Management of Neurological Emergencies in Children: An Updated Overview

Abstract

Neurological emergencies account for about one-third of the highest severity codes attributed in emergency pediatric departments. About 75% of children with acute neurological symptoms presents with seizures, headache, or other paroxysmal events. Life-threatening conditions involve a minor proportion of patients (e.g., less than 15% of children with headache and less than 5% of children with febrile seizures). This review highlights updated insights about clinical features, diagnostic workup, and therapeutic management of pediatric neurological emergencies. Particularly, details will be provided about the most recent insights about headache, febrile seizures, status epilepticus, altered levels of consciousness, acute motor impairment, acute movement disorders, and functional disorders, as well as the role of diagnostic tools (e.g., neuroimaging, lumbar puncture, and electroencephalography), in the emergency setting. Moreover, the impact of the current novel coronavirus disease2019 (COVID-19) pandemic on the evaluation of pediatric neurologic emergencies will also be analyzed.

Red Code Management in a Pediatric Emergency Department: A Retrospective Study

“…Electric therapy, including both defibrillation and cardioversion, was never utilized and this reinforces the possibility that pediatric emergency medicine faculty are at a significant risk for skill deterioration, especially concerning critical procedures performed in a pediatric ED [24]. Statistically significant correlations were also found between the administration of some drugs and the admission main complaint: for example, oxygen, steroids, drugs acting on airways (mainly a bronchodilator via aerosol or intravenous administration), and antibiotics in respiratory patients; antiemetics, anticonvulsants, and psychoactive drugs (antipsychotics and benzodiazepines) in neuropsychiatric patients; crystalloids, colloids, sedatives, and dressings in traumatic patients; colloids, crystalloids, and cardioactive drugs (adenosine, adrenaline, atropine, beta-blockers) in cardiologic patients; crystalloids, glucagon, and insulin in metabolic patients; and dressings in surgical patients, all in accordance with the guidelines and the hospital protocols [9,[11][12][13]29,30].…”

“…The routine clinical management of RCs is based on the Pediatric Advanced Life Support (PALS) approach, a systematic method for managing children in critical condition [9]. Alongside the PALS algorithm, international guidelines and local hospital protocols aim to standardize care and optimize outcomes [10][11][12][13]. Diagnostic assessments for detecting and identifying severe clinical conditions include bedside, laboratory, and instrumental tests [9,14].…”

Red Code Management in Pediatric Emergency Department: A Retrospective Study

“…The routine clinical management of RDs is based on Pediatric Advanced Life Support (PALS) approach, a systematic method to manage children in critical condition [9]. Alongside PALS algorithm, international guidelines and local hospital protocols aim to standardize care and optimize outcomes [10][11][12][13]. Diagnostic assessments to detect and identify severe clinical condition include bedside, laboratory and instrumental tests [9,14].…”

Akute neurologische Notfälle im Kindesalter

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Neurologische Notfälle zählen mit bis zu 30 % zu den häufigsten Diagnosen in der pädiatrischen Notaufnahme [1]. Dementsprechend begegnet man Kindernotfällen mit neurologischen Symptomen im Rettungsdienst ebenfalls häufig [2].

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