• Title/Summary/Keyword: Pediatric emergency medicine

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Prolapse Gastropathy Presenting with Hematemesis in a 3-year-old Child - A Case Report (3세 소아에서 토혈을 주소로 내원한 위식도 탈출증 1례)

  • Cho, Jin-Seong;Ryoo, Eell;Lee, Gun;Kim, Jae-Kwang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.183-186
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    • 2003
  • Prolapse gastropathy is not uncommon in adult, but is not reported yet in previously healthy children. A 3-year-old child came to our emergency room after a 1-day history of emesis episodes with coffee-ground hematemesis. During the endoscopic procedure, and the process of retching and vomiting was observed and a tense knuckle of gastric mucosa was seen to be forcefully and repeated prolapsed into the distal esophageal mucosa, and mucosal hematoma was found in the gastric fundus. Upper gastrointestinal study revealed no abnormality and 24 hour pH monitoring revealed no pathologic gastroesophageal reflux. Retching is thought to cause the forceful prolapse and induce subsequent trauma of gastric mucosa. This case illustrates that the episodes of vigorous retching and resultant gastric mucosa are now considered to be the cause of the hematemesis and epigastric pain in children.

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Trends in Korean Pediatric Poisoning Patients: Retrospective Analysis of National Emergency Department Information System (한국 소아청소년 중독 환자의 경향: 국가응급진료정보망을 이용한 후향적 연구)

  • Lee, Kyeongjae;Kim, Kyung Hwan;Shin, Dong Wun;Park, Junseok;Kim, Hoon;Jeon, Woochan;Park, Joon Min;Kim, Hyunjong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.2
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    • pp.69-78
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    • 2017
  • Purpose: This study reports the clinical features of infant, child, school aged and adolescent patients treated for acute poisoning in nationwide emergency departments (EDs). Methods: We retrospectively analyzed clinical data pertaining to patients under 19 years of age who were treated for acute poisoning in nationwide EDs from 2013 to 2015. The data were collected by the National Emergency Department Information System (NEDIS). All patients were divided into three groups: 'Infant and child group' (0 to 5 years), 'school age group' (6 to 12 years) and 'adolescent group' (13 to 18 years). General characteristics, Korea Standard Classification of Disease $7^{th}$ (KCD-7) codes and results of care were collected. Results: There were 14,500 pediatric poisoning cases during the study period. The distribution of patient age was bimodal with two peaks among infant, child and adolescent group. The proportion of alert mentality at the ED visit of the infant and child group was 99.3%, while that of the adolescent group was 86.4%. The proportion of intentional intoxication was higher in the adolescent group (40.7%) than other age groups. Among children less than 13 years of age, various poisonous substances and therapeutic drugs were common. Conclusion: There were some clinical differences in acute poisoning patients between age groups. It is necessary to establish a preventive plan considering characteristics by age. Since the KCD-7 code has limitations in analyzing the characteristics of poisoning patients, it is necessary to consider the registration system of poisoning patients.

A comparative analysis of the efficacy of tiny child cardiopulmonary resuscitation (CPR) by chest compression methods (가슴압박 방법에 따른 소아 심폐소생술의 효율성 비교)

  • Yong-Joon Kim;So-Yeon An;Seung-Eun Han;Kyoung-Youl Lee
    • The Korean Journal of Emergency Medical Services
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    • v.28 no.2
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    • pp.99-108
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    • 2024
  • Purpose: This study aimed to compare the effectiveness of one-hand compression method (one-hand) and two-thumb compression methods (two-thumb) using a 3-year-old pediatric mannequin. Methods: Participants in the experiment were randomly assigned to 21 people with one hand and 21 people with two thumbs, who had completed a basic life support training course. The mannequin used a few junior QCPR manikis (Laerdal, Norway), based on an age of 3. The study followed the guidelines for two-rescuer pediatric CPR, performing chest compressions and ventilations in a 15:2 ratio for 5 cycles, 10 minutes. The chest compression number, depth, speed rate, and recoil rate were measured after 1, 3, and 5 cycles, respectively. Data were analyzed using SPSS 23.0. Results: Comparing the efficiency of chest compressions performed during 1, 3, and 5 cycles, the depth of chest compressions was 40.84±3.10 mm for the two thumbs and 51.48±4.79 mm for the one-hand, which was significantly different (p<.001). According to pediatric CPR guidelines, the frequency corresponding to the compression depth range of 40.00-50.00 mm was statistically higher at 57.1% (12 people) of two thumb than at 23.8% (5 people) of one hand (p<.001). Conclusion: While the current guidelines recommend one- or two-thumb encircling hand compressions for larger children, the use of one- or two-handed wrapped thumb compressions should be considered for smaller children, depending on the rescuer's judgment, when distinguishing between a child and an infant is difficult.

