Abstract:
:Grunting respirations are recognized as a sign of serious illness in infants and children, but have not been well studied beyond the newborn period. We present three illustrative cases and the results of a descriptive study which elucidates the causes of grunting in infants and children and suggests guidelines for assessing pediatric patients with this symptom. All patients between one month and 18 years of age who presented to the Emergency Department (ED) of The Children's Hospital of Denver during the last five months of 1992 with grunting respirations were prospectively identified, and their charts were retrospectively reviewed. The 51 pediatric patients with grunting respirations (0.3% of all patients seen in the ED) fell into three groups based upon mode of presentation: 1) 55% presented with predominantly respiratory signs and symptoms, and each one had a respiratory or cardiac condition; 2) 25% presented with high fever (greater than 38.5 degrees C) but without respiratory signs and symptoms, and all had an infectious cause (three fourths of them had an invasive bacterial disease); 3) 20% presented with neither fever nor respiratory signs or symptoms and had one of a variety of conditions which appeared to cause pain. Presenting symptoms can guide the selection of tests used to evaluate the infant or child with grunting respirations. Guidelines for evaluation are provided in this report.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Poole SR,Chetham M,Anderson Mdoi
10.1097/00006565-199506000-00004subject
Has Abstractpub_date
1995-06-01 00:00:00pages
158-61issue
3eissn
0749-5161issn
1535-1815journal_volume
11pub_type
杂志文章abstract::Pulmonary infections due to anaerobic bacteria usually occur in children prone to aspiration. The source of the anaerobic bacteria is the oropharyngeal bacterial flora, where these organisms outnumber aerobic and facultative organisms in a 10:1 ratio. The most common lower respiratory tract infections where anaerobic ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000139751.63624.0b
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Extension-type supracondylar fractures can be treated with external immobilization, with the elbow flexed 100°. However, this technique requires early evaluation by true lateral x-ray of the elbow to detect secondary fracture displacement. QUESTIONS/PURPOSE:The purpose of this work is to evaluate whether ul...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001822
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:Emergency department (ED) crowding is an increasingly common problem in the United States. Crowding can lead to ED closure and diversion, poor patient satisfaction, and patient safety issues. The purpose of this study was to examine measures of ED census and measures of crowding to determine if a correlation ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318226c7dd
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:To describe a series of patients seen in a pediatric emergency department with adverse effects following an ingestion of a caterpillar. METHODS:Case series. RESULTS:Ten patients presented to the emergency department following ingestion of a caterpillar. Adverse effects ranged from drooling and refusal to drin...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:Occult pneumothoraces (OPTXs) are defined by air within the pleural space that is not visible on conventional chest radiographs (CXR). The aim of this study was to understand how frequently the Extended Focused Assessment with Sonography for Trauma (eFAST) examination identifies occult PTX in a pediatric blun...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002303
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate, in children undergoing procedural sedation for magnetic resonance imaging (MRI) scans, whether lower doses of propofol than previously published permitted a high rate of successful MRI completion, whether lower dosages result in a more rapid recovery, and whether age or b...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002289
更新日期:2020-11-11 00:00:00
abstract:OBJECTIVES:Ondansetron has been shown to decrease admission rate and the need for intravenous fluids among pediatric emergency department (ED) patients with acute gastroenteritis, but there is limited evidence regarding its use after ED discharge. This study describes prescribing patterns for ondansetron and assesses t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001343
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:In 1997, a Canadian task force published evidence-based guidelines for diagnosing pediatric pneumonia, concluding that the absence of each of four signs (ie, respiratory distress, tachypnea, crackles, and decreased breath sounds) accurately excludes pneumonia. The study was performed to evaluate the accuracy...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200108000-00003
更新日期:2001-08-01 00:00:00
abstract::Pediatric rapid sequence intubation is a skill of great importance to emergency medicine physicians. Developing a systematic strategy for approaching an emergent airway aids in the proper handling of this event. This paper is a review of the current recommendations for pediatric rapid sequence intubation including cur...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000125667.58561.62
更新日期:2004-05-01 00:00:00
abstract::This article describes a small series of injuries resulting from a new fad activity among children in Baltimore. "Flipping" involves jumping from an elevated surface and executing an aerial flip, with the intent to land upright. Because this activity takes place frequently on hard surfaces such as concrete, injuries o...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199304000-00010
更新日期:1993-04-01 00:00:00
abstract:CONTEXT:The needs of children in emergency situations differ from those of adults and require special attention, yet there has been no study of the ability of U.S. hospitals to care for emergently or critically ill children. OBJECTIVE:To estimate the distribution of pediatric services available at U.S. hospitals with ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200106000-00005
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVES:The National Pediatric Readiness Project of the Emergency Medical Services for Children surveyed emergency departments in the United States in 2013 for readiness to provide emergency care to children. However, that survey did not query for many elements considered essential to Advanced Trauma Life Support (A...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002144
更新日期:2020-06-09 00:00:00
