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Pediatric Emergency Medicine Practice

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https://www.readbyqxmd.com/read/28742305/pediatric-heat-related-illness-recommendations-for-prevention-and-management
#1
Roberta J. Dunn, Tommy Y. Kim
Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air)...
August 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28742308/nonaccidental-injury-in-pediatric-patients-detection-evaluation-and-treatment-digest
#2
Gunjan Tiyyagura, Meghan Beucher, Kirsten Bechtel, Kathryn H Pade
Emergency clinicians are likely to encounter physical abuse in children, and they must be prepared to recognize its many manifestations and take swift action. Pediatric nonaccidental injury causes considerable morbidity and mortality that can often be prevented by early recognition. Nonaccidental injuries present with a wide array of symptoms that may appear to be medically inconsequential (such as bruising in a premobile infant), but are actually sentinel injuries indicative of child abuse. This issue provides guidance regarding factors that contribute to abuse in children, key findings on history and physical examination that should trigger an evaluation for physical abuse, and laboratory and radiologic tests to perform when child abuse is suspected...
July 21, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28665574/nonaccidental-injury-in-pediatric-patients-detection-evaluation-and-treatment
#3
Gunjan Tiyyagura, Meghan Beucher, Kirsten Bechtel
Emergency clinicians are likely to encounter physical abuse in children, and they must be prepared to recognize its many manifestations and take swift action. Pediatric nonaccidental injury causes considerable morbidity and mortality that can often be prevented by early recognition. Nonaccidental injuries present with a wide array of symptoms that may appear to be medically inconsequential (such as bruising in a premobile infant), but are actually sentinel injuries indicative of child abuse. This issue provides guidance regarding factors that contribute to abuse in children, key findings on history and physical examination that should trigger an evaluation for physical abuse, and laboratory and radiologic tests to perform when child abuse is suspected...
July 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745852/vascular-access-in-pediatric-patients-in-the-emergency-department-types-of-access-indications-and-complications-digest
#4
Rachel Whitney, Melissa Langhan, Kathryn H Pade
Vascular access is a potentially life-saving procedure that is a mainstay of emergency medicine practice. There are a number of challenges associated with obtaining and maintaining vascular access, and the choice of the route of access and equipment used will depend on patient- and provider-specific factors. In this issue, the indications and complications of peripheral intravenous access, intraosseous access, and central venous access are reviewed. Timely and effective assessment and management of difficult-access patients, pain control techniques that can assist vascular access, and contraindications to each type of vascular access are also discussed...
June 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28562239/vascular-access-in-pediatric-patients-in-the-emergency-department-types-of-access-indications-and-complications
#5
REVIEW
Rachel Whitney, Melissa Langhan
Vascular access is a potentially life-saving procedure that is a mainstay of emergency medicine practice. There are a number of challenges associated with obtaining and maintaining vascular access, and the choice of the route of access and equipment used will depend on patient- and provider-specific factors. In this issue, the indications and complications of peripheral intravenous access, intraosseous access, and central venous access are reviewed. Timely and effective assessment and management of difficult-access patients, pain control techniques that can assist vascular access, and contraindications to each type of vascular access are also discussed...
June 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28749627/acute-kidney-injury-in-pediatric-patients-diagnosis-and-management-in-the-emergency-department-digest
#6
Daniel Mohrer, Melissa Langhan, Pradip Chaudhari
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children...
May 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28447934/acute-kidney-injury-in-pediatric-patients-diagnosis-and-management-in-the-emergency-department
#7
REVIEW
Daniel Mohrer, Melissa Langhan
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children...
May 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28749111/syncope-in-pediatric-patients-a-practical-approach-to-differential-diagnosis-and-management-in-the-emergency-department-digest
#8
Colleen Fant, Ari Cohen, Michelle N Vazquez
Syncope is a condition that is often seen in the emergency department. Most syncope is benign, but it can be a symptom of a life-threatening condition. While syncope often requires an extensive workup in adults, in the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes. For low-risk patients, resource-intensive workups are rarely diagnostic, and add significant cost to medical care. This issue will highlight critical diseases that cause syncope, identify high-risk "red flags," and enable the emergency clinician to develop a cost-effective, minimally invasive algorithm for the diagnosis and treatment of pediatric syncope...
