Pediatric emergency care
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Pediatric emergency care · Apr 2023
ReviewInteractions With Police in the Emergency Care of Children: Ethical and Legal Considerations.
Emergency medicine providers may interface with law enforcement personnel (LEP) on behalf of their pediatric patients for a variety of reasons, from reporting child abuse to caring for children who are in police custody. Given the unique nature of caring for minors who may not have legal or medical autonomy, interactions with LEP can raise ethical concerns for emergency providers, specifically with regard to legal representation, developmental immaturity, and the civil rights of children and their parents/guardians. ⋯ These nuanced situations require careful advocacy for the child and a collaborative approach between medical providers and LEP to balance the child's well-being with public safety. We offer recommendations here, and we maintain that clear, widely adopted best practices for the care of minors in LEP custody are long overdue.
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Pediatric emergency care · Apr 2023
Is HbA1c an Indicator of Diabetic Ketoacidosis Severity in the Pediatric Population?
Glycosylated hemoglobin (HbA1c) reflects how well blood glucose is controlled and is one of the strongest predictors of chronic complications of diabetes mellitus. The degree of acidosis helps determine the severity of diabetic ketoacidosis (DKA) (mild: pH 7.2-7.3; moderate: pH 7.1-7.2; severe: pH <7.1) and guides the level of care and predicts outcome. Many studies have implicated that higher HbA1c levels lead to recurrent DKA. ⋯ Blood pH and HbA1c returned a negative correlation (correlation coefficient, -0.557; P = 0.005). The HbA1c level correlated positively with the 3 groups of DKA (correlation coefficient, 0.595; P = 0.01). A higher A 1c was associated with more severe DKA.
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Pediatric emergency care · Apr 2023
Clinical and Laboratory Characteristics Predicting the Severity of Carbon Monoxide Poisoning in Children: A Single-Center Retrospective Study.
Carbon monoxide poisoning (COP) is extremely common throughout the world. The purpose of this study was to assess the demographic, clinical, and laboratory characteristics predicting the severity COP in children. ⋯ Carbon monoxide poisoning progressed more severely in children presented with neurological symptoms and have elevated red cell distribution width and mean platelet volume. Even in severe COP cases, satisfactory results have been obtained with early and appropriate treatment.
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Pediatric emergency care · Apr 2023
Case ReportsUltrasound-Guided Paravenous Saphenous Nerve Block for Lower Extremity Abscess Incision and Drainage in a Male Adolescent.
The use of ultrasound-guided regional anesthesia is growing as a modality for analgesia provision within the pediatric emergency department. We present a case in which a paravenous saphenous nerve block was used for anesthesia during incision and drainage of a lower extremity abscess. We further review the technique and literature concerning this straightforward and effective procedure.
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Pediatric emergency care · Apr 2023
The Use of Ketamine Sedation for the Treatment of Nail Bed Repairs in the Pediatric Emergency Department.
This study aimed to determine if sedation with ketamine is safe and effective for the treatment of nail bed injuries in the pediatric emergency department (PED). ⋯ We have demonstrated nail bed injury repair facilitated by sedation with ketamine to be safe, effective, and cost efficient in the PED. This management strategy, brought to the fore during the COVID-19 pandemic, should be adopted widely in PEDs.