Pediatric emergency care
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Pediatric emergency care · Nov 2005
Review Case ReportsAdolescent substance use: brief interventions by emergency care providers.
Use of tobacco, alcohol and other drugs plays a major role in adolescent morbidity and mortality. When under the influence of alcohol or other drugs, adolescents are at increased risk for injuries, unprotected sex, or interpersonal violence. Alcohol and other drugs are major factors in adolescent deaths, contributing to motor vehicle crashes, homicides, and suicides. ⋯ If an adolescent screens positive, then the next step is to determine their stage of use and readiness for change in preparation for doing a brief intervention. Helping patients to recognize the potential relation between their substance use and health related consequences, may motivate them to decrease their use for harm reduction. Motivational interviewing is an effective, evidence-based approach to helping people change their high risk behavior.
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Pediatric emergency care · Nov 2005
Randomized Controlled Trial Comparative StudyA randomized controlled trial of sport helmet interventions in a pediatric emergency department.
To evaluate the effectiveness of 3 competing pediatric emergency department (ED) interventions aiming to increase sport helmet use in a state without helmet legislation. ⋯ Directly receiving a free helmet in the pediatric ED appears to be an effective hospital-based strategy to increase pediatric helmet use.
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Pediatric emergency care · Nov 2005
Preprocedural fasting state and adverse events in children receiving nitrous oxide for procedural sedation and analgesia.
Established fasting guidelines for analgesia and sedation are difficult to follow in the emergency department (ED), and the association between preprocedural fasting and adverse events has been questioned. We characterize the fasting status of patients receiving procedural sedation and analgesia with nitrous oxide (N2O) in a pediatric ED and assess the relationship between fasting status and adverse events. ⋯ Seventy-one percent of patients undergoing ED procedural sedation and analgesia with N2O did not meet established fasting guidelines. In this series, there was no association between preprocedural fasting and emesis. There were no serious adverse events.
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Pediatric emergency care · Nov 2005
Case ReportsCongenital lobar emphysema: tube thoracostomy not the treatment.
A 23-month-old boy was transferred to our facility after being diagnosed with a right-sided pneumothorax in an outlying hospital emergency department. The patient's primary complaint was a nonproductive cough and runny nose. Vital signs were stable with 98% oxygen saturation by pulse oximetry. ⋯ Chest x-ray revealed a large lucency over the right lung field, yet an intact vascular pattern. Computed tomography scan of the chest revealed congenital lobar emphysema of the right upper lobe. The pathophysiology, clinical presentation, diagnostic evaluation, and management of congenital lobar emphysema are reviewed.
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The purpose of this investigation was to determine the incidence and character of pediatric emergencies on a US-based commercial airline and to evaluate current in-flight medical kits. ⋯ The most common in-flight pediatric emergencies involved infectious diseases and neurological and respiratory tract problems. Emergency medical kits should be expanded to include pediatric medications.