Pediatric Emergency Medicine Reports
RSSArticles
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Sexually Transmitted Infections in Adolescents
Unfortunately, adolescents are at increased risk for sexually transmitted infections secondary to high-risk sexual behavior, victims of commercial sexual exploitation, or sexual experimentation. The consequences can be devastating in the long term. Clinicians must maintain a high degree of suspicion and sensitivity (since most teenagers are reluctant to seek medical care and may not share all the information the clinician needs) to make this diagnosis, minimize complications, and optimize outcome for this vulnerable population.
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Infantile Vomiting
Every viral season, something gets missed. All vomiting is not acute gastroenteritis! The clinician needs to have a thorough understanding of the process of vomiting to formulate a complete differential accurately and in a timely manner. A complete history, physical exam, and targeted diagnostic testing are used to ensure an accurate diagnosis with effective management is instituted.
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Pediatric Syncope: Current Status of Diagnostic Evaluation and Management
Children may present to the emergency department with a potential syncopal event. Although the presentation is unusual, everyone fears missing a cardiac issue. The authors present a concise review, focusing on the history, physical exam, and ECG, of how to evaluate and manage a child with syncope, differentiating other mimics and discussing the current therapeutic approach to the most common diagnosis.
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Pediatric Oncology
Many emergency department (ED) visits for children are driven by parental fears of serious illness, including concerns that a child may have cancer. Some presenting symptoms are high-risk and require serious inquiry, while others are less concerning and may be managed by reassurance alone. Additionally, children with established cancer diagnoses may present to the ED with complications of their cancer, an unexpected recurrence after a period of remission, or issues related to treatment. The authors review the presentations for the most common pediatric cancers and the complications associated with pediatric cancers and their treatment.
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Pediatric Pain Management in the Emergency Department
Pain management in the pediatric population has long been a focus of healthcare providers; nevertheless, gaps in providing adequate and timely pain management remain an area of concern in EDs. This article will provide guidance for the recognition and successful management of pediatric pain in the ED setting. The authors first present definitions of pain and discuss the assessment of pain in a child, as well as common barriers to appropriate pediatric pain management in the ED. Then, the article will focus on the different aspects of pain and techniques of managing discomfort, including: anxiolysis, non-pharmacological strategies, topical medications, oral analgesics, parenteral medications, discharge medications, and misconceptions and facts about opioid analgesics. Pain control in conjunction with procedural sedation is beyond the scope of this article.
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Pediatric Procedural Sedation
Procedural sedation is a critical skill to facilitate the performance of necessary diagnostic and therapeutic procedures in children. The clinician must have knowledge of the preparatory steps, indications, pharmacologic agents, monitoring, and recovery phase to safely and effectively perform this necessary adjunct to many common procedures. The authors review steps, current recommendations, and options to utilize procedural sedation skillfully in children. In addition, they present guidelines for managing adverse events that may be associated with the administration of procedural sedation.
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Common Pediatric Upper Extremity Overuse Injuries
Pediatric overuse injuries are becoming very common as the intensity of athletic competition extends to our younger population. Acute care providers must include these injuries in their differential as they listen to and examine young athletes. Identification and coordination of care with a sports medicine expert will optimize the long-term outcomes for these children.
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Assessment of Tetanus Risk in the Pediatric Emergency Department
Tetanus is a life-threatening, preventable disease. It is most commonly acquired from a wound site; however, it can be obtained via injuries of other tissues. Both primary and secondary measures of prevention contribute to the eradication of tetanus. Therefore, appropriate tetanus prophylaxis should be administered in a timely fashion when patients present with wounds or infected tissue. Because tetanus prevention can be so effective, it is imperative to review, document, and address any tetanus deficiencies.
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An Approach to Household Toxicological Emergencies in the Pediatric Patient
Patients with toxic ingestions most often will present to the emergency department as either a well-appearing patient with a known ingestion or as an ill-appearing patient with an unknown or suspected ingestion. This article will present the approach to both of these circumstances, discussing treatment and monitoring of specific overdoses as well as the initial approach to an ill child with a suspected overdose. The focus will be on common and accidental ingestions of toxins by pediatric patients.
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Pediatric Sports-Related Injuries of the Lower Extremity: Ankle
Pediatric lower extremity injuries are common in the emergency department, especially with increasing sports specialization in young athletes. Acute care providers need to be familiar with common injury patterns, indications for radiographs, and more specialized imaging. Recognizing and maintaining a high degree of suspicion for high-morbidity injuries that may masquerade as an ankle sprain is critical. The authors review common injuries and also injuries that cannot be missed including Maisonneuve fracture, talar fractures, navicular fractures, Jones or pseudo-Jones fractures, Lisfranc injuries, and Salter-Harris fractures.