MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinical Pediatric Emergency Medicine' source. Sat, 20 Mar 2010 14:11:14 +0100 http://www.medworm.com/index.php?rid=3367542&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001153%2Fabstract%3Frss%3Dyes This article offers suggestions for physicians and other acute care providers for ways to accomplish this task by relying on skills we already possess as we increase our level of understanding. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367542 Mon, 01 Mar 2010 00:00:00 +0100 3367542 http://www.medworm.com/index.php?rid=3367541&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001098%2Fabstract%3Frss%3Dyes Most pediatric trauma patients are cared for in non-children's hospitals by providers without pediatric specialty training and in facilities that may not be used to caring for children. Children have different physiologic and psychologic responses to injury than adults. Children have different service and evaluative needs. Several studies have shown that pediatric trauma patients have improved outcomes with lower mortality, fewer operations, and improved function when cared for in pediatric facilities or adult trauma centers with pediatric expertise. Differences between injured adults and injured children need to be understood, recognized, and acted upon by care providers to optimize treatment for injured children. Limitations in the availability of pediatric specialists require that all h... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367541 Mon, 01 Mar 2010 00:00:00 +0100 3367541 http://www.medworm.com/index.php?rid=3367540&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001104%2Fabstract%3Frss%3Dyes This article reviews management principles of traumatic brain injury, mechanical ventilation, and shock in the pediatric trauma patient and is intended to guide ED management of these patients until they can be transferred to an appropriate level of inpatient care. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367540 Mon, 01 Mar 2010 00:00:00 +0100 3367540 http://www.medworm.com/index.php?rid=3367539&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001165%2Fabstract%3Frss%3Dyes This article will provide a review of pain in injured children with respect to its pathophysiology, clinical ramifications, and patterns of analgesia practices. Impediments to analgesia are examined regarding multiple providers of care for the acutely injured child including prehospital personnel, nurses, and physicians. Finally, the article will provide analgesia recommendations with an approach to pain relief and sedation for the injured pediatric patient. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367539 Mon, 01 Mar 2010 00:00:00 +0100 3367539 http://www.medworm.com/index.php?rid=3367538&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001128%2Fabstract%3Frss%3Dyes This article's objective is to review the relative risks and benefits associated with this radiographic modality. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367538 Mon, 01 Mar 2010 00:00:00 +0100 3367538 http://www.medworm.com/index.php?rid=3367537&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001141%2Fabstract%3Frss%3Dyes This article reviews the literature and makes recommendations for a simplified, cost-effective laboratory testing strategy. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367537 Mon, 01 Mar 2010 00:00:00 +0100 3367537 http://www.medworm.com/index.php?rid=3367536&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001116%2Fabstract%3Frss%3Dyes This article will review the literature regarding the risks and benefits of various aspects of pediatric trauma care in the prehospital setting. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367536 Mon, 01 Mar 2010 00:00:00 +0100 3367536 http://www.medworm.com/index.php?rid=3367535&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS152284010900113X%2Fabstract%3Frss%3Dyes The concept of a “golden hour” is a fixture in trauma care. There is a dearth of scientific proof for this concept but an abundance of controversy around how this concept should be interpreted, especially for pediatric trauma patients. Health care providers should instead focus on the “golden opportunity,” different for each patient, to provide the best care in the most appropriate environment for all injured children. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367535 Mon, 01 Mar 2010 00:00:00 +0100 3367535 http://www.medworm.com/index.php?rid=3367534&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001177%2Fabstract%3Frss%3Dyes For children younger than 14 years, there has been a dramatic and steady decline over the past 2 decades in injury-related mortality from 9427 deaths in 1986 (age-adjusted rate of 18.04/100 000) to 6530 in 2006 (age-adjusted rate of 10.59/100 000). Many factors contribute to this improvement including injury prevention strategies as well as treatment and aftercare of trauma patients. Although tremendous strides have been made, injury remains a leading cause of morbidity and mortality in the United States and is especially concerning within the pediatric population where trauma can rob years of happiness and productivity. