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Although diabetes mellitus is second only to asthma as the most prevalent chronic disease of childhood, the literature has very few comprehensive reviews of diabetic ketoacidosis (DKA), the most frequent cause of death in children with diabetes. The importance of an early diagnosis and appropriate management should not be underestimated. The authors provide a focused review for the ED physician for recognition and management of a child with DKA, with special attention to potentially serious complications.
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The authors review the classic course of common pediatric diseases associated with rashes, including varicella-zoster virus, herpes simplex virus (HSV), roseola, and rubella. Understanding the classic patterns, disease progression, high-risk populations, and potential complications allow the ED physician to avoid unnecessary testing in low-risk patients with a classic presentation, and aggressively approach potentially significant rashes in high-risk populations (e.g., neonatal HSV). This article also is designed to increase ED physicians awareness of treatment strategies associated with common viral exanthems.
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Although headache is a common symptom in children and adolescents, only a very small percentage of patients present to the emergency department for evaluation of this complaint. The majority of these headaches are benign and are either primary, such as migraine or tension-type headaches, or secondary to a viral etiology. Parents and children themselves are most concerned about the possibility of a brain tumor, whereas ED physicians are also on the alert for carbon monoxide toxicity, subarachnoid hemorrhage, meningitis, and increased intracranial pressure. The authors review the causes, diagnostic testing, and treatment of the common headache, as well as some unusual causes of non-traumatic headache.
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This article begins by reviewing the existing literature describing the epidemiology of rapid sequence intubation (RSI) in children as well as its affect on survival. The pertinent aspects of pediatric anatomy and physiology are reviewed. Finally, the various components of RSI in children including equipment, techniques, medications, and rescue devices are discussed.
