Risk management: medical malpractice and Emergency Department.

Because of the limited number of comprehensive paediatric centres, providing the entire continuum of paediatric care, including subspecialty care, and generally serving as regional referral centres for tertiary paediatrics, paediatric emergency care in Italy is often provided in adult facilities within primarily adult hospital institutions. Consequently, most paediatricians working in hospitals with a separate paediatric ward or department provide Emergency Department (ED) on-call coverage with serious liability concerns: such concerns are due to the fact that successful care of infants and children in an emergency situation requires appropriately sized equipment, well trained staff, appropriate and specialised triage and destination guidelines but, unfortunately, not all Italian facilities fulfil all these criteria. Risk management training of the entire ED staff may reduce the institution's involvement in malpractice litigation.

Acute onset of abducens nerve palsy in a child with prior history of otitis media: a misleading sign of Gradenigo syndrome.

Gradenigo syndrome in children during otitis media is a very rare complication since the use of antibiotics: nevertheless, it must be taken into account in case of otitis media, abducens nerve paralysis and facial pain in regions innervated by the first and second division of trigeminal nerve. We report the case of a 4-year-old boy whose neurological signs and clinical history prompted us to entertain a diagnosis of Gradenigo syndrome, which was not confirmed by CT and MRI findings, revealing otomastoiditis and sinus thrombosis.

[Acute carbon monoxide poisoning in children].

Epidemiological and clinical aspects of 233 children below 14 years of age with acute carbon-monoxide poisoning are presented. Patients were recorded in the retrospective part of the M.S.

The risk associated with poisonings in children.

The risk associated with poisonings in children was assessed on 6175 subjects admitted to the pediatric hospitals of 3 regions of Northern Italy between 1975 and 1990. The frequency of exposures and the severity of sequelae allowed high- and low-risk substances to be identified. Risks were studied separately in the 0-4, 5-9 and 10-13 y age group to determine age-related differences.

[The pediatric emergency department: assessment of clinical activity and interaction with local health authorities].

A perspective study was carried out at the Emergency Department of the Gaslini Institute on a sample of the children admitted from May to September 1990. The study aimed to describe types and modalities of admission. "G.