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367534 Mon, 01 Mar 2010 00:00:00 +0100 3367534 http://www.medworm.com/index.php?rid=3367533&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840110000054%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367533 Mon, 01 Mar 2010 00:00:00 +0100 3367533 http://www.medworm.com/index.php?rid=3367532&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840110000042%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3367532 Mon, 01 Mar 2010 00:00:00 +0100 3367532 http://www.medworm.com/index.php?rid=3064553&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000925%2Fabstract%3Frss%3Dyes A 5-year-old white boy was sent to the emergency department by his pediatrician for fever and abdominal distention. For 1 month, his parents had noted intermittent fevers, with daily fevers (maximum temperature, 38.5°C) for 1 week. He had an enlarging “bump” over the right upper quadrant of his abdomen for 2 weeks and vague intermittent abdominal pain for 2 days. There was no history of vomiting, and stools had been normal (1-2 per day, loose, malodorous, no blood). His parents reported decreased energy for the last month but a normal appetite. No recent weight loss, bone or joint pain, or rashes were noted. Review of systems was positive for seasonal allergies and 1 month of nonproductive cough, which was diagnosed as cough-variant asthma. The nocturnal component of the cough improve... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064553 Tue, 01 Dec 2009 00:00:00 +0100 3064553 http://www.medworm.com/index.php?rid=3064552&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000901%2Fabstract%3Frss%3Dyes The patient is a 12-month-old male infant with global developmental delay who presented to the emergency department with a history of refusal to eat. On presentation, his mother reported that for the 4 days before presentation, he had refused to take formula, been increasingly irritable, and developed abdominal distension. He has had several episodes of “spitting up,” which was slightly increased from his baseline. The mother noted 3 to 4 large, green, soft stools without blood or mucous and decreased urine output on the day of this visit. She denied the presence of fever but stated that he had been coughing and intermittently breathing “hard and fast.” Three months before this current episode, he had similar symptoms requiring hospital admission and treatment for dehydration. (Sou... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064552 Tue, 01 Dec 2009 00:00:00 +0100 3064552 http://www.medworm.com/index.php?rid=3064551&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000913%2Fabstract%3Frss%3Dyes An 11-week-old baby boy was sent to the emergency department by his pediatrician for failure to thrive and 3 days of weak cry. He had only gained 3 oz since his 2-month-old well-child checkup, despite feeds of 3 to 4 oz of Enfamil Lipil with iron every 4 hours. He had 6 to 8 wet diapers each day, without any recent changes, and he had nonbloody yellow bowel movements once every 3 days, for which his pediatrician has prescribed daily corn syrup. He had an occasional nonbilious, nonbloody emesis about every 3 to 4 days. In the office, the pediatrician had obtained a finger stick glucose, which was normal at 85 mg/dL. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064551 Tue, 01 Dec 2009 00:00:00 +0100 3064551 http://www.medworm.com/index.php?rid=3064550&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000937%2Fabstract%3Frss%3Dyes Infants and children presenting to the emergency department with hypoglycemia are a diagnostic emergency and require urgent treatment. The metabolic adaptive patterns of fasting occur earlier in children compared to adults, most notably with the development of ketone bodies. Glucose is the preferred energy source for the brain; however, when deprived of glucose, ketone bodies are an alternative fuel that may cross the blood-brain barrier. As infants and children have a relatively larger brain to body size and their rates of glucose use are higher, they are at increased risk of hypoglycemia. Collection of the "critical sample" to assist in the diagnostic work-up and urgent treatment to stabilize blood glucose levels is of paramount importance to protect the developing brain from glucose dep... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064550 Tue, 01 Dec 2009 00:00:00 +0100 3064550 http://www.medworm.com/index.php?rid=3064549&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000883%2Fabstract%3Frss%3Dyes Hyperthyroidism may present to physicians in the emergency department in a variety of ways. Using a case-based approach, this article provides a review of 3 such presentations, Graves disease, thyroid storm, and the accidental ingestion of thyroid hormone. Each case will offer a review of the evaluation and management of children with disorders of hyperthyroidism and specific recommendations pertaining to each case. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064549 Tue, 01 Dec 2009 00:00:00 +0100 3064549 http://www.medworm.com/index.php?rid=3064548&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000950%2Fabstract%3Frss%3Dyes This article will present 2 cases with sodium abnormalities and then review the epidemiology, pathophysiology, and current management practices for dysnatremias. