Metoclopramide-Induced Dystonic Reaction in an Infant

Metoclopramide-induced dystonic reaction (MIDR) is a clinical condition that can be seen even in all age groups even in treatment doses. A nine-month-old girl was brought to our emergency department with acute dystonic reaction that occurred after her 2.5-years-old sister gave her a 10 mg/kg metoclopramide tablet two hours before admission to the hospital. Diphenhydramine was given to the patient. One hour later, the patient's clinical findings regressed and patient was hospitalized, and was discharged from the hospital after 66 hours without sequelae. Although metoclopramide-induced dystonic reaction is frequently reported, the number of cases under one year of age is very limited. The case presented in this report is a patient who received a higher drug dose compared to other cases reported in the literature and recovered without sequelae after follow-up. The most important factor resulting in poisoning in children is not arranging the living spaces of the children by the parents. The easiest way to prevent such cases is to educate families on this issue

O R I G I N A L P A P E R .r . Determination of the Frequency of Clinical Skills Implementation by Senior Nursing Students in an Emergency Department

Abstract Aim: The aim of this study was to determine how often nursing students find an opportunity to observe and/or practice nursing skills during their training in an emergency department. Background: Clinical education as an integral part of nursing education offers the nursing students opportunities to gain clinical experiences in the nursing skills and procedures and deepens the theoretical part of the nursing in a real-life clinical environment. However, it is unclear that at which level clinical practice is experienced by the students in a clinical setting by the time of graduation. Methods: This descriptive study was conducted in the emergency department of a university hospital. The sample of the study was included total 67 nursing students who underwent practical training. The data were collected using the "Nursing skills evaluation form". Results: It is determined that the most practiced nursing skills were to measure blood pressure, to measure body temperature and to inform patients about the medical practices that were done by the nursing students. The least practiced skills were to feed babies, monitor chest tubes and maintain endotracheal tube care. Conclusion: The study results show that some nursing skills are practiced very often, while others are never practiced in the emergency department. Therefore, it is recommended to evaluate the frequencies of targeted nursing skills to give an each student an opportunity of practicing in more feasible clinical settings

COVID-19 Disease in Presenting to the Pediatric Emergency Department: A Multicenter Study of 8886 Cases.

Background: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical out-comes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population.Methods: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific anti-bodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of con-tact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded.Results: A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0-15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9-10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU.Conclusion: Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.(c) 2022 Elsevier Inc. All rights reserved