Category: Pediatrics
Keywords: Pertussis, Whooping Cough (PubMed Search)
Posted: 8/9/2009 by Heidi-Marie Kellock, MD
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Pertussis (Whooping Cough):
Nelson's Essentials of Pediatrics, 5th Edition
Category: Pediatrics
Posted: 8/1/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Conners GP, Chamberlain JM, Ochsenschlager DW. Symptoms and spontaneous passage of esophageal coins. Arch Pediatr Adolesc Med. 1995;149:36-39
Macpherson RI, Hill JG, Otherson HB, Tagge EP, Smith CD. Esophageal foreign bodies in children: diagnosis, treatment, and complications. AJR Am J Roentgenol. 1996;166:919-924
Category: Pediatrics
Posted: 7/25/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Haddad GG. Primary ciliary dyskinesia. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 16th ed. Philadelphia, Pa: WB SaundersCo; 2000:1327-1328
Category: Pediatrics
Posted: 7/17/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Baskin MN. Injury-knee. In:Fleisher GR, Ludwig S, eds. Textbook of Pediatric Emergency Medicine. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2000:339-347
Staheli LT. Hip. In: Fundamentals of Pediatric Ortopoedics. 2nd ed. Philadelphia, Pa: Lippincott-Raven; 1998:68-71.
Category: Pediatrics
Posted: 7/5/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Davidson M, Wasserman R. The irritable colon of childhood (chronic nonspecific diarrhea syndrome). J Pediatr. 1996;69:1027-1038
Kneepkens CM, Hoekstra JH. Chronic nonspecific diarrhea of childhood: pathophysiology and management. Pediatr Clin North Am. 1996;43:375-390
Category: Pediatrics
Keywords: Noninvasive, Ventilation, Pediatrics (PubMed Search)
Posted: 6/27/2009 by Don Van Wie, DO
(Updated: 8/14/2024)
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Noninvasive ventilation use in children has been shown in some trials to be a useful tool to avoid intubation in children with asthma.
Since children with asthma who are intubated have a much higher risk for complications including pneumotharaces and pneumomediastinum this can be a very useful tool.
Bi-Pap is usually started with typical settings of 10 for IPAP and 5 for EPAP and can be titrated up as tolerated to levels of up to 25/20 cm H2O and can be delivered with a set rate or a back up rate.
Albuterol and nebulized epiephrine may be delivered through newer BiPAP machines.
Signs that BiPAP is working include decreased Respiratory Rate, decreased retractions and accesory muscle use, improved oxygenation saturation
Noninvasive Ventilation Techniques In The Emergency Department:Applications In Pediatric Patients. Pediatric Emergency Medicine Practice June 2009. Vol 6, No 6
Category: Pediatrics
Posted: 6/21/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Category: Pediatrics
Posted: 6/8/2009 by Rose Chasm, MD
(Updated: 6/9/2009)
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DeNicola LK, Falk JL, Swanson ME, Gayle MO, Kissoon N. Submersion injuries in children and adults. Crit Care Clin. 1997;13:477-502.
Fisher DH. Near-drowning. Pediatr Rev. 1993;14:148-151.
Shaw KN, Briede CA. Submersion injuries: drowning and near-drowning. Emerg Med Clin North Am. 1989;7:355-370.
Category: Pediatrics
Posted: 5/15/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Classic presentation: breastfeeding failure with umbilical stump and gastrointestinal bleeding by postnatal day 7. Oozing from circumcision, venipuncture, and heel sticks is also common. Beware bleeding into the scalp or intracranial space.
Due to essential vitamin K deficiency which exists at birth as the fetus receives little vitamin K from the uteroplacental circulation. It is responsible for impaired neonatal clotting function (deficiency of factors II, VII, IX, and X).
Prevented by a single intramuscular dose of 1mg vitamin K in the first few hours following delivery.
American Academy of Pediatrics Committee on Fetus and Newborn. Controversies concerning vitamin K and the newborn. Pediatrics. 2003;112:191-192.
American Academy of pediatrics, the American College of Obstetricians and Gynecologists. Care of the neonate. In: Gilstrap LC, Oh W, eds. Guidelines for Perinatal Care. 5th ed. Elk Grove Village, Ill, Wash DC: American Academy of Pediatrics, teh American College of Obstetricians and Gynecologists; 2002:187-236.
Category: Pediatrics
Posted: 5/1/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Pancytopenia manifests as a decrease in the erythroid, myeloid, and megakaryocytic cell lines that appears as a decrease in red blood cells, white blood cells, and platelents on complete blood count analysis.
Pancytopenia is an absolute indication for bone marrow aspiration and biopsy to delineate and treat the cause.
Gerson SL, Lazarus HM. Hematopoietic emergencies. Semin Oncol. 1989;16:532-542.
Category: Pediatrics
Keywords: Pediatric cough and cold meds, death (PubMed Search)
Posted: 4/25/2009 by Don Van Wie, DO
(Updated: 8/14/2024)
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Dart R., Paul I., et al. Pediatric Fatalities Associated with OTC (nonprescription) cough and cold medications. Annals of Emergency Medicine. April 2009. Vol 53, No. 4 p 411-417
Category: Pediatrics
Posted: 4/17/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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2006 Report of the Committee on Infectious Diseases. American Academy of Pediatrics.
Category: Pediatrics
Keywords: Heat Stroke, Hyperthermia (PubMed Search)
Posted: 4/14/2009 by Don Van Wie, DO
(Updated: 8/14/2024)
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As we head into the warmer months we should remember that every year there are reports of a toddler left in his car seat for 15 min who comes in uresponsive with hyperthermia.
Heat related illnesses are a continuum from heat cramps to heatstroke. The hallmark of heatstroke is hyperthermia with mental status changes and when identified rapid cooling must be initiated. Mortality for heatstroke is reported as high as 80%.
