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The recognition of non-accidental injury is critical for a pediatric
trauma patient. In the year 2000, almost 3 million reports of child
abuse were made to social service agencies. Forty-four percent of the
fatalities were children younger than 1 year of age. Not only are these
statistics alarming, but they point out the need for emergency
department and trauma physicians and nurses to recognize non-accidental
injury and aggressively protect the children who seek our medical
expertise and protection.
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Burn injuries account for half a million visits to the emergency department each year and present numerous challenges in management. The spectrum of burn injuries is immense, ranging from simple first-degree burns with no sequela to third-degree burns with hypermetabolic response. In addition, pediatric patients add unique challenges to providing optimal care.
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The critically ill or injured child presents both a diagnostic and therapeutic challenge to any Emergency Department. Vascular access, airway management, fluid therapy, invasive procedures and medication selection all must be coordinated and delivered in a time-sensitive manner.
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Pediatric head trauma is a common presenting complaint to the emergency department (ED) and is a major cause of pediatric death and disability. This article will address the epidemiology, pathophysiology, diagnosis, and management of moderate to severe pediatric traumatic brain injury (TBI), with a focus on strategies to improve outcome.
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Although lower extremity fractures are much less common than upper extremity fractures in children, the correct diagnosis and management of this type of injury is critical. In the second part of this series the authors review common lower extremity fractures, fractures common in abused children and the diagnosis and treatment of radial head subluxation. Children are much more likely to sustain fractures rather than ligamentous injuries and identification of injuries and timely management will maximize an optimal outcome. Awareness of certain unique pediatric fractures such as the triplane juvenile fracture and the juvenile Tillaux fracture will allow for prompt treatment and referral. The authors also provide a table encompassing guidelines for ED management and treatment of common pediatric orthopedic injuries.
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>Pediatric fractures are commonly encountered in the emergency department (ED). Approximately 50% of children will fracture a bone during childhood. The unique injury patterns, especially those involving the physis, require that clinicians have a complete and thorough understanding of appropriate diagnostic and management strategies to maximize a child's potential for an optimal outcome.
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Hypoglycemia is the most common metabolic disorder in children.
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Health care clinicians and organizations likely will find that the new health care reform bill's positive features outweigh its drawbacks, experts say.
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