Clin Pediatr Emerg Med
· 2010 Dec · PMID 21499553
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Pain is the hallmark of sickle cell disease in children and adolescents. Many children seek relief from their pain in the emergency department. These visits have historically been characterized by undertreatment, bias an...Pain is the hallmark of sickle cell disease in children and adolescents. Many children seek relief from their pain in the emergency department. These visits have historically been characterized by undertreatment, bias and distrust. Through compassionate care, aggressive pain management, and the development of clinical pathways or care guidelines, better analgesia and a better experience can be assured for the child with sickle cell disease in need of emergency care.
Clin Pediatr Emerg Med
· 2008 Sep · PMID 19727322
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The infant presenting to the emergency department with cyanosis requires rapid assessment, diagnosis, and initiation of therapy. In this article, the potential challenges in recognizing cyanosis are discussed, including...The infant presenting to the emergency department with cyanosis requires rapid assessment, diagnosis, and initiation of therapy. In this article, the potential challenges in recognizing cyanosis are discussed, including the presence of higher concentrations of fetal hemoglobin, and its oxygen binding characteristics. A systematic approach to the diagnosis of cyanosis is presented, based on an understanding of the normal transitional physiology, and how diseases of the airway, lung, and circulatory system may disrupt these processes. Strategies for initial emergency department management of lung and cardiac disease are presented.
Clin Pediatr Emerg Med
· 2008 Dec · PMID 32288649
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Although "fever and rash" is a common complaint in the pediatric emergency department, most causes are benign. Of the more severe causes, several have been greatly reduced by vaccination programs. In addition, new vaccin...Although "fever and rash" is a common complaint in the pediatric emergency department, most causes are benign. Of the more severe causes, several have been greatly reduced by vaccination programs. In addition, new vaccines such as those for invasive meningococcal disease hold promise for an even brighter future. Although meningococcemia remains an important concern when evaluating a child with fever and a rash, the resurgence of measles, the emergence of invasive group A streptococcal disease and antibiotic-resistant Staphylococcus aureus, as well as the fear of agents of bioterrorism (anthrax, smallpox) have changed the landscape of fever and rash in the 21st century. The purpose of this article is not to offer a comprehensive differential of febrile exanthema, but rather to highlight some new concerns related to the evaluation of fever and rash in today's emergency department.
Clin Pediatr Emerg Med
· 2007 Sep · PMID 18438449
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Optimizing the quality of medical care at the end of life has achieved national status as an important health care goal. Palliative care, a comprehensive approach to treating the physical, psychosocial and spiritual need...Optimizing the quality of medical care at the end of life has achieved national status as an important health care goal. Palliative care, a comprehensive approach to treating the physical, psychosocial and spiritual needs of patients and their families facing life-limiting illnesses, requires the coordinated efforts of a multidisciplinary group of caregivers. Understanding the basic principles of palliative care can aid emergency department staff in identifying patients who could benefit from palliative care services and in managing the challenging situations that arise when such patients present to the hospital for care.In this article we present the overall philosophy of pediatric palliative care, describe key elements of quality palliative care, and identify additional referral sources readers can access for more information.
Clin Pediatr Emerg Med
· 2004 Jun · PMID 32288648
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Over the past decade there has been a dramatic increase in international adoptions in the United States. While most adopted children will have common illnesses, others may have unique medical issues as a result of the co...Over the past decade there has been a dramatic increase in international adoptions in the United States. While most adopted children will have common illnesses, others may have unique medical issues as a result of the conditions in their birth country requiring a broadened differential diagnosis. Knowledge of these issues is essential in the management of these patients. This review will predominately focus on infectious disease issues commonly seen in international adoptees but will also discuss other medical conditions and some of the psychosocial issues which may be encountered by caregivers in the emergency department.