RESUMEN
The application of emergency point-of-care ultrasound has been expanding in pediatric emergency medicine for a decade. In this case series, we describe the detection of papilledema in patients presenting to the pediatric emergency department using this technology and its potential impact on their clinical care.
Asunto(s)
Papiledema/diagnóstico por imagen , Sistemas de Atención de Punto , Adolescente , Niño , Preescolar , Urgencias Médicas , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , UltrasonografíaRESUMEN
A 3-month-old infant girl was transferred to our emergency department (ED) with a subtrochanteric femoral neck fracture due to nonaccidental trauma. She received multiple doses of parenteral analgesics both before arrival and in our ED. We performed an ultrasound-guided femoral nerve block using 2.0 mL of 0.25% bupivicaine (approximately 1.25 mg/kg) before placing the patient in a Pavlik harness. Successful pain control was achieved within 15 minutes of the procedure allowing pain-free manipulation of the affected extremity. The patient required only a single dose of parenteral narcotics during the ensuing 18 hours. To our knowledge, this is the first report of an ultrasound-guided femoral nerve block used in the ED for pain control in a pediatric patient.
Asunto(s)
Dolor Agudo/terapia , Analgesia/métodos , Maltrato a los Niños , Fracturas del Cuello Femoral/complicaciones , Nervio Femoral , Fracturas Cerradas/complicaciones , Dolor Musculoesquelético/terapia , Bloqueo Nervioso/métodos , Ultrasonografía Intervencional , Dolor Agudo/tratamiento farmacológico , Anestésicos Locales , Bupivacaína , Maltrato a los Niños/diagnóstico , Terapia Combinada , Femenino , Fracturas del Cuello Femoral/diagnóstico por imagen , Fracturas del Cuello Femoral/terapia , Fracturas Cerradas/diagnóstico por imagen , Fracturas Cerradas/terapia , Humanos , Lactante , Traumatismo Múltiple/diagnóstico por imagen , Dolor Musculoesquelético/tratamiento farmacológico , Narcóticos/uso terapéutico , RadiografíaRESUMEN
Pediatric syncope is a common presentation in the emergency department. Most causes are benign, but an evaluation must exclude rare life-threatening disorders. The lack of objective findings can pose a challenge. This case-based review emphasizes the importance of a detailed history and physical examination with electrocardiogram in determining high-risk patients.