We report a case of a rare sporadic Vestibular Schwannoma of a 9-month-old girl who had a right-sided lower motor type facial nerve palsy. The patient was initially diagnosed with Bell’s palsy and received steroid tr...We report a case of a rare sporadic Vestibular Schwannoma of a 9-month-old girl who had a right-sided lower motor type facial nerve palsy. The patient was initially diagnosed with Bell’s palsy and received steroid treatment accordingly, two months later the patient’s condition deteriorated, and further evaluation of CT and MRI brain was conducted that showed a mass lesion in the posterior fossa causing compression on the facial nerve. Misdiagnosis of facial nerve paralysis is common among children due to multiple related etiologies and varying rates of incidence in comparison to adults. The authors hope to address this issue in this report. Background: Facial nerve paralysis has been a matter of concern for many researchers to understand its nature, causes and presentation according to different age groups. In adults, Bell’s palsy (BP), the idiopathic form of facial nerve paralysis, is more common compared to children where most cases are due to secondary etiologies. Therefore, pediatricians are in an important position to identify these patients early in order to launch the most effective diagnostic and treatment approaches.展开更多
Background: Management of the acutely ill children represents one of the more complex clinical skills required of pediatric physicians. Our goal was to develop and evaluate a multidisciplinary pediatric mock code trai...Background: Management of the acutely ill children represents one of the more complex clinical skills required of pediatric physicians. Our goal was to develop and evaluate a multidisciplinary pediatric mock code training program for the pediatric residents in our institution. Methods: We performed a before and after evaluation of pediatric residents. The residents were educated by attending five mock code scenarios, followed by debriefing. Before and after the five sessions, the residents completed a self-assessment questionnaire. Results: Residents reported a significant improvement in their comfort in all aspects of managing pediatric resuscitations, with notable improvement seen in running a resuscitation requiring airway management, managing fluid resuscitation and performing endotracheal intubation. The most prominent change was demonstrated in the comfort level of the overall management of a pediatric resuscitation. Conclusion: The pediatric mock code educational training program improved residents’ self-reported knowledge and comfort level in managing pediatric emergency situations.展开更多
Currently, pediatric emergency medicine （PEM） as practiced in many developed countries is different from ours in China. Chinese pediatric emergency medicine is just children＇s internal medicine and does not include...Currently, pediatric emergency medicine （PEM） as practiced in many developed countries is different from ours in China. Chinese pediatric emergency medicine is just children＇s internal medicine and does not include general surgery, ear-nose-throat, etc. If children have an emergency condition that require specialized treatments they need to go to different departments. However in Canada, the pediatric emergency physicians will first treat the patients whatever the condition, then, if it is a complicated sub specialty problem, they will consult the specialist or let the patient see the specialist later. In addition, resuscitation is done in the pediatric intensive care unit （PICU） in China, but it is done in the emergency room in Canada. This article compares the differences in the pediatric emergency systems in Canada and China and also introduces the international standard system of pediatric triage.展开更多
文摘We report a case of a rare sporadic Vestibular Schwannoma of a 9-month-old girl who had a right-sided lower motor type facial nerve palsy. The patient was initially diagnosed with Bell’s palsy and received steroid treatment accordingly, two months later the patient’s condition deteriorated, and further evaluation of CT and MRI brain was conducted that showed a mass lesion in the posterior fossa causing compression on the facial nerve. Misdiagnosis of facial nerve paralysis is common among children due to multiple related etiologies and varying rates of incidence in comparison to adults. The authors hope to address this issue in this report. Background: Facial nerve paralysis has been a matter of concern for many researchers to understand its nature, causes and presentation according to different age groups. In adults, Bell’s palsy (BP), the idiopathic form of facial nerve paralysis, is more common compared to children where most cases are due to secondary etiologies. Therefore, pediatricians are in an important position to identify these patients early in order to launch the most effective diagnostic and treatment approaches.
文摘Background: Management of the acutely ill children represents one of the more complex clinical skills required of pediatric physicians. Our goal was to develop and evaluate a multidisciplinary pediatric mock code training program for the pediatric residents in our institution. Methods: We performed a before and after evaluation of pediatric residents. The residents were educated by attending five mock code scenarios, followed by debriefing. Before and after the five sessions, the residents completed a self-assessment questionnaire. Results: Residents reported a significant improvement in their comfort in all aspects of managing pediatric resuscitations, with notable improvement seen in running a resuscitation requiring airway management, managing fluid resuscitation and performing endotracheal intubation. The most prominent change was demonstrated in the comfort level of the overall management of a pediatric resuscitation. Conclusion: The pediatric mock code educational training program improved residents’ self-reported knowledge and comfort level in managing pediatric emergency situations.
文摘Currently, pediatric emergency medicine （PEM） as practiced in many developed countries is different from ours in China. Chinese pediatric emergency medicine is just children＇s internal medicine and does not include general surgery, ear-nose-throat, etc. If children have an emergency condition that require specialized treatments they need to go to different departments. However in Canada, the pediatric emergency physicians will first treat the patients whatever the condition, then, if it is a complicated sub specialty problem, they will consult the specialist or let the patient see the specialist later. In addition, resuscitation is done in the pediatric intensive care unit （PICU） in China, but it is done in the emergency room in Canada. This article compares the differences in the pediatric emergency systems in Canada and China and also introduces the international standard system of pediatric triage.
