Principles of drug disposition
Pearls • Studies of drug disposition in critically ill children are limited. • Effective pharmacologic therapeutic interventions should focus on choosing the right drug, right time, right dose, right duration,…
RHEUMATOLOGY
Bites and stings
• Snakebite-related morbidity and mortality are reduced most effectively by rapid transport, intensive care support, and the administration of antivenin. • Pit viper envenomation may produce both painful local tissue…
Child abuse
Pearls • Infants and children with inflicted head or other traumatic injuries often appear in emergency departments with signs and symptoms of trauma or conditions suspicious of being of medical…
Pediatric delirium
Pearls • Delirium is a frequent complication of pediatric critical illness and is associated with substantial morbidity. • Refractory agitation in the pediatric intensive care unit is often a manifestation…
Sedation and analgesia
Pearls • A wide selection of sedation and analgesia options is available in the pediatric intensive care unit. • No ideal sedative agent exists for all patients. • Most children…
Evaluation, stabilization, and initial management after trauma
Pearls • The primary survey, as defined by Advanced Trauma Life Support, is a prioritized evaluation and management protocol focused on identifying and treating the most life-threatening injuries first. This…
Burn and inhalation injury
Pearls • The accurate estimation of burn severity is crucial both for appropriate resuscitation and for maintenance of adequate urine output and hemodynamics, including blood pressure and cardiac output. The…
Pediatric sepsis
• The typical patient with septic shock has simultaneous derangements of cardiovascular function, intravascular volume status, respiratory function, immune/inflammatory regulation, renal function, coagulation, hepatic function, and/or metabolic function. • The…
Toxidromes and their treatment
• Flumazenil, when used for benzodiazepine overdose, may unmask seizures caused by a coingested substance or precipitate acute withdrawal in the patient who habitually uses benzodiazepines. • β-Adrenergic antagonists, when…
Pediatric rheumatologic disease
• Approximately 1 child in 250 has a rheumatologic disease. • A child may present to the intensive care unit (ICU) with a life-threatening manifestation of an undiagnosed rheumatologic disease…
