Air rifles are more than toys: BB gun-related traumatic brain injury.

Gunshot wounds are traumatic events that emergency departments around the country treat on a daily basis. An increasing number of these wounds are being caused by air rifles that shoot ball bearings (ie, BB guns) and, although uncommon, the results can be fatal. The general public and most practitioners may not realize the damage these "toys" can inflict.

Life-threatening Pyridium Plus intoxication: a case report.

A 16-month-old male presents with an overdose of Pyridium Plus, a combination anticholinergic, azo dye, and barbiturate, resulting in seizures, coma, and methemoglobinemia. This case report reviews the treatment of methemoglobinemia with methylene blue, activated charcoal, and exchange transfusion. Additionally, the role of the pulse oximeter is addressed when methemoglobinemia exists and is treated with methylene blue.

The MORE HEALTH bicycle safety project.

A K-2 MORE HEALTH bicycle safety education program was provided in nine elementary schools in Hillsborough County, Florida. This innovative community program consisted of interactive education sessions and reduced-cost bicycle helmet sales. Evaluation of the pilot program showed that it affected helmet use in the intervention schools compared to nine other schools that served as controls.

Autopsies and the pediatric intensive care unit.

The pediatric autopsy can provide great benefits to families at a time when their world is falling apart. It can be invaluable in the processing of grief that families endure, helping them to plan their future. Autopsy results not only provide information but may also provide consolation by giving the family the opportunity to discuss the disease process that resulted in death.

Life-threatening Pyridium Plus intoxication: a case report.

A 16-month-old male presented with an overdose of Pyridium Plus--a combination anticholinergic, azo dye, and barbiturate--resulting in seizures, coma, and methemoglobinemia. This case report reviews the treatment of methemoglobinemia with methylene blue, activated charcoal, and exchange transfusion. Additionally, the role of the pulse oximeter is addressed when methemoglobinemia exists and is treated with methylene blue.

Sertraline intoxication in a child.

We describe severe sertraline intoxication in a child after accidental ingestion. Sertraline is a new antidepressant that has potent and selective inhibition of neuronal serotonin reuptake. Drug company-sponsored research has suggested little toxicity for this compound.

New onset childhood seizures. Emergency department experience.

Fifty-six cases of new onset seizures evaluated in a pediatric emergency department (ED) during a one-year period were assessed retrospectively for efficiency of diagnosis and workup. The majority of patients (69%) were less than two years of age. Based on etiology, the most common seizure type was febrile (71%) followed by idiopathic (21%) and symptomatic (7%).

Sudden infant death syndrome. Comparison of incidence in four urban Florida counties.

The observed incidence of sudden infant death syndrome (SIDS) in Hillsborough County is significantly higher than corrected rates in three other metropolitan areas of the state which have common demographic features. An eight year analysis of data (1979-1986) demonstrates the consistency of the observation. Since SIDS is a postmortem diagnosis of exclusion utilized for deaths of infants for whom no anatomic or biochemical cause can be determined and represents a large segment of deaths between 28 days and one year of age, there is a need to assure that all areas of the state utilize similar criteria for assignment of the diagnosis.

Acute hemorrhagic diarrhea and cardiovascular collapse in a young child owing to environmentally acquired cocaine.

Acute crack cocaine intoxication has become a significant problem in both adolescent and adult patients. Recently, cases of cocaine toxicity in infants and toddlers have been described. We report a four-year-old child with acute hemorrhagic diarrhea and shock after intoxication by crack cocaine.

Acute toxicity from oral ingestion of crack cocaine: a report of four cases.

We report the symptomatology, clinical, and laboratory findings in four patients following oral ingestion of crack cocaine. All of the patients had a positive urine test for cocaine metabolites measured by gas chromatography-mass spectroscopy. Retrospective analysis of the four patients revealed alterations in function of the cardiovascular system (4), the autonomic nervous system (4), the central nervous system (3), and the gastrointestinal system (1).

Evaluation of an improved sampling method for blood gas analysis from indwelling arterial catheters.

Embolic complications of indwelling arterial lines are well documented. We evaluated a method of blood sampling from indwelling arterial lines that minimizes blood loss and eliminates the embolic risks associated with retrograde flushing. The values for PaO2, PaCO2, and pH obtained by the conventional sampling technique were compared to those obtained by a technique termed the "three drop" method.

Pulmonary artery catheterization in pediatric intensive care.

Pulmonary artery catheterization has become a routine part of pediatric intensive care even for small infants. Measured and derived variables provide clinicians with better understanding of the patient's cardiovascular and pulmonary systems and provide the means by which the results and complications of therapy may be monitored. While significant complications from pulmonary artery catheterization do occur, the risks are acceptable and warranted.