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064548 Tue, 01 Dec 2009 00:00:00 +0100 3064548 http://www.medworm.com/index.php?rid=3064547&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS152284010900086X%2Fabstract%3Frss%3Dyes Adrenal insufficiency is an important and potentially life-threatening condition that may present to the emergency department. Seven clinical scenarios of adrenal insufficiency that the emergency physician should be able to recognize and confidently manage are reviewed. Epidemiology and mortality, etiology, and pathophysiology are addressed. Clinical presentation, diagnosis, and management of acute and chronic adrenal disease are also covered. In particular, adrenal suppression due to exogenous steroid use, adrenal suppression in septic shock, and adrenal suppression associated with etomidate are reviewed. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064547 Tue, 01 Dec 2009 00:00:00 +0100 3064547 http://www.medworm.com/index.php?rid=3064546&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000895%2Fabstract%3Frss%3Dyes Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children. Subsequent endocrine changes have been illustrated in adults and have been recently investigated in children as well. Head injury occurs often in children, and TBI has accounted for many emergency department visits. The most common type of brain injury in children is diffuse brain injury caused by acceleration or deceleration forces. In adults, there is no relationship that has emerged between the occurrence of pituitary dysfunction and time after TBI, type or severity of initial injury, or later outcome. In pediatrics, studies have shown that a delay in diagnosing pituitary dysfunction was common. In children with TBI, a screening algorithm, starting with measurement of an early-morning cortisol, should ... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064546 Tue, 01 Dec 2009 00:00:00 +0100 3064546 http://www.medworm.com/index.php?rid=3064545&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000949%2Fabstract%3Frss%3Dyes Intercurrent illness may trigger hyperglycemia as a result of the secretion of stress hormones and cytokines. This condition is termed “stress hyperglycemia.” Patients with stress hyperglycemia (rather than diabetes mellitus) usually do not have a lengthy history of polyuria, polydipsia, or weight loss. They do not manifest symptoms or signs of ketoacidosis (hyperpnea, acetone smell of breath). In addition, biochemical evidence of ketoacidosis is absent. If hyperglycemia is associated with a serum glucose above the low 200s, inpatient evaluation is preferred. In the emergency department, hemoglobin A1c can help acutely in estimating chronicity, with high levels prompting admission. Levels of diabetes antibodies should be drawn, and follow-up should be arranged to ascertain normalcy of ... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064545 Tue, 01 Dec 2009 00:00:00 +0100 3064545 http://www.medworm.com/index.php?rid=3064544&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000871%2Fabstract%3Frss%3Dyes Diabetic ketoacidosis results from deficient insulin action and increased action of hormones such as catecholamines, glucagon, glucocorticoids, and growth hormone, which are produced during stress and which antagonize insulin's actions. Diabetic ketoacidosis is associated with a relatively high mortality rate. Treatment consists of appropriate fluid resuscitation, insulin infusion, adjustments of electrolytes and phosphate, and careful monitoring. The most common serious complication is cerebral edema. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064544 Tue, 01 Dec 2009 00:00:00 +0100 3064544 http://www.medworm.com/index.php?rid=3064543&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000962%2Fabstract%3Frss%3Dyes This issue of Clinical Pediatric Emergency Medicine features endocrine disorders with which pediatric patients present to the emergency department. Dr Fogel discusses diagnosis and treatment of ketoacidosis. She points out that the diagnosis depends on the presence of hyperglycemia (typically glucose >200 mg/dL) in association with HCO3 levels of 15 mEq/L or lower and venous pH of 7.3 or less. Currently, the clinical practice is to limit the total volume of fluids administered to patients with ketoacidosis to 3500/mL/m2/day. Finally, the most frequent method of insulin administration is by continuous infusion, starting with 0.1/kg/hr. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064543 Tue, 01 Dec 2009 00:00:00 +0100 3064543 http://www.medworm.com/index.php?rid=3064542&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109001001%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064542 Tue, 01 Dec 2009 00:00:00 +0100 3064542 http://www.medworm.com/index.php?rid=3064541&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000998%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=3064541 Tue, 01 Dec 2009 00:00:00 +0100 3064541 http://www.medworm.com/index.php?rid=2763658&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS152284010900055X%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763658 Mon, 31 Aug 2009 23:00:00 +0100 2763658 http://www.medworm.com/index.php?rid=2763657&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000561%2Fabstract%3Frss%3Dyes The most obvious deficiency in the current evaluation of disaster response is the lack of objective, quantifiable measures of performance. This frequently leads to assessments that are highly subjective depending on the evaluator, does not provide those who are planning with targets to achieve, and does not allow for measures that they have improved their preparedness. The goal of this article is to offer recommendations for government agencies at the federal, regional, and local levels, public health departments, and health care institutions to aid in the development of pediatric emergency management performance measures. This will be achieved through the application of traditional quality principles to the assessment of emergency management efforts and to the use of innovative analytic m... