Pediatric emergency care
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Pediatric emergency care · Jun 2021
Randomized Controlled TrialSedoanalgesia Versus Infraclavicular Block for Closed Reduction of Pediatric Forearm Fracture in Emergency Department: Prospective Randomized Study.
Procedural sedoanalgesia is commonly used in pediatric patients in the emergency department (ED) for interventional procedures, diagnosis, and treatment. However, this method causes serious systemic complications, such as respiratory and cardiac depression. To minimize these complications, ultrasound-guided regional anesthesia methods have been used in recent years. We aimed to compare the use of procedural sedoanalgesia (PSA) and infraclavicular block (ICB) in the pain management of pediatric patients who underwent closed reductions of forearm fractures. ⋯ Ultrasound-guided ICB is a safe and effective method in the management of pain during closed reduction of forearm fracture in pediatric patients in EDs. It can be used safely in emergency rooms and has a high level of both parental and operator satisfaction.
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Pediatric emergency care · Jun 2021
ReviewTop Citations of Pediatric Emergency Medicine Publications in the Emergency Medicine Literature.
The goal of this study was to identify and analyze the 100 most frequently cited journal articles pertaining to the field of pediatric emergency medicine (PEM) and published in emergency medicine (EM) peer-reviewed literature. ⋯ This analysis provides a review of citation frequency of top-cited PEM articles published in EM journals. This determines the influence of these PEM publications on the EM specialty. The importance of education on resuscitation and anesthesia topics in PEM was evident. Most of the articles were published more than 10 to 15 years ago, indicating that they could be considered landmarks in the subspecialty of PEM. This signifies their importance to other authors in this field, who chose to cite them as having created a significant impact on their own publications.
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Pediatric emergency care · Jun 2021
A Neurological Appearance of Celiac Disease: Is There Any Associated Factor?
Celiac disease may present with one or more neurological signs and/or symptoms. We aimed to define the incidence of accompanying neurological manifestations in children diagnosed as having celiac disease. ⋯ Pathophysiology of neurological involvement in celiac disease is liable for various neurological findings. This study contributes to data suggesting that female sex, mild histopathological form, and human leukocyte antigen DQ2 heterozygosity are related to neurological manifestations, and also human leukocyte antigen DQ2 heterozygosity is associated with headache in celiac disease.
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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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Death is an uncommon event in the pediatric emergency department. The sudden end of a young life is always an undesirable event. Staff and family members are never prepared. ⋯ Whether the patient is old or young, previously sick or healthy, it is important to stop and consider how hard it must be for the assembled family. As frontline clinicians, we all deeply care about the outcome of our patients and their families, yet for them to feel they have been understood and well cared for, it is recognized that clinicians must attend to health care conversations on a deeper and more relational level. Consideration that these events happen and reinforcing that it is difficult for all involved ensure staff that their challenges are recognized.