Pediatric emergency care
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Pediatric emergency care · Apr 1998
Comparative StudyChanges in treatment and outcomes of children receiving care in the intensive care unit for severe acute asthma.
Significant changes have occurred in the intensity of treatment of children with severe asthma in the last decade. The objectives of this study are 1) to describe the changes in treatment of asthmatic children needing care in the intensive care unit (ICU) initially treated in our emergency department (ED) in 1983 to 1985 (I) and in 1990 to 1992 (II), and 2) to examine if these changes correspond to changes in clinical outcomes. ⋯ Despite recent dramatic ED and ward treatment changes, ICU admission rates for pediatric asthma remain relatively constant. However, intensive treatment may have contributed to the decrease in ICU admissions via the ED to ward route in slightly less critical cases.
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Pediatric emergency care · Apr 1998
Comparative StudySedation patterns in pediatric and general community hospital emergency departments.
Although pediatric sedation (PS) is widely used in emergency departments (ED), the practice of PS in general community hospital (GH) ED has not been described. We surveyed PS practice patterns in pediatric hospitals (CH) and GH and compared frequency and usage between the two groups. ⋯ GH performed fewer sedations than did CH when matched for pediatric volume in all geographic locations and for the most common ED procedures using sedation. Since 1989, sedation patterns have shifted in CH to include the short-acting agents, while GH (with the exception of midazolam) continue to prefer the long-acting agents. Midazolam is now the most frequently used sedation agent for ED procedures in both CH and GH.
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Pediatric emergency care · Apr 1998
Case ReportsPediatric male rectal and genital trauma: accidental and nonaccidental injuries.
To characterize accidental pediatric rectal/genital trauma in males and compare these physical findings to a cohort of boys evaluated for sexual abuse. ⋯ Accidental rectal/genital trauma in the pediatric population is uncommon; scrotal trauma occurs much more frequently than rectal trauma. Rectal/genital injury in the sexual abuse group typically involves only the rectal area. Sexual assault should be considered in patients with isolated rectal injury or whenever the alleged history does not correlate with physical findings.
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Pediatric emergency care · Apr 1998
Randomized Controlled Trial Clinical TrialSaline with benzyl alcohol as intradermal anesthesia for intravenous line placement in children.
It has been suggested that saline with benzyl alcohol preservative has anesthetic properties when injected intradermally. We compared the pain associated with intravenous line (i.v.) placement in patients who received intradermal lidocaine, intradermal saline + benzyl alcohol preservative, or no anesthesia. ⋯ Saline with benzyl alcohol and 1% lidocaine are equally effective as intradermal anesthetics for i.v. line placement in children, and are both more effective than no anesthesia.