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763657 Mon, 31 Aug 2009 23:00:00 +0100 2763657 http://www.medworm.com/index.php?rid=2763656&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000494%2Fabstract%3Frss%3Dyes This article emphasizes key emergency response aspects of hospital preparedness for disasters involving children, in particular (1) hospital-based incident command, (2) strategies for operational continuity, (3) pediatric principles of surge capacity, (4) development of decontamination protocols, (5) infection control, (6) sheltering in place, and (7) evacuation strategies. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763656 Mon, 31 Aug 2009 23:00:00 +0100 2763656 http://www.medworm.com/index.php?rid=2763655&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000500%2Fabstract%3Frss%3Dyes This article provides an overview of recent literature on disasters and mental health, covering children's stress reactions, mental health problems that may arise, and risk factors that affect these reactions. Practical guidance for pediatric emergency health care providers is emphasized, including psychological first aid, recommendations for screening questions to facilitate mental health triage, and an overview of effective mental health interventions. It concludes with a discussion of the impact of providing care in the aftermath of a disaster on the health care professional. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763655 Mon, 31 Aug 2009 23:00:00 +0100 2763655 http://www.medworm.com/index.php?rid=2763654&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000512%2Fabstract%3Frss%3Dyes This article offers an outline for the components of disaster planning and response where considerations for family reunification should occur and describes the challenges and solutions within each. Challenges and solutions are described in 6 areas including practice and planning, clinical services, ancillary support, transportation and accommodations, communication and identification, and psychological support. Family reunification will be more successful if these challenges are understood and solutions are enacted. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763654 Mon, 31 Aug 2009 23:00:00 +0100 2763654 http://www.medworm.com/index.php?rid=2763653&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000548%2Fabstract%3Frss%3Dyes This article provides an overview of the need for decontamination and the process of decontamination for hospitals. Practical guidance on decontamination methods for children of different ages is presented. Recommendations for training and communication during decontamination are also reviewed. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763653 Mon, 31 Aug 2009 23:00:00 +0100 2763653 http://www.medworm.com/index.php?rid=2763652&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000524%2Fabstract%3Frss%3Dyes This article reviews the planning and triage considerations for prehospital providers caring for children in a mass casualty event. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763652 Mon, 31 Aug 2009 23:00:00 +0100 2763652 http://www.medworm.com/index.php?rid=2763651&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000536%2Fabstract%3Frss%3Dyes This article will also discuss the H1N1 outbreak that started during the spring 2009. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763651 Mon, 31 Aug 2009 23:00:00 +0100 2763651 http://www.medworm.com/index.php?rid=2763650&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000676%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "The Future of Pediatric Preparedness," will offer a perspective on future directions in pediatric preparedness. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763650 Mon, 31 Aug 2009 23:00:00 +0100 2763650 http://www.medworm.com/index.php?rid=2763649&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000688%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "Challenges Facing Pediatric Preparedness," will review some of the major challenges facing current efforts to enhance pediatric readiness. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763649 Mon, 31 Aug 2009 23:00:00 +0100 2763649 http://www.medworm.com/index.php?rid=2763648&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000664%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "The Role of Pediatric Health Care Providers," will illustrate the important role of pediatric care experts at all levels of disaster planning, and as a vital resource for pediatric emergency preparedness in the community. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763648 Mon, 31 Aug 2009 23:00:00 +0100 2763648 http://www.medworm.com/index.php?rid=2763647&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000652%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "Mental Health Concerns," will address some of the unique developmental and psychological vulnerabilities of children as disaster victims (or as disaster witnesses) and strategies for timely identification and intervention for mental health concerns in children. