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High-Yield Facts

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  • The emergency physician must have a reasonable knowledge of the developmental stages to identify abnormal or delayed development.

  • Observation of the young child during history taking provides much insight regarding the severity of his affliction.

  • Often, the best examination occurs while the parent is holding the child in her lap or arms.

  • Good history taking can minimize the need for blood work.

  • Minimizing radiation exposure, the “as low as reasonably achievable” (ALARA) principle is particularly important in children.

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The approach to children in the emergency department (ED) is completely different than for the adult. The physician gets one attempt to engage the patient, greet the parent, perform the examination, and formulate a treatment plan.

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Children present to the ED for various reasons (Table 1-1).1 This chapter focuses on deconstructing the visit and empowering the emergency physician to be comfortable with and competently treat the child.

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TABLE 1-1Most Common Diagnoses for Children Presenting to Emergency Department
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Knowledge of age-specific biologic variables is absolutely required to identify abnormalities. Tables 1-2 to 1-526 provide quick reference for normal pediatric respiratory rate, heart rate, blood pressure, and weight.

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TABLE 1-2Normal Respiratory Rates for Children
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TABLE 1-3Normal Heart Rates for Children
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TABLE 1-4Normal Blood Pressure for Children

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