Pediatric emergency care
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Pediatric emergency care · Aug 1999
Comparative StudyVariations in sedating uncooperative, stable children for post-traumatic head CT.
To characterize variations among pediatric emergency physicians and their hospital facilities regarding sedation of the uncooperative, stable child for head CT following closed head injury. ⋯ Sedation practices for post-traumatic pediatric head CT vary widely, among both physicians and individual practitioners. Institutional and individual sedation-relation policies vary widely as well. Variation and dissatisfaction with sedation practices may reflect uncertainty regarding optimal sedation strategies. Further cost-effectiveness research is necessary.
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Pediatric emergency care · Aug 1999
Comparative StudyDiscordant radiograph interpretation between emergency physicians and radiologists in a pediatric emergency department.
To describe the types of discrepancies in radiograph interpretation between emergency physicians and radiologists in a pediatric emergency department, and to determine the impact of discrepant interpretations on patient care. ⋯ Emergency physicians would benefit from more rigorous interpretation of chest x-rays to avoid unnecessary treatment with antibiotics. Emergency physicians do a good job interpreting plain radiographs, but occasionally miss significant findings that could lead to adverse outcomes. The presence of radiologists to immediately read radiographs 24 hours a day could prevent missed findings, but, given the small number of significant misinterpretations, is unlikely to be cost effective.
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Pediatric emergency care · Aug 1999
Can portable bedside fluoroscopy replace standard, postreduction radiographs in the management of pediatric fractures?
To determine the accuracy of portable bedside fluoroscopy in documenting postreduction fracture alignment in the pediatric emergency department (ED). ⋯ Bedside fluoroscopy with printed fluoroscopic images are highly reliable in evaluating fracture reduction and can replace conventional radiography in documenting adequate distal forearm fracture reduction when there is no intraarticular involvement.
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Pediatric emergency care · Aug 1999
Comparative StudyProviding immunizations in a pediatric emergency department: underimmunization rates and parental acceptance.
To assess the vaccination status and vaccinate eligible children with age-appropriate antigens. ⋯ The majority of children with documentation of immunization status were underimmunized. When documentation of underimmunization was available, parents were significantly more likely to accept vaccination. These data suggest that vaccinating children in nontraditional settings is feasible and support the creation of an accessible vaccine registry.
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There is incomplete knowledge regarding the outcome of children who suffer a cardiac arrest after blunt trauma. We sought to determine mechanisms of injury, mortality, and rate of organ donation in this population of children. ⋯ The outcome from blunt cardiac arrest in children is rapidly and nearly uniformly fatal despite resuscitation. Because severe head injuries resulting in brain death are the leading cause of mortality, a significant percentage of organ donations are obtained from these patients.