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763647 Mon, 31 Aug 2009 23:00:00 +0100 2763647 http://www.medworm.com/index.php?rid=2763646&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000640%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "Lessons Learned From Disasters Affecting Children," will address pediatric-specific vulnerabilities to disasters and pediatric patient care considerations in various phases of disaster planning and response, as has been learned from recent experiences. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763646 Mon, 31 Aug 2009 23:00:00 +0100 2763646 http://www.medworm.com/index.php?rid=2763645&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000639%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "Preparing for Natural Disasters," will address pertinent clinical and disaster management issues relating to caring for children and families impacted by natural disasters. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763645 Mon, 31 Aug 2009 23:00:00 +0100 2763645 http://www.medworm.com/index.php?rid=2763644&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000627%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "Preparation for Terrorist Threats: Explosive Devices," will promote a greater awareness of explosive devices as significant terrorism threat and pertinent clinical considerations in caring for pediatric victims of explosive injury. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763644 Mon, 31 Aug 2009 23:00:00 +0100 2763644 http://www.medworm.com/index.php?rid=2763643&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000615%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "Preparation for Terrorist Threats: Radiation Injury," will address pertinent clinical management issues relating to radioactive agents and the unique vulnerabilities and care needs of children as potential victims of such terrorism. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763643 Mon, 31 Aug 2009 23:00:00 +0100 2763643 http://www.medworm.com/index.php?rid=2763642&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000603%2Fabstract%3Frss%3Dyes This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, "Preparation for Terrorist Threats: Biologic and Chemical Agents," will address pertinent clinical management issues relating to biologic and chemical agents and the unique vulnerabilities and care needs of children as potential victims of such terrorism. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763642 Mon, 31 Aug 2009 23:00:00 +0100 2763642 http://www.medworm.com/index.php?rid=2763641&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000597%2Fabstract%3Frss%3Dyes This article, and the nine that follow, represent a collaborative effort by experts in the field of emergency and disaster preparedness, many who were colleagues of the late Michael Shannon, MD, MPH, to complete this overview he had begun for this issue of Clinical Pediatric Emergency Medicine. Each article will address a specific topic area within the broad realm of pediatric disaster readiness, reviewing current challenges and future directions. This series of articles represents a tribute to Michael Shannon and his great legacy of excellence in patient care, teaching and research, and his outstanding leadership and advocacy for children and families. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763641 Mon, 31 Aug 2009 23:00:00 +0100 2763641 http://www.medworm.com/index.php?rid=2763640&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000585%2Fabstract%3Frss%3Dyes I can no longer exactly recall how I learned of Michael Shannon's death on March 10th, the day will likely forever remain a blur. Although we had met many years earlier, I had the great fortune to partner with Michael as an external reviewer for the PEM program at the Hospital for Sick Children in 2005. Over those 2 days in Toronto, we got to know each other fairly well. I had previously been aware that Michael was a remarkable person, I just never knew until then how truly special he was. I remember musing on my journey home that I had met the “Renaissance Man.” (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763640 Mon, 31 Aug 2009 23:00:00 +0100 2763640 http://www.medworm.com/index.php?rid=2763639&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000573%2Fabstract%3Frss%3Dyes Numerous events in the United States and abroad have demonstrated the vulnerabilities of children during and after disasters in the past decade. In 2002, an issue of Clinical Pediatric Emergency Medicine (CPEM) focused on pediatric disaster management and explored the consequences to children of a terrorist attack and natural disasters. Unfortunately, experiences continue to remind us that the inclusion of children in the preparation for disasters remains incomplete and results in tragic consequences. