Pediatric emergency care
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To clarify the epidemiology of adolescent suicide, a retrospective study was undertaken of suicides (1978 to 1982) and hospitalized suicide attempts (1979 to 1983) by adolescents aged 10 to 19 years in an affluent suburban area. Data included date of injury, demography (for both suicides and suicide attempts), and recorded personal and social history (available for attempts only). There were 11 deaths due to suicide (definite or possible) in the five years reviewed: seven male, 10 aged 15 to 19 years. ⋯ The mean annual suicide attempt rate was approximately 140 per 100,000 for 15 to 19 year olds, and 45 per 100,000 for 10 to 14 year olds, with female rates exceeding male rates. There was an association between suicide attempt dates and occurrence of holidays, and there was a peak in attempts at the end of the school year. Detailed analysis of personal and social attributes associated with suicide attempts was prevented by poor recording of relevant factors in the medical record.(ABSTRACT TRUNCATED AT 250 WORDS)
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Pediatric emergency care · Dec 1987
Review Case ReportsNear-fatal caffeine intoxication treated with peritoneal dialysis.
Caffeine is generally regarded as a safe drug, as evidenced by its wide availability in "over-the-counter" preparations and beverages. However, it is capable of producing a lethal outcome in cases of intoxication. ⋯ Previous cases of caffeine intoxication meriting hospital care or resulting in death which have been reported in the English language medical literature are summarized. It is suggested that drug-drug interactions and the use of peritoneal dialysis and hemoperfusion be given particular consideration in such patients.
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Lacerations are common in emergency departments. A review of pediatric patients was carried out to determine the infection rate. During a three-month period, from August to October, 415 patients were prospectively evaluated to determine the occurrence of infections in sutured lacerations. ⋯ Falls accounted for 61% of the injuries. The infection rate in children is less than that in adults. However, large lacerations in the lower extremities are at greater risk.
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Pediatric emergency care · Dec 1987
Review Case ReportsGarlic burns: a naturopathic remedy gone awry.
We report the case of a child who sustained partial thickness burns from a garlic-petroleum jelly plaster, which had been applied at the direction of a naturopathic physician. A review of the literature reveals that "garlic burns" have not previously been reported, although medicinal properties of garlic have been investigated by physicians and biochemists. The pediatrician caring for children in an area where naturopathic medicine is routinely practiced should be aware of the potential side effects of plasters, poultices, and other "natural" remedies in children.
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A study was undertaken in order to identify factors correlated with the outcome of pediatric cardiopulmonary resuscitation (CPR). A total of 35 children who experienced a total of 41 cardiopulmonary arrests were included. Sixteen of 41 patients (39%) could not be resuscitated; 16/41 (39%) were resuscitated temporarily but did not survive to discharge; 9/41 (22%) survived to discharge. ⋯ A statistically significant difference in outcome was also demonstrated between patients with an initial arterial blood pH greater than 7.0 and those with an initial arterial blood pH less than 7.0 (P less than 0.05). We conclude that an initial arterial blood pH less than 7.0 predicts a poor outcome from cardiopulmonary arrest in children. Access to early basic CPR may improve the initial pH and the ability of the patient to be resuscitated.