A simple modified bicarbonate regimen for urine alkalinization in moderate pediatric salicylate poisoning in the emergency department.

Abstract:

:A 4-year-old Indian girl was seen in our emergency department for unintentional ingestion of topical medication oil with subsequent salicylate poisoning. Serum levels were 52 mg/dL at 12 hours after ingestion.She was started on urine alkalization therapy to enhance salicylate elimination. This was achieved by a bicarbonate bolus of 1 mEq/kg for an hour and a continuous bicarbonate-potassium-dextrose combination infusion. The infusion regimen was modified from adult recommendations to tailor for pediatric physiological requirements in a young child. This consisted of a combination solution of dextrose 5%-sodium bicarbonate-potassium chloride with similar sodium content as half-strength (0.45%) saline and supplemental potassium, which is crucial for effective urine alkalinization. The combination fluid was administered at a rate 1.5 times her maintenance fluid requirement to achieve a urine output of 1.5 to 2 mL/kg per hour and a urine pH of 7.5 to 8.5. This regimen was well tolerated with good outcome.Many pediatricians and toxicologists achieve urine alkalinization by giving multiple bicarbonate boluses and have separate hydration fluids with dextrose and supplemental potassium. These regimens may involve complex calculations and multiple infusions that may lead to increased risk of calculation and medication errors especially in the busy emergency department setting. This case report highlights the use of a simple modified urine alkalinization regimen for moderate salicylate poisoning in a young child in the emergency department.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Ong GY

doi

10.1097/PEC.0b013e3182131556

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

306-8

issue

4

eissn

0749-5161

issn

1535-1815

pii

00006565-201104000-00012

journal_volume

27

pub_type

杂志文章
  • A warning: don't be stumped by stump appendicitis.

    abstract::When an emergency medicine physician evaluates a child with abdominal pain and a history of appendectomy, appendicitis is often excluded from the differential. We present a case of a 16-year-old boy who developed stump appendicitis 3 years after laparoscopic appendectomy. Knowledge of this rare phenomenon in children ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e31827b54db

    authors: Schreiner C,Hartin CW Jr,Yamout SZ,Ozgediz DE,Glick PL

    更新日期:2013-01-01 00:00:00

  • Holiday ornament-related injuries in children.

    abstract:OBJECTIVES:Holiday ornament injuries in children have not been well documented in the medical literature. Our aim was to investigate the patterns of injuries sustained from these ornaments as a first measure toward prevention. METHODS:This was a retrospective cohort analysis of all patients examined in an urban pediat...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3181c33109

    authors: Kimia A,Lee L,Shannon M,Capraro A,Mays D,Johnston P,Hummel D,Shuman M

    更新日期:2009-12-01 00:00:00

  • Stress: A Factor Explaining the Gap Between Simulated and Clinical Procedure Success.

    abstract:BACKGROUND:Stress may impair the success of procedures in emergency medicine. The aims were to assess residents' stress during simulated and clinical lumbar punctures (LPs) and to explore the correlation of stress and performance. METHODS:A prospective study (2013-2016) was carried out in a pediatric emergency departm...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001962

    authors: Oriot D,Trigolet M,Kessler DO,Auerbach MA,Ghazali DA

    更新日期:2020-01-20 00:00:00

  • Acute Dystonia Versus Neuroleptic Malignant Syndrome Without Fever in an Eight-Year-Old Child.

    abstract::Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication of the use of certain medications. It is being seen more often in the pediatric population because of the increasing use of both typical and atypical antipsychotics in children. Rapid recognition of NMS is important to emergency physicia...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001000

    authors: Sridaran R,Nesbit CE

    更新日期:2017-01-01 00:00:00

  • Grunting respirations in infants and children.