Current Status of Intraosseous Infusion Technique Use at Emergency Departments in Korea (국내 응급실에서의 골수강내 주입법 사용 현황)

  • Choi, Sang Cheon;Park, Hyun Soo;Kim, Jae Woo
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.6-11
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    • 2007
  • Purpose: Gaining vascular access is difficult and time-consuming in critically ill children, so nowdays, in many countries, intraosseous vascular access is frequently used for rapid vascular access in critically ill children. Its pharmacokinetics is close to that of the peripheral intravenous route, but its infusion flow rate is faster. The purpose of this study was to determine how widely the intraosseous infusion technique was being used in Korean emergency departments. Methods: We telephoned forty-two (42) randomly selected university-affiliated hospitals. We asked physicians if they use the intraosseous infusion technique. Responders were emergency and pediatric residents and emergency faculty. If they responded that they were not using the intraosseous infusion technique, we asked the reason. Also, we asked about their experiences with the intraosseous infusion technique. Results: Forty-two (42) hospitals were enrolled in this study. No hospital used the intraosseous infusion technique on a regular basis. However, 8 hospitals used the intraosseous infusion technique occasionally. None of the responders had experience with the intraosseous infusion technique. Conclusion: The intraosseous infusion technique is currently underrepresented at emergency departments in Korea.

Poisoning in Korean Children and Adolescents

  • Woo, Jae Hyug;Ryoo, Eell
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.4
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    • pp.233-239
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    • 2013
  • Drug intoxication in children and adolescents is not uncommon in Korea. But the tendency of intoxication is changing with some factors, such as national surveillance system, Naderism and increasing concern among physicians. But the death rate of intoxication among adolescents is increasing in spite of decreasing total death rate of intoxication among children and adolescents. Therefore the physician must be concerned about the basic management of intoxication and figure out the common toxic substance among children and adolescents.

Fomepizole for Ethylene Glycol or Methanol Poisoning in Children (소아의 에틸렌글리콜 및 메탄올 중독에서 Fomepizole의 효과)

  • Min, Ha Na;Hwang, Yoon Jung;Ko, Dong Ryul;Joo, Young Seon;Kong, Tae Young;Choa, Min Hong;Park, In Cheol;Chung, Sung Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.2
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    • pp.79-85
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    • 2017
  • Purpose: The purpose of this study is to evaluate the effectiveness and adverse effect of fomepizole in the management of acute ethylene glycol or methanol poisoning in children. Methods: Databases such as PubMed, Embase, Cochrane library, and KoreaMed were searched using terms related to fomepizole, ethylene glycol, methanol and pediatric. All studies, regardless of study design, reporting effectiveness or safety endpoints in children were included. Reference citations from identified publications were reviewed. Only reports written in English or Korean languages were included. The reference search was performed by two authors. Results: Twenty-two relevant literatures were finally included. They were one narrative review, 4 retrospective case series, and 17 case reports (19 cases). Case reports were classified as 5 fomepizole only, 8 fomepizole with other therapies, and 6 no fomepizole. All patients from the literatures were fully recovered without long term sequelae. Adverse effects of fomepizole were reported including anaphylaxis, thrombophlebitis and nystagmus. Conclusion: There are insufficient literatures regarding fomepizole treatment in children with ethylene glycol or methanol poisoning. The benefits or harms are not clearly established based on the clinical evidences. More prospective comparative studies are required in the future.

Clinical aspects of injury and acute poisoning in Korean pediatric patients (소아의 응급질환 - 우리나라 소아 및 청소년의 손상과 급성 중독을 중심으로 -)

  • Lee, Mi Jin;Park, Joon Seok
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.116-121
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    • 2008
  • Unintentional injuries are the most important cause of morbidity and mortality in the pediatric population, and the home is the most common site of injury for children in Korea. The most common cause of injury was slip down. Fall down and burn were frequent in infant/toddlers group, automobile and bicycle accident more frequent in preschool children. Findings from the survey could then be used to provide targets for direct educational efforts by medical services and to direct environmental safety modifications tailored to the unique situation of each family. Pediatric toxic ingestions are treated commonly by pediatricians and emergency physicians. Significant injury after these ingestions is infrequent, but identifying the dangerous ingestion is sometimes a difficult task. By performing a detailed history, focused physical examination, and directed laboratory evaluation, an estimation of risk can be developed. According to recent Korean poison papers, there were bimodal peak of age distribution in poisoned children patient on the whole: infant and adolescents group. Various types of materials belonged the classes of drugs, household products, and industrial solvents. Most of the poisoned children patients had been poisoned accidentally, while most cases of adolescents poisoning had been intentional. More than half of the adolescents group had a suicidal purpose in Korea, so an understanding of the demographic factors associated with self-harm poisoning may provide useful information to improve prevention and treatment strategies.

