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Pediatric Emergency Medicine Practice

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https://read.qxmd.com/read/30821950/points-pearls-pediatric-hypertension-and-hypertensive-emergencies-recognition-and-management-in-the-emergency-department
#1
Emily MacNeill, Kathryn H. Pade
Pediatric hypertension is increasing in incidence, but remains greatly underrecognized, despite its severe long-term health consequences. Often discovered as incidental to another complaint, pediatric patients with hypertension may be asymptomatic but with markedly abnormal blood pressure, or they may have a true hypertensive emergency. This issue provides strategies to ensure that the child with asymptomatic hypertension receives appropriate screening and referrals, and outlines a systematic approach for the evaluation and treatment of the critically ill child who presents with symptoms of severe hypertension...
March 1, 2019: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30794368/pediatric-hypertension-and-hypertensive-emergencies-recognition-and-management-in-the-emergency-department
#2
Emily MacNeill
Pediatric hypertension is increasing in incidence, but remains greatly underrecognized, despite its severe long-term health consequences. Often discovered as incidental to another complaint, pediatric patients with hypertension may be asymptomatic but with markedly abnormal blood pressure, or they may have a true hypertensive emergency. This issue provides strategies to ensure that the child with asymptomatic hypertension receives appropriate screening and referrals, and outlines a systematic approach for the evaluation and treatment of the critically ill child who presents with symptoms of severe hypertension...
March 2019: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30707537/points-pearls-identification-and-management-of-adolescent-gynecologic-emergencies-in-the-emergency-department
#3
Tatyana Vayngortin, Shruti Kant, Bryan Wilson
In the emergency department, gynecologic complaints are common presentations for adolescent girls, who may present with abdominal pain, pelvic pain, vaginal discharge, and vaginal bleeding. The differential diagnosis for these presentations is broad, and further complicated by psychosocial factors, confidentiality concerns, and the need to recognize abuse and sexual assault. This issue provides recommendations for the evaluation and management of obstetric and gynecologic emergencies including infectious, anatomic, and endocrine etiologies...
February 1, 2019: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30676713/identification-and-management-of-adolescent-gynecologic-emergencies-in-the-emergency-department
#4
Tatyana Vayngortin, Shruti Kant
In the emergency department, gynecologic complaints are common presentations for adolescent girls, who may present with abdominal pain, pelvic pain, vaginal discharge, and vaginal bleeding. The differential diagnosis for these presentations is broad, and further complicated by psychosocial factors, confidentiality concerns, and the need to recognize abuse and sexual assault. This issue provides recommendations for the evaluation and management of obstetric and gynecologic emergencies including infectious, anatomic, and endocrine etiologies...
February 2019: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30592591/points-pearls-management-of-pediatric-hypothermia-and-peripheral-cold-injuries-in-the-emergency-department
#5
Ashish Shah, Manu Madhok, Kathryn H. Pade
Hypothermia occurs when the core body temperature falls below 35ºC (95ºF) due to primary exposure (eg, environmental exposure) or secondary to other pathologies. Infants, children, and adolescents are at higher risk for primary cold injuries due to a combination of physiologic and cognitive factors, but quick rewarming and appropriate disposition can result in survival and improved neurological outcomes. Treatment for cold injuries is guided by severity and can include passive or active measures. This issue reviews the stages of hypothermia and offers recommendations for emergent management of pediatric patients with hypothermia; guidance is also provided for the identification and management of frostnip and frostbite...
January 1, 2019: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30570249/management-of-pediatric-hypothermia-and-peripheral-cold-injuries-in-the-emergency-department
#6
Ashish Shah, Manu Madhok
Hypothermia occurs when the core body temperature falls below 35ºC (95ºF) due to primary exposure (eg, environmental exposure) or secondary to other pathologies. Infants, children, and adolescents are at higher risk for primary cold injuries due to a combination of physiologic and cognitive factors, but quick rewarming and appropriate disposition can result in survival and improved neurological outcomes. Treatment for cold injuries is guided by severity and can include passive or active measures. This issue reviews the stages of hypothermia and offers recommendations for emergent management of pediatric patients with hypothermia; guidance is also provided for the identification and management of frostnip and frostbite...
January 2019: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30525348/points-pearls-bioterrorism-attacks-involving-pediatric-patients-preparedness-and-early-recognition-are-critical
#7
Joelle N Simpson, Bryan Wilson
Due to their anatomic, physiologic, developmental, and behavioral characteristics, children are particularly vulnerable to bioterrorism agents. Symptoms associated with most bioterrorism agents can be difficult to differentiate from common childhood illnesses. It is extremely important that emergency clinicians are able to recognize unusual illness patterns that could distinguish a natural outbreak from a bioterrorism attack. Resources available through government agencies and leading pediatric organizations can aid in diagnosis and treatment...
December 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30476431/bioterrorism-attacks-involving-pediatric-patients-preparedness-and-early-recognition-are-critical
#8
Joelle N Simpson
Due to their anatomic, physiologic, developmental, and behavioral characteristics, children are particularly vulnerable to bioterrorism agents. Symptoms associated with most bioterrorism agents can be difficult to differentiate from common childhood illnesses. It is extremely important that emergency clinicians are able to recognize unusual illness patterns that could distinguish a natural outbreak from a bioterrorism attack. Resources available through government agencies and leading pediatric organizations can aid in diagnosis and treatment...
