Principles of Pediatric Emergency Care

Abstract

Background: Children account for only a small percentage of pre-hospital emergency patients but are a special challenge for the treating physician.Methods: The Medline database was selectively searched for articles appearing up to June 2009. The authors added other important litera ture of which they were aware.Results: The broad spectrum of diseases, the wide age range with the physiological and anatomical changes that occur in it, and the special psychological, emotional, and communicative features of children make pediatric emergencies a special challenge for emergency physicians.Conclusions: A mastery of basic emergency techniques including clinical evaluation of the child, establishment of venous access, airway man agement, resuscitation, and drug dosing is essential for the successful emergency treatment of children. We recommend classifying the common non-traumatic pediatric emergencies by four cardinal manifestations: respiratory distress, altered consciousness, seizure, and shock. Classifying these rare emergency situations in this way helps assure that their treatment will be goal-oriented and appropriate to the special needs of sick children.

Mortality in children with classic congenital adrenal hyperplasia and 21-hydroxylase deficiency (CAH) in Germany

“…Cardiac output decreases before the onset of arterial hypotension. Therefore, therapy for shock in children must be started before the onset of hypotension [ 28 ]. CAH children seem to have a markedly elevated risk of acute adrenal crisis in the presence of acute gastroenteritis due to dehydration and/or lack of drug uptake during diarrhoea and/or vomiting.…”

Reanimation eines Säuglings – ST-Hebungsinfarkt und Kammerflimmern, nicht nur ein Phänomen des Erwachsenen

“…Deshalb sollte möglichst frühzeitig die Anlage eines intraossären Zugangs in Erwägung gezogen werden [13]. Dies wird in der Literatur zwar als simple Maßnahme beschrieben, jedoch gestaltet sich die Implementierung in einer Notfallsituation schwierig [14]. Umso wichtiger ist es, diese Maßnahme regelmäßig zu trainieren sowie alternative Punktionsorte, außer dem Zugangsweg zur proximalen Tibia, zu kennen [15].…”

Evaluación inicial del paciente pediátrico: ¿cómo se debe realizar?

“…Cada componente del TEP se evalúa por separado, utilizando los hallazgos visuales, auditivos o físicos. Con el TEP no se pretende realizar un diagnóstico específico, sino que está diseñado para identificar el tipo Manchas en la piel por diversos grado de vasoconstricción y la gravedad del problema fisiológico y priorizar el tratamiento inicial [21]. La impresión general que se obtiene de la valoración pediátrica inicial permite hacer una clasificación simple del estado fisiológico del niño (tabla 4).…”