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763639 Mon, 31 Aug 2009 23:00:00 +0100 2763639 http://www.medworm.com/index.php?rid=2763638&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000731%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763638 Mon, 31 Aug 2009 23:00:00 +0100 2763638 http://www.medworm.com/index.php?rid=2763637&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS152284010900072X%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2763637 Mon, 31 Aug 2009 23:00:00 +0100 2763637 http://www.medworm.com/index.php?rid=2449367&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000305%2Fabstract%3Frss%3Dyes With a grant from the Robert Wood Johnson Foundation, we developed and evaluated an emergency department (ED) based intervention in which patients returned to the ED for a structured 90-minute appointment during the weeks after an acute asthma visit. The intervention, which emphasized disease management using national asthma guidelines, successfully reduced overdependence on EDs for episodic care of asthma while also improving asthma-related quality of life among a cohort of low-income, urban, and largely minority children with moderate to severe asthma and a history of ED recidivism. We have since sustained and grown this multifaceted approach to addressing the disparities in asthma care and outcomes among children in our community. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449367 Mon, 01 Jun 2009 04:00:00 +0100 2449367 http://www.medworm.com/index.php?rid=2449366&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000342%2Fabstract%3Frss%3Dyes Current guidelines recommend that all children obtain follow-up within 1 to 4 weeks after an emergency department (ED) visit for acute asthma. Follow-up may be an important link to reestablish regular care with the primary care provider, review reasons for the ED visit, and update the home management plan. Obtaining follow-up from the ED can be challenging. Studies have reported baseline follow-up rates between 7% and 44% without intervention. Successful interventions report follow-up rates of 36% to 78%. Studies that demonstrated improved follow-up from the ED found methods to personalize care such as individualized education, assistance with follow-up, and/or providing medications or transportation free of charge. A few studies effectively used computer-based interventions in the ED. As ... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449366 Mon, 01 Jun 2009 04:00:00 +0100 2449366 http://www.medworm.com/index.php?rid=2449365&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000287%2Fabstract%3Frss%3Dyes Asthma is the most common chronic illness during childhood and significantly impacts all aspects of the health care system. Disconnects between the different facets of the health care system exist, leading to less than optimal quality of care. Improving the quality of care received by patients with asthma requires an understanding that systems-based changes are needed. Quality improvement efforts in pediatric asthma care delivery are described in 2 case examples: one involving hospital-wide metered dose inhaler use with phase out of nebulized mask treatment therapy and the second involving emergency department educational strategies. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449365 Mon, 01 Jun 2009 04:00:00 +0100 2449365 http://www.medworm.com/index.php?rid=2449364&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000329%2Fabstract%3Frss%3Dyes Asthma is a complex heterozygous multifactorial condition with variability in clinical features and response to treatment, likely related to interactions between genetics and environmental exposures. Pharmacogenomic research seeks to identify and elucidate relationships between genetic variation and therapeutic response. Multiple studies have examined genetic variation in the β2-adrenergic receptor gene and association with asthma phenotypes. Results suggest that single-nucleotide polymorphisms in this gene are associated with greater bronchodilation acutely after albuterol, worse pulmonary function over time with daily albuterol use, and tachyphylaxis to albuterol with chronic use. Although these results are intriguing, there are limitations of individual studies and discrepancies among ... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449364 Mon, 01 Jun 2009 04:00:00 +0100 2449364 http://www.medworm.com/index.php?rid=2449363&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000299%2Fabstract%3Frss%3Dyes This article reviews the effects of NPPV on the pathophysiology of acute lower respiratory tract disease, evidence on the use of NPPV in acutely ill patients, and challenges and potential complications of the use of NPPV specific to children. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449363 Mon, 01 Jun 2009 04:00:00 +0100 2449363 http://www.medworm.com/index.php?rid=2449362&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000317%2Fabstract%3Frss%3Dyes Children with respiratory diseases present commonly to the emergency department. As a continuous, dynamic measure of the ventilatory status, capnography can provide valuable information in the assessment and management of these patients. After a review of the relevant physiology and technology of carbon dioxide monitoring, clinical applications for the use of capnography in patients with respiratory illnesses are discussed. Characteristic waveforms are provided, and their interpretation and clinical significance are discussed. A focus on the current literature investigating the noninvasive monitoring of patients with obstructive lung disease is included. Practical tips for successfully using capnography are also presented. