The American journal of emergency medicine
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Hospital records from 1974 through 1983 contained the cases of 20 patients over 18 years old admitted with supraglottitis (epiglottitis). Most patients presented with pharyngitis and odynophagia, and were diagnosed by laryngoscopy and neck radiographs. ⋯ Adults without respiratory distress can be treated in the intensive care unit with inhaled mist, antibiotics, and corticosteroids, and such patients usually recover in a few days. Tracheostomy is being supplanted by nasotracheal intubation as the preferred means of securing an endangered airway.
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Epiglottitis should be suspected in the adolescent with throat pain and dysphagia out of proportion to pharyngeal inflammation. Endolateral neck radiographs or indirect laryngoscopy will confirm the diagnosis. ⋯ Therapy consists of airway stabilization and antibiotic administration. Although epiglottitis in adolescents is often less acute and less severe than in younger children, it may be life-threatening.
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The flow rates of the 18- to 24-gauge catheters most commonly used in pediatrics were studied to determine which catheters and infusion techniques allowed for rapid volume replacement in infants and children. As expected, short, large-diameter catheters were found to have a higher flow rate, and flows under pressure in the largest catheters tested were up to 17 times greater than in a longer, smaller diameter catheter. ⋯ Thus, intravenous access via a central vein does not guarantee more rapid fluid infusion unless the use of the central vein permits the insertion of a catheter larger in diameter than any that could be placed peripherally. Knowledge of the flow rates determined for the various catheters in this study will assist the physician in optimizing fluid resuscitation of the critically ill or injured child.
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Over a six-month period, the New Jersey Poison Information System received 61 calls related to exposures to alkaline corrosives. Seven of these calls related to a new oven-cleaner product, oven-cleaner pads. These pads are sealed in a protective plastic wrap and contain lye in excess of 5%. ⋯ Five of the callers sustained injuries from their exposure, and three of these sustained burns, one in the oral cavity and one in the eye. None suffered permanent sequelae, but the potential for such is considerable. The method of application, concentration of base, and prolonged exposure to a widely covered area may make this product particularly hazardous.