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Abdominal pain in childhood is a common presentation to the emergency department (ED). While most cases are benign, they frequently create a diagnostic dilemma. The spectrum of disease varies widely from neonates to infants, children, and adolescents, and requires the clinician to rapidly differentiate between a benign medical diagnosis versus a potential surgical abdomen to minimize morbidity and mortality.
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Procedural sedation is an important tool for the emergency department physician, especially when faced with a child who requires a painful procedure. The ability to adequately address the pain and anxiety of the child and safely complete the procedure is rewarding to both the physician and the family of the child.
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Bronchiolitis is the most common lower respiratory tract disease in infants, and respiratory syncytial virus (RSV) bronchiolitis is the leading cause of hospitalization in infants.
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The child with an inborn error of metabolism often cannot be easily identified. Nonspecific symptoms and relative infrequent occurrence make diagnosis difficult and can lead to potential delays in both recognition and treatment.
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The successful repair of congenital heart diseases has led to an increase in the incidence of pediatric dysrhythmias. The presentation of dysrhythmias can be a diagnostic challenge to clinicians, and is especially difficult since most children present with vague and nonspecific symptoms such as "fussiness" or "difficulty feeding."
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Injuries of the wrist and elbow in children are frequently seen in the emergency department (ED), and as children and adolescents are participating in sports in record numbers, the frequency of these injuries is continuing to rise. Sports injuries in children and adolescents are by far the most common cause of musculoskeletal injuries treated in the ED, accounting for 41% of all musculoskeletal injuries.
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With the increasing skill of our NICUs in saving extremely premature babies and the capability of rescuing children with acute illnesses and injuries in our PICUs, children with special healthcare needs are being discharged from tertiary centers and returning to their home communities.
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The incidence of back pain in children is directly proportional to the age of the child, with back pain an unusual complaint in children younger than age 6. There is a steady increase in incidence, with adolescents having the highest rates of back pain by the time they are age 18. Approximately 60% of adults experience significant back pain in their lifetimes.
