Pediatric Emergency Medicine Reports
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Pediatric Abdominal Ultrasound: A Comprehensive Guide to Making the Diagnosis — Part I
Ultrasound is rapidly evolving as the ideal imaging modality for many common pediatric complaints. This two-part series reviews the select applications of ultrasound, reviewing the basic techniques, indications, and limitations for each exam.
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Cervical Spinal Injury
Although spinal injuries are uncommon, they should be considered when children have sustained head or neck trauma or multiple severe injuries. Children with severe or multisystem trauma are more likely to suffer a spinal injury. Thus, emergency department providers should have a lower threshold to immobilize and image such patients to prevent morbidity and mortality. This article reviews the most common pediatric spinal fractures and injuries and optimal management practices.
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Infectious Meningitis: A Focused Review
The effectiveness of the current vaccine schedule has led to a significant decline in the incidence of bacterial meningitis. Delays in recognition and antibiotic administration result in increased morbidity and mortality; therefore, clinicians must maintain a high degree of vigilance for the subtle findings of meningitis, particularly in infants. Current standards for selective imaging, diagnostic testing, and empiric antibiotics are discussed.
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Respiratory Distress in Pediatric Patients
Respiratory diseases are common in pediatrics, and providers need to have an in-depth knowledge of the presentation, diagnostic approach, and therapeutic options to optimize outcomes.
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Orofacial, Eye, and Ear Trauma
Facial trauma is uncommon in children. However, the unique features of these injuries, as well as the assessment and management considerations to minimize radiation exposure and ensure optimal cosmetic outcome, require an awareness of the diagnostic and therapeutic approach in pediatric patients. The authors provide an overview of orofacial, eye, and ear trauma in children.
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Pediatric Sepsis and Septic Shock
Pediatric sepsis is a high-stakes diagnosis that requires vigilance to make an early, timely diagnosis. Aggressive resuscitation, including fluids, antibiotics, and vasoactive agents, may be necessary. Rapidly changing standard of care also makes sepsis a critical diagnosis for clinicians.
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Soft Tissue Disorders of the Neck in Children
Pediatric patients frequently present to the emergency department with issues affecting the soft tissues of the neck. This article will focus on the assessment, evaluation, differential, and treatment of both superficial and deep neck soft tissue disorders that clinicians should consider in the emergency setting.
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Approach to Pediatric Eye Discharge and Periorbital Swelling
Eye problems, particularly conjunctivitis and periorbital swelling, are very common. The majority are managed easily, but more serious disease processes must be considered. Early recognition and prompt treatment of more serious etiologies, such as gonococcal conjunctivitis and herpes simplex virus, can prevent vision loss.
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Hypersensitivity Reactions in the Pediatric ED: The Tip of the Iceberg
Hypersensitivity reactions are very common. Understanding the different types, including serum sickness-like reactions, Stevens-Johnson syndrome, toxic epidermolytic necrolysis, and drug reaction with eosinophilia and systemic symptoms, is valuable both for an accurate and timely diagnosis as well as appropriate management.
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Pediatric Airway Management
Pediatric patients frequently present with respiratory complaints. Fortunately, most children respond well to simple medical interventions. Understanding a child's anatomic and physiologic differences is critical to effectively preventing respiratory failure and stabilizing a child when it occurs.