Pediatric emergency care
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Pediatric emergency care · Dec 1990
Case ReportsPott's puffy tumor: a complication of frontal sinusitis.
In children sinusitis is a frequent complication of upper respiratory infections but an infrequently considered diagnosis. Although most sinus infections are resolved without complications, when complications do occur they can be serious or life threatening. ⋯ This paper describes two patients with subperiosteal abscess resulting from frontal sinusitis, one with CNS and orbital extension. A brief literature review is presented, and presentation, diagnosis, and treatment are discussed.
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Pediatric emergency care · Dec 1990
Case ReportsPresentation and management of an acute caffeine overdose.
A one-year-old white female ingested approximately two to three grams of caffeine (200-300 mg/kg). The patient survived the ingestion with a maximum caffeine concentration of 385 micrograms/ml four hours postingestion. The child developed ventricular arrhythmias, seizures, metabolic disturbances, and severe pulmonary edema. She survived without apparent long-term sequelae despite having reached a serum caffeine concentration that is the second highest reported level in a survivor.
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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.
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Pediatric emergency care · Sep 1990
Rapid intravenous rehydration in the pediatric emergency department.
Children suffering from mild to moderate (3 to 6%) dehydration likely caused by viral gastroenteritis are often hospitalized because they are unable to tolerate oral fluids. We studied 17 such children, aged one to six years, who were otherwise healthy. All had isonatremic dehydration and were treated with 30 ml/kg of 3.3% dextrose and 0.3% saline over a period of three hours in the emergency department before being discharged. ⋯ Only one patient required another course of rapid intravenous rehydration and subsequently improved without hospitalization. Although all our patients experienced vomiting before treatment, 65% had no vomiting after treatment. Rapid intravenous rehydration is an effective treatment, for children with mild to moderate dehydration secondary to presumed viral gastroenteritis, that obviates the need for hospitalization.