Children emergency department

Kruesi, M.J., Grossman, J., Pennington, J.M., Woodward, P.J.,Duda, D., and Hirsch, J.G. (1999) Suicide and violence prevention parent education in the emergency department. / Am Acad Child Adolesc Psychiatry 38 250-255. 

The major concern of the emergency department physicians was the lethargy, hypotonia, and seizure activity. Initial laboratory studies revealed that the child had a normal complete blood count and smear. Other blood tests revealed metabolic acidosis with a bicarbonate concentration of 11 mEq/L (normal is 20-25 mEq/L) and an anion gap of 22 mEq/L (normal is < 15 mEq/L). His serum glucose, calcium, and magnesium concentrations were normal. To exclude the diagnosis of meningitis, a spinal tap was performed. The cell counts and chemistries of the cerebrospinal fluid were normal. The physicians considered that the child might have sepsis and administered antibiotics and intravenous fluids. Prior to administration of antibiotics, blood, urine, and cerebrospinal fluid were sent for bacterial culture. 

What happens if a doctor is called by distraught parents because their child has swallowed something that might be poisonous, such as paracetamol tablets or weedkiller If the doctor is a general practitioner he/ she may not know specifically what to do but can telephone the nearest Poisons Information Service in the United Kingdom or Poison Control Centers in the United States, who may be able to give advice on treatment. Often the patient will be taken to an Accident and Emergency department at the nearest hospital. 

Emesis has been used for children and also for adults who refuse activated charcoal or gastric lavage, or if the poison is not absorbed by activated charcoal. Its routine use in emergency departments has been abandoned, as there is no clinical trial evidence that the procedure improves outcome for poisoned patients. Emesis is induced, in fully conscious patients only, by Ipecacuanha Emetic Mixture, Pediatric (BNF), 10 ml for a child 6-18 months, 15 ml for an older child and 30 ml for an adult, i.e. all ages may receive the same preparation but in a different dose, which is followed by a tumblerful of water (250 ml). The active constituent of ipecacuanha is emetine it can cause prolonged vomiting, diarrhoea and drowsiness that may be confused with effects of the ingested poison. Even... 

A 2-year-old child developed hyperirritability, psychosis, and ataxia after being overmedicated with a cough formulation containing pseudoephedrine and dextromethorphan. The child made an uneventful recovery after an observation period of 4 hours in the emergency department. 

Direct nonmedical costs are any costs for nonmedical services that are results of illness or disease but do not involve purchasing medical services. These costs are consumed to purchase services other than medical care and include resources spent by patients for transportation to and from health care facihties, extra trips to the emergency department, child or family care expenses, special diets, and various other out-of-pocket expenses. 

Many times, AD is not perceived as a major iUness and is frequently dismissed as a minor skin condition. However, studies have demonstrated considerable financial, emotional, and social impact on families of those with moderate or severe AD. An Australian study reported results of significantly more stress in taking care of a child with moderate or severe AD than that involved with care of a child with insulin-dependent diabetes. Disturbed or lack of sleep has also been reported. In the United States, AD accounts for 4% of emergency department visits. The health systems of all countries are burdened with the economic load of AD s direct and indirect costs of treatment and social morbidity. ... 

The 6-year-old child is experiencing an acute exacerbation of reactive airway disease. The child passed out, and the parents brought the child to the emergency department. Which intervention should the nurse implement first ... 

The 3-year-old child is admitted to the emergency department with an acute episode of laryngotracheobronchitis (LTB). The health-care provider has prescribed racemic epinephrine nebulized with oxygen. Which intervention should the nurse implement ... 

The nurse should teach the parent how to care for the child, not send the child to the emergency department. 

A 4-year-old child is brought to the emergency department as a suspected poisoning victim. Which interventions should the nurse implement Select all that apply. 

The nurse working in the emergency department receives a child who has ingested a poison. Which referral agency should he contacted for specific information regarding the poison ... 

The mother of a 2-year-old child calls the emergency department and reports that the child has swallowed a bottle of prenatal vitamins. Which question is most important for the nurse to ask the mother ... 

The emergency department (ED) nurse is notifying the Poison Control Center concerning an accidental poisoning of a 4-year-old child. Which action by the ED nurse warrants intervention by the charge nurse ... 

StremskI E, Hennes H Accidental Isopropanol Ingestion In ohildren. Pediatr Emerg Care 2000 16(4) 238-240. [PMID 10966340] (Retrospective review of 91 children who presented to an emergency department after Isopropyl alcohol Ingestion. Toxicity was noted In 26 children, and Included spontaneous emesis In 24, ataxia In 5, altered mental status In 3, and apnea In one child. Toxicity developed within 0.5-2 hours after Ihgestloh, ahd was more likely If more than 1 ounce was Ingested.)... 

Prepare in advance a hose with 85°F water, soap, and an old gurney for rapid decontamination outside the emergency department entrance. Have a child s inflatable pool or another container ready to collect water mnoff, if possible. However, do not delay patient decontamination if water runoff cannot be contained easily. 

The code in the emergency department was probably one of the best-handled codes ever," Hellmich remembers. "The child s heart rate and pulse came back quickly, and she walked out of the hospital the next day."... 

Trauma is one of the most common reasons for a child s attendance in the emergency department. Plain radiographs may remain the primary imaging modality following suspected skeletal injury, but with the advent of first single detector CT (SDCT) and now multi-detector row CT (MDCT) scanners, the role of CT in skeletal trauma has continued to develop. 

In the Zambian emergency contraception voucher scheme, all public maternal and child health units had to be excluded from the list of service providers because of their restricted working hours (Monday to Friday only). Since, to be effective, emergency contraception needs to be taken within 72 hours of unprotected sex, any outlet that could potentially be contracted had to be open 24 hours a day, 7 days a week. The agency eventually chose private pharmacies and hospital outpatient departments. Pharmacies have the additional advantage of anonymity, which is particularly well suited to a sensitive issue such as emergency contraception. 

The 6-year-old child with attention deficit-hyperactivity disorder (ADHD) is admitted to the pediatric department after having an emergency appendectomy. Which intervention should the nurse implement when administering methylphenidate (Ritalin), a central nervous stimulant to the child ... 

---