April 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28362251/syncope-in-pediatric-patients-a-practical-approach-to-differential-diagnosis-and-management-in-the-emergency-department
#9
Collen Fant, Arl Cohen
Syncope is a condition that is often seen in the emergency department. Most syncope is benign, but it can be a symptom of a life-threatening condition. While syncope often requires an extensive workup in adults, in the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes. For low-risk patients, resource-intensive workups are rarely diagnostic, and add significant cost to medical care. This issue will highlight critical diseases that cause syncope, identify high-risk "red flags," and enable the emergency clinician to develop a cost-effective, minimally invasive algorithm for the diagnosis and treatment of pediatric syncope...
April 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745853/pneumothorax-in-pediatric-patients-management-strategies-to-improve-patient-outcomes-digest
#10
Matthew Harris, Joshua Rocker, Kathryn H Pade
The clinical presentation of pneumothorax is highly variable. Spontaneous pneumothoraces may present with subtle symptoms when a small air leak is present, but can progress to hemodynamic instability in the setting of tension physiology. The etiologies are broad and the severity can vary greatly. A trauma patient with a pneumothorax may also have the added complexity of other potentially life-threatening injuries. While there is a wealth of evidence-based guidelines for the management of pneumothoraces in the adult literature, the approach to pediatric patients is largely extrapolated from that literature without a significant evidence base...
March 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28252382/pneumothorax-in-pediatric-patients-management-strategies-to-improve-patient-outcomes
#11
Matthew Harris, Joshua Rocker
The clinical presentation of pneumothorax is highly variable. Spontaneous pneumothoraces may present with subtle symptoms when a small air leak is present, but can progress to hemodynamic instability in the setting of tension physiology. The etiologies are broad and the severity can vary greatly. A trauma patient with a pneumothorax may also have the added complexity of other potentially life-threatening injuries. While there is a wealth of evidence-based guidelines for the management of pneumothoraces in the adult literature, the approach to pediatric patients is largely extrapolated from that literature without a significant evidence base...
March 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28749625/diphtheria-pertussis-and-tetanus-evidence-based-management-of-pediatric-patients-in-the-emergency-department-digest
#12
Lara Zibners, Pradip Chaudhari
Diphtheria, pertussis, and tetanus are potentially deadly bacterial infections that are largely preventable through vaccination, though they remain in the population. This issue reviews the epidemiology, pathophysiology, diagnosis, and current recommended emergency management of these conditions. Disease-specific medications, as well as treatment of the secondary complications, are examined in light of the best current evidence. Resources include obtaining diphtheria antitoxin from the United States Centers for Disease Control and Prevention and best-practice recommendations with regard to testing, involvement of government health agencies, isolation of the patient, and identification and treatment of close contacts...
February 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28749121/diphtheria-pertussis-and-tetanus-evidence-based-management-of-pediatric-patients-in-the-emergency-department
#13
Lara Zibners
Diphtheria, pertussis, and tetanus are potentially deadly bacterial infections that are largely preventable through vaccination, though they remain in the population. This issue reviews the epidemiology, pathophysiology, diagnosis, and current recommended emergency management of these conditions. Disease-specific medications, as well as treatment of the secondary complications, are examined in light of the best current evidence. Resources include obtaining diphtheria antitoxin from the United States Centers for Disease Control and Prevention and best-practice recommendations with regard to testing, involvement of government health agencies, isolation of the patient, and identification and treatment of close contacts...
February 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745857/altered-level-of-consciousness-evidence-based-management-in-the-emergency-department-digest
#14
Joo Lee Song, Vincent J Wang, Michelle N Vazquez
A child who presents to the emergency department with an altered level of consciousness can be clinically unstable and can pose a great diagnostic challenge. The emergency clinician must quickly develop a wide differential of possible etiologies in order to administer potentially life-saving medications or interventions. The history, physical examination, and appropriate diagnostic tests can aid greatly in rapidly narrowing the differential diagnosis. Once initial stabilization, workup, and first-line interventions are completed, most patients who present with unresolved or unidentified altered level of consciousness should be admitted for further evaluation and close monitoring...
