Pediatric emergency care
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Acute pancreatitis in childhood is not a rare condition, and it should be considered in all children presenting with acute abdominal complaints. A complete history should be obtained, with emphasis on recent trauma or infection, current medications, and the presence of any chronic diseases. ⋯ Appropriate aggressive treatment, instituted early, will help to reduce the associated morbidity and mortality. Most children with acute pancreatitis will recover with conservative management and suffer no significant long-term sequelae.
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In summary, the emergency department or office-based physician should distinguish first between inflammation and injury. A clinical diagnosis of fracture should be made before obtaining and reading films. ⋯ A neurologic examination should be documented before undertaking reduction. Finally, if in doubt, a splint for 24 to 48 hours until an orthopedic opinion is available causes no harm.
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Pediatric emergency care · Sep 1990
ReviewRapid sequence anesthesia induction for emergency intubation.
Emergency intubations are done for a variety of reasons in the emergency department (ED). In some patients, a rapid, controlled induction of anesthesia is useful to facilitate intubation and to reduce the complications of intubation. This is referred to a rapid sequence induction (RSI) in the anesthesia literature. ⋯ We feel that a sedative in combination with vecuronium represents the most optimal means of achieving RSI in the ED setting. Although the induction of general anesthesia is best done by anesthesiologists, emergency physicians are often the most experienced physicians immediately available to manage an airway in a critical emergency. An objective protocol such as that described will make it easier for emergency physicians to perform this procedure when needed.