The Child With a Syndrome: Considerations for Management in the Emergency Department

Points & Pearls Excerpt

• Unique diagnostic and therapeutic considerations are needed for the evaluation and management of the child with a syndrome who presents to the emergency department (ED).
• Children with spina bifida exhibit motor and sensory deficits below the level of the affected spinal cord lesion, with motor, bladder, and bowel dysfunction. They may also have Chiari malformations and hydrocephalus, requiring shunt placement.
• All children with spina bifida are at risk for urinary tract infection (UTI) due to bladder dysfunction. Initial testing for febrile children with spina bifida includes urinalysis, urine culture, complete blood cell count and electrolytes, glucose, blood urea nitrogen, and creatinine. Diagnostic imaging or blood culture should be considered, based on clinical presentation.