What’s This Pounding in My Head?

2020 ◽  
pp. 123-130
Author(s):  
Sakina Sojar ◽  
Lauren Allister
Keyword(s):  
Emergency Department ◽  
Severe Pain ◽  
Imaging Modality ◽  
Pediatric Population ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Advantages And Disadvantages ◽  
Common Causes ◽  
Viral Illness ◽  
Life Threatening

Headaches are a common chief complaint within the pediatric emergency department. They can be a source of significant morbidity in the pediatric population causing severe pain, cognitive dysfunction, and missed school days. It is critical that the physician delineates between life-threatening versus non-life-threatening etiologies of headache and obtain imaging of the head when appropriate. Computed tomography and magnetic resonance imaging are the modalities of choice. Each imaging modality presents advantages and disadvantages. Common causes of headaches in the pediatric emergency department include migraine, tension headaches, and viral illness. Physicians must be aware of more serious etiologies (such as space occupying lesions) that may warrant further investigation.

Stairway Injuries in Children

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 457-461 ◽  
Author(s):  
Mark Joffe ◽  
Stephen Ludwig
Keyword(s):  
Emergency Department ◽  
Body Part ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Mechanism Of Injury ◽  
Neck Injuries ◽  
Severity Of Injury ◽  
Proximal Extremity ◽  
Life Threatening ◽  
Extremity Injuries

Children frequently injure themselves falling down stairways, but the characteristics of these injuries are not well described. A total of 363 consecutive patients seen in a pediatric emergency department were studied. The majority of patients had minor superficial injuries. Bony injuries occurred in 7% of patients. Head and neck injuries occurred in 73% of patients, extremity injuries, which were predominantly distal, in 28%, and truncal injuries in 2%. Children younger than 4 years of age were more likely to sustain head trauma than children older than 4 years of age (P < .005). Injury to more than one body part occurred in only 2.7% of patients. Children who fell down more than four steps had no greater number or severity of injury than those who fell down less than four steps (P = .67). Patients were admitted to hospitals in 3% of cases. No patient had life-threatening injuries and no patients required intensive care. When multiple, severe, truncal, or proximal extremity injuries are noted in a patient who reportedly fell down stairs, a different mechanism of injury should be suspected.

scholarly journals Point-of-care ultrasound for evaluating intra-abdominal calcification in the pediatric emergency department: case series and review of literature

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Vigil James ◽  
John Samuel ◽  
Chor Yek Kee ◽  
Gene Yong-Kwang Ong
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Pediatric Population ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
Pediatric Emergency Department ◽  
Wall Calcification

Abstract Background The presence of intra-abdominal calcification in the pediatric population can be due to a wide range of conditions. Calcification in the abdomen can be seen in normal or abnormal anatomical structures. In some patients, abnormal calcification points towards the pathology; whereas in others, calcification itself is the pathology. After a thorough history and clinical examination, point-of-care ultrasound (POCUS) would complement the assessment of acute abdominal pain, based on the list of differentials generated as per the abdominal region. The main objective of this article is to review commonly encountered causes of intra-abdominal calcifications in the pediatric population and help in clinical decision-making in a Pediatric Emergency Department. Case presentation We describe a series of pediatric patients who presented to the Pediatric Emergency Department with acute abdominal pain, in whom point-of-care ultrasound helped expedite the diagnosis by identifying varying types of calcification and associated sonological findings. For children who present to the Pediatric Emergency Department with significant abdominal pain, a rapid distinction between emergencies and non-emergencies is vital to decrease morbidity and mortality. Conclusions In a child presenting to the Pediatric Emergency Department with abdominal pain, POCUS and the findings of calcifications can narrow or expand the differential diagnosis when integrated with history and physical exam, to a specific anatomic structure. Integrating these findings with additional sonological findings of an underlying pathology might raise sufficient concerns in the emergency physicians to warrant further investigations for the patient in the form of a formal radiological ultrasound and assist in the patient's early disposition. The use of POCUS might also help to categorize the type of calcification to one of the four main categories of intra-abdominal calcifications, namely concretions, conduit wall calcification, cyst wall calcification, and solid mass-type calcification. POCUS used thoughtfully can give a diagnosis and expand differential diagnosis, reduce cognitive bias, and reduce physician mental load. By integrating the use of POCUS with the history and clinical findings, it will be possible to expedite the management in children who present to the Pediatric Emergency Department with acute abdominal pain.