January 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28027458/altered-level-of-consciousness-evidence-based-management-in-the-emergency-department
#15
REVIEW
Joo Lee Song, Vincent J Wang
A child who presents to the emergency department with an altered level of consciousness can be clinically unstable and can pose a great diagnostic challenge. The emergency clinician must quickly develop a wide differential of possible etiologies in order to administer potentially life-saving medications or interventions. The history, physical examination, and appropriate diagnostic tests can aid greatly in rapidly narrowing the differential diagnosis. Once initial stabilization, workup, and first-line interventions are completed, most patients who present with unresolved or unidentified altered level of consciousness should be admitted for further evaluation and close monitoring...
January 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745854/vaccine-preventable-diseases-in-pediatric-patients-a-review-of-measles-mumps-rubella-and-varicella-digest
#16
Deborah A Levine, Kathryn H Pade
Vaccine-preventable diseases such as measles, mumps, rubella, and varicella continue to plague children and adults worldwide. Although public health programs have helped decrease the prevalence and sequelae of these diseases, outbreaks still occur. To limit the spread of these diseases, emergency clinicians must be able to readily identify the characteristic presentations of the rashes associated with measles, rubella, and varicella, as well as the common presenting features associated with mumps. Diagnostic laboratory studies are not usually necessary, as a complete history and physical examination usually lead to an accurate diagnosis...
December 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/27893360/vaccine-preventable-diseases-in-pediatric-patients-a-review-of-measles-mumps-rubella-and-varicella
#17
REVIEW
Deborah A Levine
Vaccine-preventable diseases such as measles, mumps, rubella, and varicella continue to plague children and adults worldwide. Although public health programs have helped decrease the prevalence and sequelae of these diseases, outbreaks still occur. To limit the spread of these diseases, emergency clinicians must be able to readily identify the characteristic presentations of the rashes associated with measles, rubella, and varicella, as well as the common presenting features associated with mumps. Diagnostic laboratory studies are not usually necessary, as a complete history and physical examination usually lead to an accurate diagnosis...
December 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745855/managing-acute-complications-of-sickle-cell-disease-in-pediatric-patients-digest
#18
Sathyaseelan Subramaniam, Jennifer H Chao, Pradip Chaudhari
Sickle cell disease is a chronic hematologic disease with a variety of acute, and often recurring, complications. Vaso-occlusive crisis, a unique but common presentation in sickle cell disease, can be challenging to manage. Acute chest syndrome is the leading cause of death in patients with sickle cell disease, occurring in more than half of patients who are hospitalized with a vaso-occlusive crisis. Uncommon diagnoses in children, such as stroke, priapism, and transient red cell aplasia, occur more frequently in patients with sickle cell disease and necessitate a degree of familiarity with the disease process and its management...
November 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/27775898/managing-acute-complications-of-sickle-cell-disease-in-pediatric-patients
#19
REVIEW
Sathyaseelan Subramaniam, Jennifer H Chao
Sickle cell disease is a chronic hematologic disease with a variety of acute, and often recurring, complications. Vaso-occlusive crisis, a unique but common presentation in sickle cell disease, can be challenging to manage. Acute chest syndrome is the leading cause of death in patients with sickle cell disease, occurring in more than half of patients who are hospitalized with a vaso-occlusive crisis. Uncommon diagnoses in children, such as stroke, priapism, and transient red cell aplasia, occur more frequently in patients with sickle cell disease and necessitate a degree of familiarity with the disease process and its management...
November 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745856/severe-traumatic-brain-injury-in-children-an-evidence-based-review-of-emergency-department-management-digest
#20
Kirsten Morrissey, Hilary Fairbrother, Michelle N Vazquez
More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. Early identification and management of severe traumatic brain injury is crucial in decreasing the risk of secondary brain injury and optimizing outcome. The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes...
October 22, 2016: Pediatric Emergency Medicine Practice
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