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449362 Mon, 01 Jun 2009 04:00:00 +0100 2449362 http://www.medworm.com/index.php?rid=2449361&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000330%2Fabstract%3Frss%3Dyes Bronchiolitis is a common respiratory illness in infancy for which there is a great deal of clinical practice variation, leading to costly resource utilization without clear evidence for benefit. Recent literature has focused on developing a broad base of evidence through systematic reviews and meta-analyses. This review will focus on this literature as it relates to pharmacologic and nonpharmacologic therapies and other management decisions. In addition, it will highlight some emerging evidence regarding the management of bronchiolitis and innovative new therapies. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449361 Mon, 01 Jun 2009 04:00:00 +0100 2449361 http://www.medworm.com/index.php?rid=2449360&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000354%2Fabstract%3Frss%3Dyes This article will primarily focus on heliox inhalation therapy and heliox-driven nebulizer therapy for acute asthma exacerbations. The emergence of heliox inhalation therapy for acute viral bronchiolitis will also be addressed. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449360 Mon, 01 Jun 2009 04:00:00 +0100 2449360 http://www.medworm.com/index.php?rid=2449359&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000366%2Fabstract%3Frss%3Dyes Respiratory illness is a leading reason for children to receive emergency care. Given its clinical importance, efforts to improve respiratory therapy have played a key role in the development of pediatric emergency medicine as both a physician specialty and a broader system of care involving many disciplines and resources. Any attempt to review innovation in pediatric respiratory care is a risky business, given the nearly constant evolution of the literature; however, the articles included here represent a few common principles that are likely to endure. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449359 Mon, 01 Jun 2009 04:00:00 +0100 2449359 http://www.medworm.com/index.php?rid=2449358&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000408%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449358 Mon, 01 Jun 2009 04:00:00 +0100 2449358 http://www.medworm.com/index.php?rid=2449357&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000391%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2449357 Mon, 01 Jun 2009 04:00:00 +0100 2449357 http://www.medworm.com/index.php?rid=2350381&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS152284010900007X%2Fabstract%3Frss%3Dyes Adolescents are frequent visitors to the emergency department (ED), and many use the ED as their only source of care. They may choose to obtain treatment in the ED for the anonymity and privacy it affords and may be unaccompanied by a parent who can provide consent for treatment. The provision of sexual and reproductive health care to adolescents in the ED presents challenges to the medical provider specifically with regard to consent and confidentiality issues. This review discusses the various state and federal laws governing the provision of sexual and reproductive health care services to adolescents, including the diagnosis and treatment of sexually transmitted infections and HIV, contraceptive services, prenatal care, and abortion services. We review the circumstances under which an a... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350381 Sun, 01 Mar 2009 05:00:00 +0100 2350381 http://www.medworm.com/index.php?rid=2350380&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000123%2Fabstract%3Frss%3Dyes Conditions that affect the foreskin and glans penis that should be recognized by the emergency medicine practitioner include phimosis, paraphimosis, and inflammatory penile skin conditions, such as balanitis, posthitis, and balanoposthitis. Despite some difficulty in clearly defining phimosis and balanitis/balanoposthitis, paraphimosis remains a true urologic emergency that requires immediate identification and management. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350380 Sun, 01 Mar 2009 05:00:00 +0100 2350380 http://www.medworm.com/index.php?rid=2350379&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000111%2Fabstract%3Frss%3Dyes This article reviews the anatomical considerations in the pediatric patient, which predispose to the development of scrotal masses. In addition, it reviews the diagnosis and treatment of common scrotal masses, including inguinal hernias and hydroceles, and provides tips to distinguish between simple, communicating, and cord hydroceles. More unusual pediatric diagnoses, such as varicoceles and scrotal and testicular tumors, are also discussed, along with indications for urgent or emergent referral to a pediatric surgeon or urologist. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350379 Sun, 01 Mar 2009 05:00:00 +0100 2350379 http://www.medworm.com/index.php?rid=2350378&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000147%2Fabstract%3Frss%3Dyes This article discusses both blunt and penetrating injuries to the penis, urethra, and scrotum. The anatomy, epidemiology, pathophysiology, clinical symptoms, and evaluation of each type of injury are discussed. Testicular rupture, urethral disruption, and penile fracture and amputation are acute surgical emergencies that require emergent referral to and management by a qualified urologist. Most of the other conditions can be diagnosed and managed by an emergency physician with access to high-resolution ultrasonography. