Indian Journal of Trauma and Emergency Pediatrics

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Background: Most reports of traumatic asphyxia, a condition which is rare in children pertain to injuries sustained following motor vehicle accidents. The clinical picture which is diagnostic of this condition should be recognized for appropriate management. Objective: We report a child with traumatic asphyxia with an unique mechanism of injury. Case report: 4 year old child was injured due to compression between the moving belts of an industrial equipment. He had classic clinical picture suggestive of traumatic asphyxia with pulmonary contusion and was managed conservatively. Conclusion: Though the clinical presentation looks alarming in traumatic asphyxia, the outcome is good in majority. It is important to recognize associated organ injuries which can influence the outcome. Causes other than road traffic accidents and stampede can also result in traumatic asphyxia in children. 

Keywords: Trauma; Asphyxia; Mechanism. 

 Pulse oximetry is probably the most commonly employed monitoring tool in the emergency department. It is a simple, noninvasive and affordable medical tool that enables monitoring of oxygenation continuously. Like any other medical instrument, it has its own pitfalls and therefore, knowledge of these as well as the correct method of using this device is important for accurate interpretation of results. In this review, we have briefly covered the practical aspects of use of this important monitoring tool.

Keywords: Pulse oximeter; Oxyhemoglobin dissociation curve; Oxygenation; Saturation probe. 

Background: Acetaminophen (paracetamol) is widely used in children as an antipyretic because its safety and efficacy are well established. Parental anxiety coupled with easy availability makes it one of the common poisonings seen in children. The symptoms of acetaminophen intoxication are non specific. The availability of acetaminophen in various concentrations and preparations, delays the diagnosis and treatment of acetaminophen intoxication in unintentional toxicity. Objective: To analyse the toxic effects of acute and multiple dose acetaminophen ingestion in a tertiary care pediatric emergency setting. Methods: Case records of 54 children diagnosed with acetaminophen toxicity between February 2009 and February 2013 were retrospectively analysed. Result: Acetaminophen toxicity was common in infants, common diagnosis at presentation being viral fever with vomiting . Hepatomegaly and elevated liver enzymes were noted in the majority. Double strength preparation (250mg/5ml) in accidental and drops (100 to 125mg /ml) contributed to toxicity in multi dose ingestions. Parenteral N Acetyl cysteine was well tolerated. Conclusion: Unintentional acetaminophen toxicity is as common as accidental ingestion. High index of suspicion is important. It mimics common childhood illness. Detailed prescription of acetaminophen and parental counseling are necessary. 

Keywords: Acetaminophen; NAC; N-acetylcysteine; Paracetamol; Poisoning; Toxicity.