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 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…
Key Concepts An asphyxiant is any gas that displaces sufficient oxygen from the breathable air. Treatment consists of removal from exposure, supplemental oxygen, and supportive care. Highly water-soluble gases produce rapid irritation and predominantly upper respiratory tract effects, such as…
Key Concepts Aspiration is the major toxic risk of hydrocarbon poisoning. Hydrocarbons may cause systemic toxicity, burns, cardiac dysrhythmias, altered mentation, and seizures depending upon the specific agent, dose, and duration of exposure. Gastrointestinal decontamination is potentially harmful in cases…