. Such a training will definitely help the new generation of pediatricians improve their curriculum and, therefore, child health.