Pediatric emergency care
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Pediatric emergency care · Dec 2021
Multicenter StudyMulticenter Retrospective Review of Adult Patients Presenting to Pediatric Emergency Departments: Impact of Interfacility Distance.
This descriptive study aimed at evaluating the impact of distance between a general and pediatric emergency department (PED) on adults seeking care at PEDs. ⋯ Statistically significant differences were seen in the adult population presenting to PEDs based on the interfacility distance between a pediatric and general ED. These data can help PEDs prepare for the adult patients they are more likely to treat.
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Pediatric emergency care · Dec 2021
Balanced Electrolyte Solutions or Normal Saline? Resuscitative Fluid Administration Practice in Swiss Pediatric Acute Care: A Cross-Sectional Study.
The ideal asanguineous intravenous fluid for volume resuscitation in children is controversially debated and clinical practice guidelines are scarce. Administration of large amounts of normal saline has been associated with complications including hyperchloremic acidosis, dysnatremia, neurologic damage, and fatality. ⋯ There is a distinct practice variation in intravenous fluid and blood product administration in children in Switzerland. Although NS is most frequently given, we observed a trend toward the use of balanced electrolyte solutions. Prospective studies are warranted to compare NS with balanced electrolyte solution (BES) in the pediatric acute care setting. We suggest that pediatric fluid administration guidelines and mass transfusion protocols are implemented to standardize this frequent intervention and minimize complications.
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Paraquat is an herbicide that is highly toxic to humans. Paraquat ingestion is a common cause of fatal poisoning in many areas of Asia. The aim of the study was to analyze the characteristics of children with acute paraquat poisoning. ⋯ Left-behind children living in rural areas have a high risk of paraquat poisoning. Interventions and policies are urgently needed to prevent paraquat poisoning in children. Preventative efforts are the most important measures.
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Pediatric emergency care · Dec 2021
Case ReportsCongenital Malaria in a Febrile Infant Born to an Immigrant Mother With No Travel During Pregnancy.
Congenital malaria is a condition that can be acquired during pregnancy or perinatally at the time of delivery by transplacental transmission of parasitized maternal erythrocytes. Because of its rare incidence in the United States, it is most frequently missed as a differential diagnosis by physicians when evaluating a febrile infant born to an immigrant mother. ⋯ Pediatric emergency department physicians hence must obtain a thorough history and elicit any exposure to malaria in the past when evaluating a febrile infant. We report a case of an 18-day male infant with congenital malaria and no maternal history of travel and febrile illnesses during pregnancy.
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Pediatric emergency care · Dec 2021
Observational StudyBradycardia Without Hypertension: Is It a Common Clinical Presentation of Ventriculoperitoneal Shunt Malfunction in Pediatric Patients?
Mechanical shunting of cerebrospinal fluid is an effective treatment for hydrocephalus. Some studies suggest that bradycardia without hypertension may also be observed in ventriculoperitoneal (VP) shunt malfunction; however, in our experience, this is not a common presenting sign. ⋯ Bradycardia is not a common presentation in patients with VP shunt malfunction. Bradycardia is often recognized as a significant sign; however, it is one of the last presenting signs. Educating patients about the early signs must be considered as part of the treatment for VP shunt malfunction.