Preface

During the first year of life, children progress from a neonate, progress to an infant, and approach the toddler stage. They develop from individuals whose main functions are to smile spontaneously, feed, void and defecate to individuals who cruise, walk, speak (a few words), and have a pincer grasp. Not only do they develop through motor, language, and social skills, but also their physiologies and disease processes develop as well. Such assessment of a child in the first year of life can be challenging to even the most experienced clinician. This issue is dedicated to state of the art information regarding the emergency care of the child during his or her first year of life. Current areas of interest, clinical practice, and controversy are addressed.

Hyperbilirubinemia is a common occurrence in the newborn period. Neonatal jaundice has shifted from an inpatient issue to an outpatient issue, and management of hyperbilirubinemia is one of the most common reasons for newborn readmission. Kernicterus, the feared complication of hyperbilirubinemia, was considered to be almost extinct but has reemerged recently. Because of this, a review targeted to the emergency department presentation, evaluation, and management of the jaundiced newborn is included. Abdominal concerns are a common complaint in the emergency department. Children under a year of age may present with abdominal catastrophies with subtle presentations. In the article on abdominal emergencies, an approach to the emergent pediatric abdomen during the neonatal and infant periods is discussed. Seizures are a common neurologic problem in childhood. In this issue of Emergency Medicine Clinics of North America, one article will differentiate seizures from other childhood disorders and focus on emergency treatment, patient stabilization, termination of seizure activity, and determination of seizure cause. Metabolic diseases can vary as much in clinical presentation as it can in classifications. Neonates and infants who have metabolic diseases frequently present with subtle symptoms that are similar to other emergencies. The article on metabolic illness discusses recognition and management of specific disorders and specific laboratory entities including hypoglycemia, hyponatremia, and metabolic acidosis. The crying infant can present a sense of anxiety and a diagnostic dilemma to the clinician; a discussion of differential diagnosis and management of the crying infant is included. In 2005, the American Heart Association updated the guidelines for newborn and pediatric resuscitation. These changes currently are being taught in Pediatric Advanced Life Support classes. One article reviews the pertinent changes in the care for the critically ill child. A detailed discussion of the newborn exam for background information complements all of these articles.

We thank all of our authors for their time and effort in preparing the articles. We also thank our loving spouses (Jeahan, and Javaid) and our wonderful children (Jimmy, Mariyah, Aleena, and Grace) for their support, patience, and understanding during this endeavor.