Annals of emergency medicine
-
Randomized Controlled Trial Clinical Trial
Efficacy of rectal midazolam for the sedation of preschool children undergoing laceration repair.
To determine the efficacy of rectal midazolam as sedation for laceration repair in preschool children in the pediatric emergency department. ⋯ Rectal midazolam is an effective method of sedation for facilitating uncomplicated laceration repair in preschool children. However, physicians must be aware of the possibility of paradoxical reactions when using midazolam in children.
-
We report a case of emergence delirium in a 26-month-old girl after she received oral midazolam to achieve conscious sedation. This patient's clinical course is discussed. To our knowledge this is the first reported case of emergence delirium related to use of oral midazolam.
-
Comparative Study
Pulmonary mechanics of dogs during transtracheal jet ventilation.
To quantify the delivered tidal volume and other selected measurements of pulmonary mechanics in an animal model during transtracheal jet ventilation (TTJV), with comparison to positive-pressure mechanical ventilation (PPMV) and spontaneous breathing. ⋯ TTJV delivers an effective tidal volume comparable to both spontaneous breathing and PPMV in a dog model. In the absence of upper-airway obstruction, there was no significant difference in the pulmonary pressures, resistance, and compliance during TTJV, as compared to mechanical ventilation. Variation in TI:TE during TTJV had no major effect on pulmonary mechanics, except to increase minute ventilation and decrease PCO2 as the frequency was increased significantly. Increasing the driving air pressure to the TTJV apparatus significantly augmented delivered tidal volume due to increased air flow.
-
To assess factors related to emergency department use in the Ontario population. ⋯ Our study estimated that approximately one in five Ontario residents had reported one or more visits to the ED in the past 12 months. There were identifiable subgroups in the population with increased ED usage even after adjustment for health needs factors.