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350378 Sun, 01 Mar 2009 05:00:00 +0100 2350378 http://www.medworm.com/index.php?rid=2350377&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000135%2Fabstract%3Frss%3Dyes This article reviews the differential diagnosis and management of the acute scrotal pain in the pediatric population, specifically focusing on testicular torsion, epididymitis, and torsion of the appendix testis. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350377 Sun, 01 Mar 2009 05:00:00 +0100 2350377 http://www.medworm.com/index.php?rid=2350376&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000044%2Fabstract%3Frss%3Dyes Ovarian torsion is a rare occurrence, but it is frequently considered in the differential diagnosis of a female with abdominal pain. A thorough knowledge of the pathophysiology, clinical presentation, and imaging options will allow the emergency department (ED) provider to facilitate rapid diagnosis and thus improve outcomes. In addition to these topics, success rates of detorsion and the argument for ovarian-sparing surgery are reviewed. The ED provider is encouraged to educate patients regarding these options and to advocate for ovarian-preserving procedures. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350376 Sun, 01 Mar 2009 05:00:00 +0100 2350376 http://www.medworm.com/index.php?rid=2350375&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000056%2Fabstract%3Frss%3Dyes Adolescent females presenting to the emergency department (ED) with acute pelvic pain may have diagnoses with significant morbidity and in some cases, mortality. An adolescent female with a complaint of acute pelvic pain can create a challenging clinical situation for busy ED providers. Differentiating between acute and chronic pain, and determining gynecologic vs other origins is an important first step. A thorough knowledge of adolescent development and the legal requirements of confidential care are helpful in sorting through these complicated complaints. Assessing for sexual activity and risk taking, pregnancy, and other sexual health components is critical to a thorough assessment and accurate diagnostic plan. Using an organ-specific approach to the reproductive system, this article w... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350375 Sun, 01 Mar 2009 05:00:00 +0100 2350375 http://www.medworm.com/index.php?rid=2350374&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS152284010900010X%2Fabstract%3Frss%3Dyes This article reviews the potential causes, clinical presentations, and management of vaginal bleeding in the prepubescent child. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350374 Sun, 01 Mar 2009 05:00:00 +0100 2350374 http://www.medworm.com/index.php?rid=2350373&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000068%2Fabstract%3Frss%3Dyes This article will also review management strategies of improved hygiene and sitz baths and the indications for antibiotics. (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350373 Sun, 01 Mar 2009 05:00:00 +0100 2350373 http://www.medworm.com/index.php?rid=2350372&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000093%2Fabstract%3Frss%3Dyes The prepubescent female genital examination can be challenging. In this article, we describe some techniques that can help to allow the examination to be performed effectively and efficiently. We will review the normal anatomy and anatomic variation present in prepubescent females, as well as how anatomic appearance changes with positioning. We will describe conditions that can distort the normal anatomy, dermatologic conditions that can alter skin color and surface characteristics, and systemic illness with genital findings. Although the differential diagnosis of genital complaints in prepubescent females is broad, skills in performing the genital examination and knowledge about normal anatomic variation are essential to informed diagnostic decisions for this population. (Source: Clinical... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350372 Sun, 01 Mar 2009 05:00:00 +0100 2350372 http://www.medworm.com/index.php?rid=2350371&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000081%2Fabstract%3Frss%3Dyes Pediatric gynecologic and genitourinary issues can be challenging to the care provider in the emergency department (ED). Although some of the specific complaints and relevant diagnoses are familiar, others occur infrequently, which precludes the development of clinical expertise that often results from repetitive clinical exposures. The ED physician may serve as the acute care provider for a new concern or may be the recipient of a referral from a primary care provider seeking assistance in the management of a specific clinical problem. The ED physician needs the knowledge and skills to recognize and address common issues; they also need to be able to identify the conditions that warrant subspeciality involvement as well as those issues that require urgent intervention. (Source: Clinical P... Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350371 Sun, 01 Mar 2009 05:00:00 +0100 2350371 http://www.medworm.com/index.php?rid=2350370&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000184%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350370 Sun, 01 Mar 2009 05:00:00 +0100 2350370 http://www.medworm.com/index.php?rid=2350369&cid=s_38455_14_f&fid=38455&url=http%3A%2F%2Fwww.clinpedemergencymed.com%2Farticle%2FPIIS1522840109000172%2Fabstract%3Frss%3Dyes (Source: Clinical Pediatric Emergency Medicine) Clinical Pediatric Emergency Medicine journals http://www.medworm.com/rss/comments.php?id=2350369 Sun, 01 Mar 2009 05:00:00 +0100 2350369