Annals of emergency medicine
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[Committee on Pediatric Equipment and Supplies for Emergency Departments, National Emergency Medical Services for Children Resource Alliance: Guidelines for pediatric equipment and supplies for emergency departments. Ann Emerg Med January 1998;31: 54-57.].
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Review Comparative Study
Failure of adjunctive bicarbonate to improve outcome in severe pediatric diabetic ketoacidosis.
Although adjunctive intravenous bicarbonate therapy is commonly recommended for children with severe diabetic ketoacidosis (DKA), no studies assessing clinical outcome with this therapy have ever been performed. Our objective was to determine whether bicarbonate therapy influenced outcome for pediatric DKA. ⋯ We found no evidence that adjunctive bicarbonate improved clinical outcome in children with severe DKA. The rate of metabolic recovery and complications were similar in patients treated with and without bicarbonate, and prolonged hospitalizations were noted in the bicarbonate group. We conclude that adjunctive bicarbonate is unnecessary and potentially disadvantageous in severe pediatric DKA.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pain of local anesthetics: rate of administration and buffering.
To determine the impact of administration rate and buffering on the pain associated with subcutaneous infiltration of lidocaine. ⋯ This is the largest blinded study to assess administration rate and the pain of a local anesthetic. We found that administration rate had a greater impact on the perceived pain of lidocaine infiltration than did buffering.