Articles: emergency-department.
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Pediatric emergency care · Mar 2014
ReviewThe use of alternate light sources in the clinical evaluation of child abuse and sexual assault.
Alternate light sources are devices that produce visible and invisible light at specific wavelengths to allow for enhanced visualization of fluorescent substances. These devices (which include Wood's lamp and blue light) are often used in forensics for evidence collection and can be quite useful to physicians in the medical evaluation of suspected physical or sexual assault. An understanding of the proper applications, as well as the limitations, of each alternate light source is imperative to correctly performing and interpreting medical evaluations in the emergency department. This review discusses the evidence from prospective trials in children and adults on the ability of specific alternate light sources to identify evidence of physical or sexual assault and also highlights some promising new technological adjuncts to alternate light sources that may allow for accurate dating of bruising.
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Observational Study
Addition of a lateral view improves adequate visualization of the abdominal aorta during clinician performed ultrasound.
Full visualization of the abdominal aorta using the standard midline view is often inadequate for the detection of abdominal aortic aneurysm. We evaluated whether the addition of a lateral midaxillary right upper quadrant view could improve visualization of the abdominal aorta. ⋯ Combining a lateral view to the standard midline approach improves adequate visualization of the abdominal aorta by approximately 28%. Further study is required to determine if the lateral view is equivalent for detecting abdominal aortic aneurysm.
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Pediatric emergency care · Mar 2014
Diagnostic findings in infants presenting to a pediatric emergency department for lethargy or feeding complaints.
Lethargy is a common complaint among infants in the pediatric emergency department (ED), yet there is little data to guide appropriate evaluation. The objectives of the study were (1) to determine the frequency of diagnoses requiring intervention/monitoring and (2) to identify predictors of these diagnoses. ⋯ Infants with lethargy or poor feeding who require an intervention are likely to have conditions that are clinically evident or focal examination findings that lead to the diagnosis. Well-appearing infants with normal findings in examinations are unlikely to have a condition requiring intervention and should receive minimal testing.
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Fever can be treated with a higher priority than pain in the pediatric emergency department (ED) population. ⋯ Fever is treated more promptly than pain in the pediatric ED. This difference is associated with prevailing and largely unfounded concerns about fever and the undertreatment of pain (oligoanalgesia).