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Biomedical subjects

J W Graneto

Publications and source records attributed to J W Graneto.

4 recordsLinked to original sources

An unusual cause of chest pain in an adolescent presenting to the emergency department.

Chest pain as a chief complaint is very common in most emergency departments. While well defined and numerous causes of chest pain in adults are previously described, the adolescent presenting with chest pain raises the possibilities of other causes. Previously undiscovered congenital anomalies are rare as causes of pain in this age group. A case of coarctation of the aorta, previously undetected in a teenager, is presented. The signs of congenital heart disease are usually present on history and physical examination, which can lead the emergency physician to the appropriate diagnosis.

Adolescent↗

Maternal screening of childhood fever by palpation.

Fever is a common chief complaint for the pediatric emergency patient. It has been reported that a mother's tactile examination of a child, as historical information, offers little useful information. The study objective is to determine whether mothers can accurately detect the presence or absence of a fever without using a thermometer. The study is a prospective comparison of historical information with measured temperature, performed over a two-month period. The settings are in two inner-city university hospital emergency departments. Mothers of children less than 10 years old who presented to the emergency department with any chief complaint were selected as subjects. The interventions were interviewing the mother and the performance of routine vital signs on the child. Three hundred and twenty-two mothers participated. Of 124 febrile children, 104 mothers accurately detected a fever in their children (sensitivity 84%), while of 198 afebrile children, 150 mothers accurately detected the absence of fever (specificity 76%). We conclude that mothers are able to provide accurate information about the presence or absence of fever in their children by touch and without the use of a thermometer. Thus emergency physicians should heed the historical statements of mothers presenting with only the subjective complaints of fever and no history of thermometer use.

Chicago↗

Transport and stabilization of the pediatric trauma patient.

The incidence of pediatric trauma continues to increase, presenting at almost every emergency department. Life-threatening injuries need to be cared for immediately, in whatever institution the patient presents. For severely injured children, optimal care is ultimately provided at specialized trauma centers. Physicians caring for trauma patients in less specialized institutions must be aware of who to transfer to a trauma center. Effective stabilization and timely, safe transport are vital to reduce further injury.

Adolescent↗