    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 ass...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/00006565-199506000-00004

    authors: Poole SR,Chetham M,Anderson M

    更新日期:1995-06-01 00:00:00

  • Laxative-Induced Contact Dermatitis.

    abstract::A 5-year-old female with Charcot-Marie-Tooth neuropathy and a history of constipation presented to the emergency department with a new blistering buttocks rash, which was initially concerning for nonaccidental burn. Upon further investigation, it was found that Ex-Lax had been given to the patient for constipation. Th...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001498

    authors: Melvin JE,Hickey RW

    更新日期:2019-07-01 00:00:00

  • Methodology and Demographics of a Brief Adolescent Alcohol Screen Validation Study.

    abstract:OBJECTIVE:The aim of this study was to determine the psychometric properties of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question alcohol screen within 16 Pediatric Emergency Care Applied Research Network pediatric emergency departments. This article describes the study methodology, sample chara...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/PEC.0000000000001221

    authors: Bromberg JR,Spirito A,Chun T,Mello MJ,Casper TC,Ahmad F,Bajaj L,Brown KM,Chernick LS,Cohen DM,Fein J,Horeczko T,Levas MN,McAninch B,Monuteaux M,Mull CC,Grupp-Phelan J,Powell EC,Rogers A,Shenoi RP,Suffoletto B,Va

    更新日期:2019-11-01 00:00:00

  • Occult Pneumothorax Identification on Extended Focused Assessment with Sonography for Trauma Examination in Children.

    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

    authors: Malek D,Santillanes G,Hsiao V,Mailhot T,Claudius I

    更新日期:2020-12-01 00:00:00

  • Leadership and management in pediatric emergency medicine.

    abstract::The development of leadership and management skills requires a commitment to personal introspection and the development of self-knowledge. Difficult decisions concerning the determination of that which is truly important is central to the process. At both the personal and organizational levels, this process can be fac...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,评审

    doi:10.1097/00006565-199506000-00014

    authors: Petrack EM,Li MM

    更新日期:1995-06-01 00:00:00

  • Plasma β-Hydroxybutyrate for the Diagnosis of Diabetic Ketoacidosis in the Emergency Department.

    abstract:OBJECTIVE:Diabetic ketoacidosis (DKA) is a common emergency department presentation of both new-onset and established diabetes mellitus (DM). β-Hydroxybutyrate (BOHB) provides a direct measure of the pathophysiologic derangement in DKA as compared with the nonspecific measurements of blood pH and bicarbonate. Our objec...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000002035

    authors: Tremblay ES,Millington K,Monuteaux MC,Bachur RG,Wolfsdorf JI

    更新日期:2020-02-01 00:00:00

  • Test characteristics of an automated age- and temperature-adjusted tachycardia alert in pediatric septic shock.

    abstract:OBJECTIVES:This study aimed to create and analyze the performance of an automated triage tool alerting triage nursing staff and physicians to an abnormal heart rate consistent with septic shock in a pediatric emergency department. METHODS:A computerized best-practice alert (BPA) triage system corrected heart rate for ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e318267a78a

    authors: Cruz AT,Williams EA,Graf JM,Perry AM,Harbin DE,Wuestner ER,Patel B

    更新日期:2012-09-01 00:00:00

  • Adverse events in pediatric ketamine sedations with or without morphine pretreatment.

    abstract:OBJECTIVE:To assess outcomes between 2 groups of patients receiving ketamine for procedural sedations in our pediatric emergency department. Our hypothesis is that there is no difference in the number of adverse events in ketamine sedations with and without morphine pretreatment. METHODS:This was a retrospective cohor...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/01.pec.0000221339.26873.14

    authors: Waterman GD Jr,Leder MS,Cohen DM

    更新日期:2006-06-01 00:00:00

  • When a funduscopic examination is the clue of maltreatment diagnostic.

    abstract:OBJECTIVE:: To report a case of unexpected shaken baby syndrome, the diagnosis of which was possible after an incidental funduscopic examination. METHODS:: Observational case report. An infant was to be sent back home with an apparent unprovoked seizure diagnosis when a funduscopic examination was made because of an i...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/01.pec.0000227385.46143.20

    authors: Barcenilla AI,de la Maza VT,Cuevas NC,Ballús MM,Castanera AS,Fernández JP

    更新日期:2006-07-01 00:00:00

  • Discitis and epidural abscess after dental extraction in a pediatric patient: a case report.

    abstract::Neck pain is a relatively common pediatric complaint. Most is of benign etiology. We present an unusual case of epidural abscess with associated discitis in the cervical spine of a 12-year-old after a dental extraction. This potentially dangerous complication was diagnosed before neurological complications developed a...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3181c8c60b

    authors: Henton JM,Dabis HS

    更新日期:2009-12-01 00:00:00

  • Maternal somatic symptoms, psychosocial correlates, and subsequent pediatric emergency department use.

