Pediatric emergency care
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Pediatric emergency care · Mar 1989
Case ReportsNear-miss asphyxiation from a toy ball: a small parts failure.
The case report of a near-fatal asphyxiation of an 11-month-old child by a 26 mm (diameter) toy ball is presented. The lack of compliance with existing Consumer Product Safety Commission standards for small parts is discussed, and a recommendation is made regarding the coloring of ingestible objects.
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Pediatric emergency care · Mar 1989
Case ReportsNormal pulmonary function after baby powder inhalation causing adult respiratory distress syndrome.
We report a case of baby powder inhalation (BPI), causing adult respiratory distress syndrome (ARDS) in a 16-month-old girl, with follow-up after six years. Pulmonary function studies in the child and her monozygotic twin, used as a control, were normal. ⋯ A review of the literature of talcum aspiration indicates that the management of this condition is largely supportive. The long-term effects of BPI remain unknown, since serial follow-up studies are not available.
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The ability to obtain an arterial blood gas analysis within a few minutes in most medical facilities enables the clinician to rapidly evaluate the acid-base status of his or her critically ill patients and to treat disorders as they appear. Although acid-base charts, graphs, and nomograms are available and can help to establish a diagnosis of acid-base disorders, the common practice is that most emergency and critical care clinicians tend to interpret acid-base data rapidly, usually without using any of these tools. The intent of this discussion is to provide the clinician with the pathophysiologic background of acid-base imbalance, the diagnostic criteria for acid-base disturbances, and the clinical approach to management. The standard arterial blood gas analysis, serum and urine electrolytes, and clinical assessment of the alveolar ventilation are the only data upon which this discussion is based.
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A retrospective chart review of 102 consecutive cases of gunshot wound injuries in children was conducted. Victims were identified by emergency department log review and computer search for inpatient discharge diagnoses. Results are compared with other studies. ⋯ Nonpowder weapons were found to have inflicted major injury in as many patients as did handguns. Methodologic problems of studying gunshot wounds in children are discussed. It is suggested that injury prevention strategies address nonpowder weapons as well as handguns.