Children are more susceptible to heat stroke because of a greater surface area to body mass ratio, higher metabolic rates, less developed sweating mechanisms, and inability to always remove themselves from the hot environment.
The quickest and easiest way to cool a conscious patient is by evaporation. Changing water from a liquid to a vapor is an endothermic process. Removal of all clothes, followed by misting or wiping with tepid water of the entire skin is very effective. Having a fan pointed at the child can enhance this method.
Lin, J. Losey, R. Prendergast, H. An Evidence-Based Approach to hyperthermia and other heat-related emergencies. Pediatric Emergency Medicine Practice. April 2009. Vol 6, No 4
Category: Pediatrics
Keywords: Hemolytic-uremic syndrome (HUS) (PubMed Search)
Posted: 4/3/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Hemolytic-uremic syndrome (HUS)
Category: Pediatrics
Keywords: Acute Laryngotracheobronchitis, Croup (PubMed Search)
Posted: 3/25/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Parainfluenza viruses (types 1, 2, 3) account for more than 65% of all cases. The different serotypes have seasonal patterns, with type 1 and 2 occuring in the autumn and being the most common pathogens associated with croup while type 3 is more frequent in the spring and summer and is associated with pneumonia and bronchiolitis.
Infections are rarely associated with high fever and usually last 4 to 5 days. There are no distinctive laboratory abnormalities, and diagnosis is generally made clinically. Chest and neck xray may demonstrate a “steeple sign” from narrowing of the subglottic region. Viral cultures and immunofluorescent rapid antigen identification can be obtained from respiratory secretions. Specific antiviral therapy is not available. Aerosolized epinephrine can be given to severely affected, hospitalized patients to decrease airway obstruction. Parental (>0.3mg/kg) and oral ((0.15mg/kg) dexamethasone have been demonstrated to lessen the severity and duration of symptoms and hospitalization in patients with moderate to severe croup.
American Academy of Pediatrics. Parainfluenza viral infections. In: Pickering LK, ed Red Book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, Ill: American Academy of Peditrics; 2006
Category: Pediatrics
Keywords: Appendicitis, Pediatrics (PubMed Search)
Posted: 3/13/2009 by Don Van Wie, DO
(Updated: 8/14/2024)
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Acute Appendicitis in Childhood: Diagnosis and Treatment in the new Millennium. PEM Practice. December 2008
Category: Pediatrics
Posted: 3/6/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Rocky Mountain spotted fever (RMSF)
Systemic small vessel vasculitis caused by R rickettsii which is transmitted by a tick bite.
Clinical features: fever, headache, myalgia, nausea, vomiting, and characteristic rash. Rash usually appears before the sixth day of the illness initially on the wrists and ankles, and spreads to the trunk within hours. Initially. It is erythematous and macular, later becoming petechial.
Laboratory findings: thrombocytopenia, anemia, and hyponatremia.
Complications: meningitis, multiorgan involvement, DIC, shock, and death.
Treatment: doxcycycline (even despite the risk of dental staining in children younger than 8 years old)
American Academy of Pediatrics. Rickettsial diseases, Rickettsialpox, Rocky Mountain spotted fever. In: Pickering LK, ed. Red Book: 2006 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2006:529-534.
Category: Pediatrics
Keywords: pediatric seizures (PubMed Search)
Posted: 2/28/2009 by Don Van Wie, DO
(Updated: 8/14/2024)
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Berg C, Schumann H. An Evidence-Based Approach to Pediatric Seizures in the Emergency Department. Pediatric Emergency Medicine Practice. Feb 2009. Vol 6, Number 2.
Category: Pediatrics
Posted: 2/19/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Krogstad P. Osteomyelitis and septic arthritis. In: Feigin RD, Cherry JD, Demmler GJ, Kaplan SL, eds. Textbook of Pediatric Infectious Diseases. Philadelphia, Pa: WB Saunders Co; 2004713-736.
Tan TQ. Osteomyelitis and septic arthritis. In: Perkin RM, Swift JD, Newton DA, eds. Pediatric Hospital Medicine: Textbook of Inpatient Management. Philadelphia, Pa: Lippincott Williams & Wilkins; 2003:497-500.
Yagupsky P, Bar-Ziv Y, Howard CB, Dagan R. Epidemiology, etiology, and clinical features of septic arthritis in children younger than 24 months. Arch Pediatr Adolesc Med. 1995; 149:537-540.
Category: Pediatrics
Keywords: Epstien Barr Virus, Mononucleosis (PubMed Search)
Posted: 2/6/2009 by Rose Chasm, MD
(Updated: 8/14/2024)
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Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM)
Most commonly presenting clinical findings: fever, fatigue, exudative pharyngitis, lymphadenopathy, and hepatosplenomegaly.
Self-limited illness that lasts an average of 2 - 3 weeks.
Treatment is primarily supportive. Use of ampicillin, amoxicillin, or penicillin during the acute phase not indicated and may result in the development of a morbilliform rash, which studies have suggested may occur in more than 50% of the cases. Antiviral therapy is not recommended. Splenic rupture occurs in about 1 - 2:1000 cases. Therefore, avoidance of activities that increase the risk for injury is recommended until splenomegaly has resolved.
Hickey SM, Strasburger VC. What every pediatrician should know about infectious mononucleosis in adloscents. Pediatr Clin North Am. 1997;44:1541-1556.
Katz BZ. Epstein-Barr virus. In: Long SS, Pickering LK, Prober CG, eds. York, NY: Churchill Livingstone; 2—3:1059-1068
Peter J, Ray CG. Infectious mononucleosis. Pediatr Rev. 1998; 19:276-279.