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Since 1996, at least 150 children have died as a result of being trapped in hot, parked vehicles. Contrary to what would be expected, these deaths occurred throughout all regions of the United States, making it important for all emergency medicine physicians to be familiar with the resuscitation of a child with a heat-related illness. This article provides an overview of heat-related illnesses in children and prevention and management strategies to facilitate care.
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Whether a bite or sting results in an anaphylactic reaction, impressive
local effects, or a life-threatening systemic reaction, the emergency
physician must be able to institute appropriate and effective
treatment. Emergency physicians also must be able to recognize clinical
envenomation patterns, since some critically ill patients may not be
able to convey the details of the attack. Since all areas of the
country are represented in the envenomation statistics, all emergency
physicians should be familiar with identification and stabilization of
envenomated patients and know what resources are available locally for
further management of these often complicated patients.
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The emergency department physician can be an advocate for the appropriate use of antibiotics in children by becoming familiar with the pathogenesis of common ENT infections and the latest treatment guidelines for some of these entities. This article reviews common ENT infections, diagnostic criteria, and treatment options.
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The diagnosis of genitourinary pathology may be challenging, especially in a busy emergency department. It is important in any infant with a complaint of fussiness, vomiting, or not acting right to undo the diaper and do a careful assessment of the genitalia. It is easy to miss a hernia or testicular torsion if an infant is not fully examined. Identification of children with a potential for underlying pathology is also essential.
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This article, the second of two parts, deals with the potentially
disastrous situation in which either the patients airway presents a
substantial challenge or standard intubation methods have failed.
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Bronchiolitis is an acute lower respiratory tract infection caused by a virus, resulting in small airway obstruction. Although some classic symptomswheezing, hypoxia, and hyperinflationtypically are associated with bronchiolitis, many young infants may not have wheezing as part of their initial presentation.
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The appearance of epileptic activity and etiologies of seizures vary with age. Anticonvulsant drug therapy optimally should stop seizure activity and prevent further brain injury that may later manifest as repeat spontaneous seizures or other neurodevelopmental injury. Since not all types of recurrent or persistent seizure activity are known to cause brain injury, the decision to treat must be individualized. Knowledgeable parents of children with known underlying disease and their pediatric neurologists can provide valuable information that can be integral in management decisions.