Vertigo/dizziness in pediatric emergency department: Five years’ experience

Cephalalgia ◽  
2015 ◽  
Vol 36 (6) ◽  
pp. 593-598 ◽  
Author(s):  
Umberto Raucci ◽  
Nicola Vanacore ◽  
Maria Chiara Paolino ◽  
Romina Silenzi ◽  
Rosanna Mariani ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Characteristics ◽  
Signs And Symptoms ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Nervous System Diseases ◽  
Central Nervous System Diseases ◽  
Cardiac Syncope ◽  
Life Threatening ◽  
Rule Out

Background Vertigo/Dizziness in childhood is not a rare cause of visits to the emergency department (ED). We analyzed a selected group with vertigo/dizziness to identify signs and symptoms that may help to guide the diagnostic approach and management. Methods A total of 616 children admitted for vertigo to the ED over a five-year period were retrospectively reviewed. Their medical history, clinical characteristics, laboratory and neuroimaging tests, final diagnoses and management were analyzed. Results Migraine and syncope were the most frequent causes. Two patients were affected by life-threatening cardiac syncope, while structural life-threatening central nervous system diseases were found in 15 patients, none of whom presented with vertigo as an isolated clinical finding. Conclusions Most cases of vertigo/dizziness in childhood that consist mainly of migraine and syncope are of benign origin. The prompt identification of neurological or cardiological signs or symptoms associated with vertigo in children is mandatory to rule out life-threatening conditions.

Life-Threatening Rhabdomyolysis Induced by Streptococcus bovis Sepsis in a 6-Year-Old Girl Presented to the Pediatric Emergency Department

2012 ◽  
Vol 28 (5) ◽  
pp. 469-471 ◽  
Author(s):  
Hui-Hsien Pan ◽  
Hung-Ming Chang ◽  
Shan-Ming Chen ◽  
Tung-Wei Hung ◽  
Ko-Huang Lue ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Streptococcus Bovis ◽  
Life Threatening

scholarly journals Epidemiology and Trends over Time of Foreign Body Injuries in the Pediatric Emergency Department

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 938
Author(s):  
Honoria Ocagli ◽  
Danila Azzolina ◽  
Silvia Bressan ◽  
Daniele Bottigliengo ◽  
Elisabetta Settin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Pediatric Emergency ◽  
Incidence Rates ◽  
Pediatric Emergency Department ◽  
Injury Incidence ◽  
Poisson Models ◽  
Life Threatening ◽  
Trends Over Time ◽  
Over Time

This paper presents the epidemiology of foreign body injuries in the Pediatric Emergency Department (PED) of Padova (Italy) along with its trends over an eleven-year period based on administrative data. Annual incidence rates (IRs) of PED presentations for foreign body (FB) injuries per 1000 person-years were calculated. Univariable and multivariable generalized linear (GLM) Poisson models were estimated to evaluate the relationship between FB injury incidence and year, triage priority, nationality, injury site, and FB type. During the study period, there were 217,900 presentations of pediatric residents in the province of Padova; of these, 3084 (1.5%) reported FB injuries involving the ears, nose, throat, gastrointestinal tract or eyes. The annual IR of FB injury episodes increased from 10.45 for 1000 residents in 2007 (95% CI, 9.24, 11.77) to 12.66 for 1000 residents in 2018 (95% CI, 11.35, 14.08). Nonfood items were the FBs that were most frequently reported. The intermediate urgent triage code was the most represented for FB injuries, with IRs ranging from 5.44 (95% CI: 4.59, 6.40) in 2008 to 8.56 in 2018 (95% CI: 7.50, 9.74). A total of 170 patients who presented for FB injuries were hospitalized (5.5%). The annual FB-related injury IR has increased over time, although most episodes are not life threatening. Educational and prevention programs on FB-related injuries should be promoted and dedicated to childcare providers.

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