Pediatric emergency care
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Pediatric emergency care · Jun 2021
ReviewCaring for Pediatric Hidradenitis Suppurativa Patients in the Emergency Department.
Hidradenitis suppurativa (HS) is a chronic and recurrent inflammatory skin condition resulting in the formation of nodules, sinus tracts, and abscesses in intertriginous areas. We provide recommendations for the management of children presenting to the emergency department with acute HS flares, based on a review of literature and insights from our own clinical experience. The purpose of the recommendations is to educate clinicians on specific considerations that should be made when caring for children with HS.
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Pediatric emergency care · Jun 2021
Case ReportsSeizures, Meds, and Vtach: A Journey to a Brugada Diagnosis.
Sudden cardiac arrest of cardiac etiology is rare in children and adolescents and most often occurs with exertion. Conversely, syncope is a common pediatric emergency department complaint but rarely is associated with a serious underlying cardiac disorder. This report describes a case of the channelopathy Brugada syndrome (BrS) as a cause of sudden cardiac arrest in a febrile preadolescent child taking medications known to affect cardiac conduction. ⋯ Confirmatory electrophysiologic testing was performed, and an implantable cardiac defibrillator was placed. Pediatric emergency specialists must recognize both the importance of ECG in the workup of syncope and be familiar with the specific ECG findings suggestive of BrS. Ventricular arrhythmias that occur at rest should raise the suspicion of this genetic cardiac channelopathy, regardless of age.
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Rhabdomyolysis is a syndrome caused by injury to skeletal muscle and subsequent release of intracellular components into the systemic circulation. We report a case of rhabdomyolysis causing acute paralysis from underlying and unrecognized hypothyroidism in an 11-year-old girl. To date, publications of rhabdomyolysis secondary to hypothyroidism have been limited, especially in the pediatric population. Early intervention with intravenous fluids and levothyroxine led to resolution of our patient's symptoms and is overall important in preventing the serious sequela of rhabdomyolysis including renal failure, cardiac dysrhythmias, compartment syndrome, and disseminated intravascular coagulation.
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Pediatric emergency care · Jun 2021
Epipericardial Fat Pad Necrosis-A Rare Cause of Chest Pain in an Adolescent.
Epipericardial fat necrosis is a rare cause of acute pleuritic chest pain reported in approximately 40 cases. This diagnosis mimics a myocardial infarction, pulmonary embolism, or pericarditis; however, the cardiac enzymes and electrocardiogram are usually normal. We present the first reported case of epipericardial fat necrosis in an adolescent.
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Pediatric emergency care · Jun 2021
Hypothermia as an Outcome Predictor Tool in Pediatric Trauma: A Propensity-Matched Analysis.
Hypothermia is an independent risk factor for mortality in adult trauma patients. Two small studies have shown similar results in pediatric trauma patients. Temperature is not included in any pediatric trauma assessment scores. This study sought to compare mortality and various descriptive outcomes between pediatric hypothermic and normothermic trauma patients. ⋯ Hypothermia has been shown to be a significant prognostic indicator in the pediatric trauma patient with further potential application. Future studies are indicated to evaluate the incorporation of hypothermia into the Pediatric Trauma Score not only to help predict injury severity and mortality but also to improve appropriate and expeditious patient transfer to pediatric trauma centers and potentially facilitate earlier intervention.