December 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30383347/points-pearls-pediatric-bacterial-meningitis-an-update-on-early-identification-and-management
#9
Emerson Posadas, Jay Fisher, Kathryn Pade
The presentation of bacterial meningitis can overlap with viral meningitis and other conditions, and emergency clinicians must remain vigilant to avoid delaying treatment for a child with bacterial meningitis. Inflammatory markers, such as procalcitonin, in the serum and cerebrospinal fluid may help distinguish between bacterial meningitis and viral meningitis. Appropriate early antibiotic treatment and management for bacterial meningitis is critical for optimal outcomes. Although debated, corticosteroids should be considered in certain cases...
November 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30383346/calculated-decisions-bacterial-meningitis-score-for-children
#10
Cullen Clark
The bacterial meningitis score for children rules out bacterial meningitis in pediatric patients with suspected meningitis.
November 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30358380/pediatric-bacterial-meningitis-an-update-on-early-identification-and-management
#11
Emerson Posadas, Jay Fisher
The presentation of bacterial meningitis can overlap with viral meningitis and other conditions, and emergency clinicians must remain vigilant to avoid delaying treatment for a child with bacterial meningitis. Inflammatory markers, such as procalcitonin, in the serum and cerebrospinal fluid may help distinguish between bacterial meningitis and viral meningitis. Appropriate early antibiotic treatment and management for bacterial meningitis is critical for optimal outcomes. Although debated, corticosteroids should be considered in certain cases...
November 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30280870/points-pearls-diagnosing-and-managing-common-genital-emergencies-in-pediatric-girls
#12
Michelle K. Arzubi-Hughes, Laila A. Salts, Melanie A. Weller, Bryan Wilson
The presentation of genital injuries and emergencies in pediatric girls can sometimes be misleading. A traumatic injury with excessive bleeding may be a straddle injury that requires only conservative management, while a penetrating injury may have no recognizable signs or symptoms but require extensive surgery. This issue reviews the most common traumatic genital injuries in girls presenting to the emergency department, including straddle injuries, hematomas, and impalement injuries. Nontraumatic emergencies, including hematocolpos and urethral prolapse, are also discussed...
October 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30251816/diagnosing-and-managing-common-genital-emergencies-in-pediatric-girls
#13
Michelle K Arzubi-Hughes, Laila A Salts, Melanie A Weller
The presentation of genital injuries and emergencies in pediatric girls can sometimes be misleading. A traumatic injury with excessive bleeding may be a straddle injury that requires only conservative management, while a penetrating injury may have no recognizable signs or symptoms but require extensive surgery. This issue reviews the most common traumatic genital injuries in girls presenting to the emergency department, including straddle injuries, hematomas, and impalement injuries. Nontraumatic emergencies, including hematocolpos and urethral prolapse, are also discussed...
October 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30183415/calculated-decisions-wound-closure-classification
#14
Jennie Kim, Ronald Simon
The Wound Closure Classification stratifies types of wounds to help guide strategies for closure.
September 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30183241/calculated-decisions-ottawa-knee-rule
#15
Calvin Hwang
The Ottawa Knee Rule describes criteria for knee trauma patients who are at low risk for clinically significant fracture and do not warrant knee imaging.
September 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30183240/calculated-decisions-ottawa-ankle-rule
#16
Calvin Hwang
The Ottawa Ankle Rule shows the areas of tenderness to be evaluated in ankle trauma patients to determine the need for imaging.
September 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30179415/points-pearls-tick-borne-illnesses-identification-and-management-in-the-emergency-department
#17
Jennifer Bellis, Ee Tein Tay, Bryan Wilson
Tick-borne illnesses are increasing in prevalence and geographic reach. Because the presentation of these illnesses is sometimes nonspecific, they can often be misdiagnosed, especially in the early stages of illness. A detailed history with questions involving recent activities and travel and a thorough physical examination will help narrow the diagnosis. While some illnesses can be diagnosed on clinical findings alone, others require confirmatory testing, which may take days to weeks to result. This issue reviews the emergency department presentation of 9 common tick-borne illnesses and evidence-based recommendations for identification, testing, and treatment...
September 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30179409/calculated-decisions-rule-of-7s-for-lyme-meningitis
#18
REVIEW
Matthew Lecuyer
The Rule of 7s for Lyme Meningitis is a validated clinical prediction rule to distinguish Lyme meningitis from aseptic meningitis.
September 1, 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30130011/tick-borne-illnesses-identification-and-management-in-the-emergency-department
#19
REVIEW
Jennifer Bellis, Ee Tein Tay
Tick-borne illnesses are increasing in prevalence and geographic reach. Because the presentation of these illnesses is sometimes nonspecific, they can often be misdiagnosed, especially in the early stages of illness. A detailed history with questions involving recent activities and travel and a thorough physical examination will help narrow the diagnosis. While some illnesses can be diagnosed on clinical findings alone, others require confirmatory testing, which may take days to weeks to result. This issue reviews the emergency department presentation of 9 common tick-borne illnesses and evidence-based recommendations for identification, testing, and treatment...
September 2018: Pediatric Emergency Medicine Practice
https://read.qxmd.com/read/30070815/points-pearls-emergency-department-management-of-dental-trauma-recommendations-for-improved-outcomes-in-pediatric-patients
#20
Joyce Li, Kathryn Pade
Nearly 50% of children will experience dental trauma by the age of 4 years. Timely and effective care is important in the management of dental injuries, as several studies have shown poor outcomes with delayed treatment. The current evidence in the management of dental injuries is primarily from a dentist's perspective, with limited evidence specific to management in the emergency department. The goal of pediatric dental injury management is dictated largely by whether the dentition is primary or permanent...
August 1, 2018: Pediatric Emergency Medicine Practice
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