Pediatric emergency care
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Pediatric emergency care · Apr 2021
Observational StudyPrognostic Factors of Children Admitted to a Pediatric Intensive Care Unit After an Episode of Drowning.
The aim of this study was to evaluate the prognostic factors of patients admitted to a pediatric intensive care unit (PICU) after drowning. ⋯ The need for advanced CPR with epinephrine administration on the scene predicts poor neurological outcome (severe encephalopathy or death) in drowned children.
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Pediatric emergency care · Apr 2021
Missed Diagnosis of Anaphylaxis in Patients With Pediatric Urticaria in Emergency Department.
This study was to determine the characteristics of missed diagnosis of pediatric anaphylaxis that were registered as urticaria only at the emergency department (ED) by comparing those who had only urticaria symptoms with those who had both anaphylaxis and urticaria symptoms. ⋯ Of all pediatric urticaria patients, 3.5% of patients were not registered as anaphylaxis although they had anaphylaxis symptoms. Missed diagnosis of anaphylaxis in pediatric urticaria patients at ED was associated with a history of past food allergy, milk, egg, and seafood as causes of allergy, treated with fluid administration, steroid, and epinephrine.
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Pediatric emergency care · Apr 2021
Elevated Heart Rate and Risk of Revisit With Admission in Pediatric Emergency Patients.
The aim of this study was to identify emergency department (ED) heart rate (HR) values that identify children at elevated risk of ED revisit with admission. ⋯ Last recorded ED HR discriminates poorly between children who are and are not at risk of revisit with admission in a pediatric ED. The use of single-parameter HR in isolation as an automated trigger for mandatory reevaluation prior to discharge may not improve revisit outcomes.
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Pediatric emergency care · Apr 2021
Observational StudyRadiologic Assessment of Skull Fracture Healing in Young Children.
Skull fractures are commonly seen after both accidental and nonaccidental head injuries in young children. A history of recent trauma may be lacking in either an accidental or nonaccidental head injury event. Furthermore, skull fractures do not offer an indication of the stage of healing on radiologic studies because they do not heal with callus formation as seen with long bone fractures. Thus, a better understanding on the timing of skull fracture resolution may provide guidance on the medical evaluation for accidental or nonaccidental head injury. ⋯ Healing or resolution of a skull fracture can take months in children younger than 24 months. With the high variability in skull fracture presentation and large window to fracture resolution, unexplained or multiple skull fractures in children younger than 24 months may be the result of a single or multiple events of head trauma.
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Pediatric emergency care · Apr 2021
Lazarus Syndrome - Challenges Created by Pediatric Autoresuscitation.
Pediatric autoresuscitation is extremely rare, with only 4 documented cases in the literature. The longest recorded time between stopping cardio pulmonary resuscitation (CPR) and return of spontaneous circulation is 2 minutes. We report a previously well 18-month-old who attended the emergency department after an unexplained cardiac arrest. ⋯ There are a variety of theories regarding the pathology of pediatric autoresuscitation. The most commonly accepted model is that there is a degree of autopositive end-expiratory pressure impending venous return as a consequence of vigorous ventilation during CPR. This case challenges clinicians to reassess our current definition of death and reaffirms the need for clearer guidelines surrounding the certification of death.