Foundations Genitourinary (GU) and renal tract emergencies in children are common. These issues span age and gender and have varying clinical presentations. Underlying pathology is due to both congenital and acquired disease. Careful history of present illness and family history…
Key Concepts Identification of Pathogen Stool studies are not indicated in most uncomplicated cases of acute gastroenteritis (AGE). Exceptions are those cases in which specific treatment, specific prophylaxis, or health precautions are required, or in which the patient has systemic…
Key Concepts Physiologic jaundice of the newborn and breast milk jaundice are the most common causes of jaundice in the neonatal period. Direct hyperbilirubinemia in infants is always pathologic and requires a detailed evaluation. Hypertrophic pyloric stenosis is associated with…
Key Concepts Consider a congenital heart defect in an infant with central cyanosis who does not respond to 100% supplemental oxygen (hyperoxia challenge). Neonates with ductal-dependent cardiac lesions typically present within the first 2 to 3 weeks of life with…
Key Concepts Determining the causative agent of pneumonia by clinical presentation and radiographic findings is not reliable; empirical treatment is based on guideline recommendations and likely pathogens. Causative agents vary by age; viral agents predominate, especially in younger children, and…
Asthma Key Concepts No single asthma score has been universally adopted to assess the degree of illness or treatment responses. However, most scores include some combination of respiratory rate, degree of wheezing, inspiratory-to-expiratory ratio, use of accessory muscles, and oxygen…
Key Concepts Respiratory arrest precedes most pediatric cardiac arrests. Quick recognition of an airway problem and intervention in potentially life-threatening upper airway obstruction in children are critical. Retropharyngeal Abscess This is a potentially life-threatening emergency in young children with signs…
Key Concepts Fever is the most common complaint among pediatric patients presenting to the emergency department (ED). Although rates of bacterial illness are lower since the advent of universal vaccination for Haemophilus influenzae type b and Streptococcus pneumoniae , serious…
Key Concepts Trauma is the leading cause of death in children in the United States. Avoid hypoxia and hypotension by early administration of oxygen and assisted ventilation, and fluid resuscitation with crystalloid at 20 mL/kg increments. Initiate transfusion of 10…
Key Concepts Resuscitation should be anticipated for all deliveries; 10% of newborns will require some resuscitation, and 1% will require advanced life support interventions after birth. Predictable indications for resuscitation include hypoxia, hypothermia, hypoglycemia, hypovolemia, prematurity, maternal infection, and adverse…