    abstract:BACKGROUND:Somatization is associated with increased health care use in adults. Whether mothers with somatic symptoms use more health care resources for their children has not been investigated. OBJECTIVE:This study aimed to explore the association of maternal somatic symptoms and emergency department (ED) use. DESIG...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3182809a10

    authors: Dang AT,Ho M,Kroenke K,Grupp-Phelan J

    更新日期:2013-02-01 00:00:00

  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Challenging Diagnosis in the Emergency Department.

    abstract::Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an underdiagnosed disease that has been described thus far only in case series. Patients, the majority of which are females, develop neuropsychiatric symptoms that can often be misdiagnosed as purely psychiatric illness. Although teratomas are nearly pathognom...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001853

    authors: Zhao B,Nelson DG

    更新日期:2019-09-01 00:00:00

  • Deadly proposal: a case of catecholaminergic polymorphic ventricular tachycardia.

    abstract::Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare adrenergically mediated arrhythmogenic disorder classically induced by exercise or emotional stress and found in structurally normal hearts. It is an important cause of cardiac syncope and sudden death in childhood. Catecholaminergic polymorphic ve...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3182360606

    authors: Heiner JD,Bullard-Berent JH,Inbar S

    更新日期:2011-11-01 00:00:00

  • Curanderismo: consequences of folk medicine.

    abstract::Curanderismo, folk medicine, is an important and common aspect of Hispanic culture. Its use is not well understood by US medical physicians and is often overlooked when Hispanic patients present to US hospitals. We present a case of isopropyl alcohol toxicity in a 4-year-old child due to the use of a curanderismo trea...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e31816b7a92

    authors: DeBellonia RR,Marcus S,Shih R,Kashani J,Rella JG,Ruck B

    更新日期:2008-04-01 00:00:00

  • Subcutaneous Granuloma Annulare: A Diagnostic Conundrum-Learning From Mistakes.

    abstract::Subcutaneous granuloma annulare is an inflammatory lesion occurring in otherwise healthy children. We present 3 pediatric patients with different diagnostic-therapeutic paths depending on the ward they were referred to. The lesions regress spontaneously, and medical or surgical treatments are generally not necessary. ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000591

    authors: Pederiva F,Paloni G,Berti I

    更新日期:2017-08-01 00:00:00

  • Why not your pediatrician's office? A study of weekday pediatric emergency department use for minor illness care in a community hospital.

    abstract::To determine the rationale for using a community hospital's emergency department for minor illness care on weekdays, we surveyed 150 parents of children 15 years of age or younger. Fifty (33.3%) participants had no identified source of routine pediatric care, and 31 (20.7%) had pediatric providers not locally availabl...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/00006565-198806000-00005

    authors: Smith RD,McNamara JJ

    更新日期:1988-06-01 00:00:00

  • Physicians' Approach to Anaphylaxis in Childhood.

    abstract::Anaphylaxis is a life-threatening, severe, generalized, or systemic hypersensitivity reaction. The incidence of anaphylaxis is increasing especially in pediatric age. Our aim in this study was to investigate the knowledge and attitudes of the physicians on the diagnosis and treatment of anaphylaxis. METHODS:A questio...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000002064

    authors: Tuncel T,Sancakli O,Bag O,Cetin HS,Özdoğru EE

    更新日期:2020-02-24 00:00:00

  • Application of Pediatric Appendicitis Score on the emergency department of a secondary level hospital.

    abstract:BACKGROUND:Acute appendicitis is the most common surgical emergency during childhood. Accurate early diagnosis is important to avoid complications and unnecessary interventions. In 2002, Samuel developed the Pediatric Appendicitis Score (PAS) based on a series of data obtained from anamnesis, physical examination, and ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3182586d34

    authors: Zúñiga RV,Arribas JL,Montes SP,Fernandez MN,Abad CG,Martin LG,González-Sagrado M

    更新日期:2012-06-01 00:00:00

  • Use of Emergency Medical Service transport system in medical patients up to 36 months of age.