abstract:OBJECTIVES:Nonoperative management of hemodynamically stable liver lacerations in pediatric trauma patients is a safe and effective management strategy for pediatric patients; approximately 90% will be successfully managed nonoperatively. No study has specifically identified risk criteria for the need for intervention ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001538
更新日期:2020-07-01 00:00:00
abstract::Ultrasound-guided regional anesthesia is a growing modality within the pediatric emergency department. Here we present a case where a posterior tibial nerve block was used for anesthesia during foreign body removal from the plantar foot. We further review the technique and literature regarding this straightforward and...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001897
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001262
更新日期:2020-08-01 00:00:00
abstract::Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have b...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e31826d1e9a
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:The objectives of the study were to identify factors associated with adolescent emergency department (ED) visits for substance abuse, including those complicated by mental health (dual diagnosis), and to analyze their effect on ED length of stay (LOS) and disposition. METHODS:We performed a secondary analys...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000421
更新日期:2015-05-01 00:00:00
abstract:INTRODUCTION:Viral gastroenteritis with dehydration is one of the most frequent reasons for visits to pediatric emergency departments (ED). Parental intervention before presentation to the ED can make a significant difference in the course of a child's illness. There is a discrepancy between medical knowledge of dehydr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/pec.0b013e3181d6d9de
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:Blood culture contamination rates (CRs) in emergency departments (EDs) vary from 1% to 9% in previous studies. High CRs cause unnecessary admissions, antibiotics, and costs. Different measures have been tried to improve CR. This study sought to determine the ED CR at Arkansas Children's Hospital (ACH) and eva...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318230285b
更新日期:2011-10-01 00:00:00
abstract::We present a case of a six-week-old infant who developed life-threatening complications after unintentional sodium bicarbonate intoxication. Baking soda was being used by the mother as a home remedy to "help the baby burp." A review of the literature regarding the use (or misuse) of baking soda follows. Our patient, a...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:
更新日期:1995-04-01 00:00:00
abstract::The recent popularity of elastic bands on the wrist may put children at risk for acute compartment syndrome. Acute compartment syndrome is a limb-threatening condition characterized by elevated interstitial pressure in a confined fascial compartment. If left untreated, it may result in tissue necrosis, irreversible ne...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318217b5a7
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:This study aimed to explore a dose-response relationship of delta-9-tetrahydrocannabinol (THC) in THC-naïve children after unintentional acute exposure and compare clinical outcomes with non-naïve children. METHODS:A retrospective review was performed on children aged 31 days to 20 years who presented to Ch...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000770
更新日期:2018-07-01 00:00:00
abstract::Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and the most common cause of gastrointestinal bleeding in children. Although it usually follows the rule of 2's, exceptions to this rule are reported in the literature. Often asymptomatic, MD is commonly an incidental finding ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001388
更新日期:2020-05-01 00:00:00
abstract::We describe the case of an 18-month-old child with recurrent apneic episodes, often requiring resuscitation, who was admitted to an academic pediatric medical center after previous evaluations had been unrevealing. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318180ff44
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:Urgent medical evaluation is recommended for patients with sickle cell disease (SCD) and fever. Clear recommendations exist regarding certain aspects of treatment, but other areas lack evidence. We determined practice variation for children with SCD presenting with fever to the emergency department (ED). ME...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000001569
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of a single dose of oral dexamethasone (Dex) versus 5 days of twice-daily prednisolone (Pred) in the management of mild to moderate asthma exacerbations in children. STUDY DESIGN:A prospective, randomized, double-blinded trial of children 2 to 16 years of age who presented to the emer...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.pec.0000248683.09895.08
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Optimizing patient/family caregiver satisfaction with emergency department (ED) encounters has advantages for improving patient health outcomes, adherence with medical plans, patient rights, and shared participation in care, provider satisfaction, improved health economics, institutional market share, and li...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318235be06
更新日期:2011-11-01 00:00:00
abstract::Enterobius vermicularis may cause infections of the gastrointestinal tract and occurs approximately in 4% to 28% of children worldwide. It is most common in children aged 5 to 14 years.The most commonly reported symptoms are pruritus in the perianal region, abdominal pain, urinary tract infection, insomnia, irritabili...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000480
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:We present a case of Kasabach-Merritt syndrome with discussion of hemangiomas of childhood relevant to the emergency physician. DESIGN:This is a case report. SETTING:The case is described in the setting of a tertiary care hospital level I pediatric emergency department. PATIENTS:A single case is discussed....
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199612000-00009
更新日期:1996-12-01 00:00:00
abstract::Vomiting in young infants is a common presentation to the pediatric emergency department with a broad differential diagnosis. We present 2 cases seen in our emergency department of infant females with symptomatic complex ovarian cysts who presented with vomiting. The first case study describes a patient with a prenata...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002209
更新日期:2020-08-10 00:00:00