Browse Pediatric Emergency Medicine Reports Articles…

Emergency Management of Rabies Exposure

Rabies is an uncommon disease with a very high fatality rate. Recognition of a potential exposure and effective prophylaxis are critical in prevention of this devastating disease. The authors review recognition of suspicious bites/exposures, clinical presentation of rabies, and utilization of effective prevention strategies.

Anaphylaxis: The Underrecognized Killer

This article will cover the presentation and emergency department (ED) management of allergic reactions in children, focusing on anaphylaxis. The current definition and recommended guidelines are reviewed.

Sexually Transmitted Infections in Adolescents

Unfortunately, adolescents are at increased risk for sexually transmitted infections secondary to high-risk sexual behavior, victims of commercial sexual exploitation, or sexual experimentation. The consequences can be devastating in the long term. Clinicians must maintain a high degree of suspicion and sensitivity (since most teenagers are reluctant to seek medical care and may not share all the information the clinician needs) to make this diagnosis, minimize complications, and optimize outcome for this vulnerable population.

Infantile Vomiting

Every viral season, something gets missed. All vomiting is not acute gastroenteritis! The clinician needs to have a thorough understanding of the process of vomiting to formulate a complete differential accurately and in a timely manner. A complete history, physical exam, and targeted diagnostic testing are used to ensure an accurate diagnosis with effective management is instituted.

Pediatric Syncope: Current Status of Diagnostic Evaluation and Management

Children may present to the emergency department with a potential syncopal event. Although the presentation is unusual, everyone fears missing a cardiac issue. The authors present a concise review, focusing on the history, physical exam, and ECG, of how to evaluate and manage a child with syncope, differentiating other mimics and discussing the current therapeutic approach to the most common diagnosis.

Pediatric Oncology

Many emergency department (ED) visits for children are driven by parental fears of serious illness, including concerns that a child may have cancer. Some presenting symptoms are high-risk and require serious inquiry, while others are less concerning and may be managed by reassurance alone. Additionally, children with established cancer diagnoses may present to the ED with complications of their cancer, an unexpected recurrence after a period of remission, or issues related to treatment. The authors review the presentations for the most common pediatric cancers and the complications associated with pediatric cancers and their treatment.

Pediatric Pain Management in the Emergency Department

Pain management in the pediatric population has long been a focus of healthcare providers; nevertheless, gaps in providing adequate and timely pain management remain an area of concern in EDs. This article will provide guidance for the recognition and successful management of pediatric pain in the ED setting. The authors first present definitions of pain and discuss the assessment of pain in a child, as well as common barriers to appropriate pediatric pain management in the ED. Then, the article will focus on the different aspects of pain and techniques of managing discomfort, including: anxiolysis, non-pharmacological strategies, topical medications, oral analgesics, parenteral medications, discharge medications, and misconceptions and facts about opioid analgesics. Pain control in conjunction with procedural sedation is beyond the scope of this article.

Pediatric Procedural Sedation

Procedural sedation is a critical skill to facilitate the performance of necessary diagnostic and therapeutic procedures in children. The clinician must have knowledge of the preparatory steps, indications, pharmacologic agents, monitoring, and recovery phase to safely and effectively perform this necessary adjunct to many common procedures. The authors review steps, current recommendations, and options to utilize procedural sedation skillfully in children. In addition, they present guidelines for managing adverse events that may be associated with the administration of procedural sedation.

Common Pediatric Upper Extremity Overuse Injuries

Pediatric overuse injuries are becoming very common as the intensity of athletic competition extends to our younger population. Acute care providers must include these injuries in their differential as they listen to and examine young athletes. Identification and coordination of care with a sports medicine expert will optimize the long-term outcomes for these children.

Assessment of Tetanus Risk in the Pediatric Emergency Department

Tetanus is a life-threatening, preventable disease. It is most commonly acquired from a wound site; however, it can be obtained via injuries of other tissues. Both primary and secondary measures of prevention contribute to the eradication of tetanus. Therefore, appropriate tetanus prophylaxis should be administered in a timely fashion when patients present with wounds or infected tissue. Because tetanus prevention can be so effective, it is imperative to review, document, and address any tetanus deficiencies.