Annals of emergency medicine
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Clinical Trial
A prospective analysis of intramuscular meperidine, promethazine, and chlorpromazine in pediatric emergency department patients.
To examine physiologic responses and efficacy of 2, 1, and 1 mg/kg IM meperidine, promethazine, and chlorpromazine (MPC), respectively, in children. ⋯ IM MPC is a safe and generally effective agent for ED procedures in selected children.
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To develop a diagnosis-based case mix classification system for emergency department patient visits based on direct costs of care designed for an outpatient setting. ⋯ We have developed a diagnosis-based case mix classification system for ED patient visits based on direct costs of care designed for an outpatient setting which, unlike diagnosis-related groups, includes the measurement of time-based cost for physician and nonphysician services. This classification system helps to define direct costs of hospital and physician emergency services by type of patient.
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Comparative Study Clinical Trial
High-dose epinephrine improves outcome from pediatric cardiac arrest.
Animal studies suggest that the standard dose of epinephrine (SDE) for treatment of cardiac arrest in human beings may be too low. We compared the outcome after SDE with that after high-dose epinephrine (HDE) in children with refractory cardiac arrest. ⋯ HDE provided a higher return of spontaneous circulation rate and a better long-term outcome than SDE in our series of pediatric cardiac arrest. HDE may warrant incorporation into standard resuscitation protocols at an early enough point to prevent irreversible brain injury.
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Comparative Study
Comparison of rectal, axillary, and tympanic membrane temperatures in infants and young children.
To evaluate the reliability of a tympanic membrane thermometer in detecting fever in young children presenting to the emergency department. ⋯ Tympanic membrane and axillary temperatures should be viewed with caution in children less than 3 years old as neither can detect fever reliably.