Stunting and Gut Microbiota: A Literature Review

  • Jessy Hardjo;Nathasha Brigitta Selene
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.3
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    • pp.137-145
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    • 2024
  • Stunting, a condition characterized by impaired growth and development in children, remains a major public health concern worldwide. Over the past decade, emerging evidence has shed light on the potential role of gut microbiota modulation in stunting. Gut microbiota dysbiosis has been linked to impaired nutrient absorption, chronic inflammation, altered short-chain fatty acid production, and perturbed hormonal and signaling pathways, all of which may hinder optimal growth in children. This review aims to provide a comprehensive analysis of existing research exploring the bidirectional relationship between stunting and the gut microbiota. Although stunting can alter the gut microbial community, microbiota dysbiosis may exacerbate it, forming a vicious cycle that sustains the condition. The need for effective preventive and therapeutic strategies targeting the gut microbiota to combat stunting is also discussed. Nutritional interventions, probiotics, and prebiotics are among the most promising approaches to modulate the gut microbiota and potentially ameliorate stunting outcomes. Ultimately, a better understanding of the gut microbiota-stunting nexus is vital for guiding evidence-based interventions that can improve the growth and development trajectory of children worldwide, making substantial strides toward reducing the burden of stunting in vulnerable populations.

Analysis of Exposure Factors for Clinical and Preventive Aspects of Pediatric Electrical Burn Patients who Visited the Emergency Department (응급실에 내원한 소아 전기 화상 환자의 임상적 양상과 예방을 위한 노출 요인 분석)

  • Park, Sang Jun;Kim, Sung Wook;Jeong, Won Jung;Oh, Sang Hoon;Park, Jeong Taek
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.170-176
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    • 2015
  • Purpose: The aims of this study were to discuss treatment and prevention under the age of 18 to identify the characteristics of the electrical burn patients. Methods: We retrospectively reviewed medical records of 97 patients with under age 18 of electric burn who were treated in emergency department of quarterly over 10,000 targets within the desired hospital for evaluation of electrical injuries between January 1, 2009 and December, 2013. We investigated age, gender, injury mechanism, season, degree of burn, surface of burn, complication, blood test, and voltage, kind of current. Results: Of the patients, 50 (50.5%) patients were in the first degree burn and 47 (49.5%) patients were in second degree burn. 68 (70.1%) patients had electric burn at home. 75 (85.2%) of 88 patients had normal sinus rhythm and other 13 people showed a RBBB, VPC, sinus bradycardia, sinus tachycardia. 41 (42.3) of 97 patients were in infants and 26 (26.8%) patients were in adolescence. Conclusion: The results of this study emphasize the need for prevention of electricity at home for childhood and education of the adolescence.

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Evidence-based management of isolated dentoalveolar fractures: a systematic review

  • Samriddhi Burman;Babu Lal;Ragavi Alagarsamy;Jitendra Kumar;Ankush Ankush;Anshul J. Rai;Md Yunus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.3
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    • pp.123-133
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    • 2024
  • Dentoalveolar (DA) trauma, which can involve tooth, alveolar bone, and surrounding soft tissues, is a significant dentofacial emergency. In emergency settings, physicians might lack comprehensive knowledge of timely procedures, causing delays for specialist referral. This systematic review assesses the literature on isolated DA fractures, emphasizing intervention timing and splinting techniques and duration in both children and adults. This systematic review adhered to PRISMA guidelines and involved a thorough search across PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 1980 to December 2022. Inclusion and exclusion criteria guided study selection, with data extraction and analysis centered on demographics, etiology, injury site, diagnostics, treatment timelines, and outcomes in pediatric (2-12 years) and adult (>12 years) populations. This review analyzed 26 studies, categorized by age into pediatrics (2-12 years) and adults (>12 years). Falls were a common etiology, primarily affecting the anterior maxilla. Immediate management involved replantation, repositioning, and splinting within 24 hours (pediatric) or 48 hours (adult). Composite resin-bonded splints were common. Endodontic treatment was done within a timeframe of 3 days to 12 weeks for children and 2-12 weeks for adults. Tailored management based on patient age, tooth development stage, time elapsed, and resource availability is essential.