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Texas Children's Hospital HandbookTexas Children's Hospital Handbook

Section 3. Pediatrics > 

Chapter 13. Emergency Medicine

Topics Discussed: abdominal pain; abdominal pain, acute; acute abdomen; appendicitis, acute; arthralgia; asthma; asthma, acute; bacterial arthritis; bite; bronchiolitis; cat bite; child abuse; coma; critical care; dog bite; emergency medical service; epididymitis; febrile infection; fever; fever of the newborn; fever of unknown origin; fever with rash; gastroenteritis, acute; human bite; intussusception; lameness; lung compliance; mental state abnormal; pediatric emergency medicine; petechiae; physical abuse of child; pyloric stenosis; respiration disorders; respiratory severity score; scrotal edema; scrotal pain; scrotal swelling; shaken baby syndrome; shunt infection; spermatic cord torsion; stridor; testicular appendage torsion; transient synovitis; ventricular shunt device; ventriculoperitoneal shunt; ventriculoperitoneal shunt evaluation; vomiting.
Excerpt:"
  • Location of obstruction: Can be determined based on the phase of the stridor.
    • During inspiration supraglottic obstruction
    • During expiration intrathoracic obstruction
    • During inspiration and expiration (biphasic) glottic or subglottic obstruction
  • Etiology
    • Foreign body acute stridor in otherwise healthy child
    • Infection croup, retropharyngeal abscess, epiglottitis, tracheitis
    • Anatomic malformation laryngomalacia, tracheomalacia, vascular ring
  • Epidemiology: Male:female ratio 2:1; primarily in adolescence
  • Diagnosis: Diagnosis of appendicitis is a clinical diagnosis (see pediatric appendicitis score table). Laboratory data is not necessary if clinical signs/symptoms are consistent with appendicitis.
    • History and physical exam: Fever, nausea/vomiting, anorexia, Periumbilical pain migrating to right lower quadrant (McBurney's point, 1/3 between ASIC and umbilicus), positive psoas sign (pain with hyperextension of the right leg), positive..."
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