Cardiac Arrest Key Concepts Unlike adults, most cardiac arrests in children arise from respiratory etiologies. Therefore, emphasis is first on oxygenation and ventilation. Detection of a child’s pulse may be difficult; if a brachial pulse is not definitively present after…
Key Concepts Patients of all ages experience pain, including infants, neonates, and premature babies. Oligoanalgesia, the inadequate treatment of pain, has many short-term and long-term consequences: worse patient outcomes, increase in patient’s pain threshold, and development of chronic pain. Pain…
Key Concepts Pediatric advanced airway management is a relatively rare skill to perform in most emergency departments (EDs), and skill maintenance is difficult based solely on clinical practice. There are several anatomic differences that impact pediatric airway management, and these…
Key Concepts Patterns of illness and injury vary by age, and a number of anatomic and physiologic characteristics affect the presentation and management of pediatric emergencies. A basic understanding of normal development will aid the emergency clinician in assessment of…
Acknowledgments We would like to acknowledge the valuable contributions of the previous edition authors Drs. Andrea Carlson and Leon Gussow. Key Concepts Supportive care, with a focus on respiratory depression, is the foundation of management of all sedative-hypnotic ingestions. Benzodiazepines…
Key Concepts Most botanical exposures result in minimal toxicity and management is largely supportive. Most serious toxicities result from exposure to plants with anticholinergic, antimitotic, cardiovascular or convulsive properties. Most cases of mushroom ingestion in which gastrointestinal (GI) symptoms begin…
Key Concepts Organophosphates cause symptoms by accumulation of acetylcholine. Treat cholinergic symptoms with atropine. Reverse the inhibition of acetylcholinesterase with oximes. Aging, which results in prolonged toxicity, occurs with organophosphate poisoning, but not with carbamates. Chlorinated hydrocarbons can present with…
Key Concepts The opioid toxidrome includes three prominent findings—central nervous system depression, miosis, and, most importantly, respiratory depression—but presentations may be variable. A negative urine screen is often unreliable, and absence of detection should not deter a diagnosis of opioid…
Key Concepts Antipsychotics are commonly categorized into typical, or first-generation antipsychotics (FGAs) with primary antagonism to dopamine receptors, and atypical, or second-generation antipsychotics (SGAs) which include serotonin receptors as a target. Aripiprazole is an example of a third type of…
Key Concepts The clinical pattern of acute and chronic lithium toxicity is different. Gastrointestinal symptoms occur early, and neurologic toxicity manifests late in acute toxicity. Neurologic findings (e.g., tremors, altered mental status and seizures) often are presenting signs of chronic…