    abstract:OBJECTIVES:To determine the frequency of inappropriate transport by Emergency Medical Service (EMS). DESIGN:A retrospective study. SUBJECTS:Patients up to 36 months of age with medical complaints transported by EMS to an urban pediatric emergency department (ED). INTERVENTIONS:None. MEASUREMENTS:Arbitrary criteria ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/00006565-199806000-00004

    authors: Rosenberg N,Knazik S,Cohen S,Simpson P

    更新日期:1998-06-01 00:00:00

  • Efficacy of vibration on venipuncture pain scores in a pediatric emergency department.

    abstract:OBJECTIVE:Venipuncture is a frequent source of painful procedures for infants. It has been well documented that infants react to pain with a combination of physiologic and behavioral responses. Infants are unable to describe pain and at particularly high risk for inadequate pain management. The Vibration Anesthesia Dev...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/PEC.0000000000000228

    authors: Secil A,Fatih C,Gokhan A,Alpaslan GF,Gonul SR

    更新日期:2014-10-01 00:00:00

  • Abusive head trauma in young children: a population-based study.

    abstract:OBJECTIVE:The objectives of this study were to provide population-based incidence estimate of abusive head trauma (AHT) in children aged 0 to 5 years from inpatient and emergency department (ED) and identify risk characteristics for recognizing high-risk children to improve public health surveillance. METHODS:This was...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e31828503ea

    authors: Selassie AW,Borg K,Busch C,Russell WS

    更新日期:2013-03-01 00:00:00

  • Do published guidelines predict pneumonia in children presenting to an urban ED?

    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

    authors: Rothrock SG,Green SM,Fanelli JM,Cruzen E,Costanzo KA,Pagane J

    更新日期:2001-08-01 00:00:00

  • Emergency visits for childhood poisoning: a 2-year prospective multicenter survey in Spain.

    abstract:OBJECTIVES:To describe the characteristics of childhood poisoning leading to consultation to 17 pediatric emergency departments in Spain. METHODS:During a 2-year period (January 2001 to December 2002), accompanying people of 2157 children with acute intoxication who visited consecutively at the emergency room were pro...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/01.pec.0000215651.50008.1b

    authors: Mintegi S,Fernández A,Alustiza J,Canduela V,Mongil I,Caubet I,Clerigué N,Herranz M,Crespo E,Fanjul JL,Fernández P,Humayor J,Landa J,Muñoz JA,Lasarte JR,Núñez FJ,López J,Molina JC,Pérez A,Pou J,Sánchez CA,Vázquez

    更新日期:2006-05-01 00:00:00

  • Leaving Without Being Seen From a Pediatric Emergency Department: Identifying Caregivers' Perspectives Using Q-methodology.

    abstract:OBJECTIVE:National rates of left (or leaving) without being seen (LWBS) in pediatric emergency departments (PED) are higher than general emergency departments. We investigated coexisting perspectives on LWBS. METHODS:Q-methodology was implemented through a mixed-methods design. Semistructured interviews elicited a con...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001792

    authors: Moskalewicz RL,Pham PK,Liberman DB,Hall JE

    更新日期:2019-04-11 00:00:00

  • Pediatric emergency physicians and communicable diseases: can we be trusted to take care of ourselves?

    abstract:OBJECTIVE:To determine if pediatric emergency physicians (PEP) are following Centers for Disease Control and Prevention (CDC) recommendations that all health care workers receive routine vaccines and annual tuberculosis screens. DESIGN:A two-page mail survey with one follow-up mailing. PARTICIPANTS:All active members...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/00006565-199710000-00002

    authors: Lane NE,Paul RI,Bratcher DF,Stover BH

    更新日期:1997-10-01 00:00:00

  • Implementation of Pediatric Emergency Care Applied Research Network Guidelines for Traumatic Brain Injury in a Rural Tertiary Care Center.

    abstract:OBJECTIVES:To evaluate changes in imaging practices for pediatric head trauma after publication of the Pediatric Emergency Care Applied Research Network (PECARN) guidelines, explore areas for quality improvement regarding neuroradiology referrals. We also sought to determine the prevalence of incidental findings discov...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000002124

    authors: Tsao J,Hook M,Shah P,Bingham PM

    更新日期:2020-06-12 00:00:00