Pediatric emergency care
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Pediatric emergency care · Dec 2006
Randomized Controlled Trial Comparative StudySingle-dose oral dexamethasone in the emergency management of children with exacerbations of mild to moderate asthma.
To compare the efficacy of a single dose of oral dexamethasone (Dex) versus 5 days of twice-daily prednisolone (Pred) in the management of mild to moderate asthma exacerbations in children. ⋯ A single dose of oral Dex (0.6 mg/kg) is no worse than 5 days of twice-daily prednisolone (1 mg/kg per dose) in the management of children with mild to moderate asthma.
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Pediatric emergency care · Dec 2006
ReviewReview of bispectral index monitoring in the emergency department and pediatric intensive care unit.
Sedation is a key component in the management of pediatric patients both in the pediatric emergency department (PED) and pediatric intensive care unit (PICU) for the treatment of pain and anxiety. Bispectral (BIS) index monitoring has been developed to help clinicians assess degree of hypnosis with anesthesia and may be useful in these environments. ⋯ Bispectral values correlate fairly well with commonly used clinical sedation scores, but more variability in the scores has been observed at lighter levels of sedation. More studies are needed to assess the value of titrating sedation in the PED and PICU within specific BIS parameters to reduce morbidity and costs associated with over-sedation.
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Pediatric emergency care · Dec 2006
Transitional medicine: will emergency medicine physicians be ready for the growing population of adults with congenital heart disease?
Currently, approximately 85% of children with significant congenital heart problems survive to adolescence and adulthood. This survival rate represents a dramatic improvement in the medical and surgical care of congenital heart disease (CHD) during the last 35 years. Nevertheless, these patients remain at increased risk for significant cardiac problems long after primary interventions are completed. They are more likely than the general population to seek urgent medical care, often in an emergency department setting. They represent a new and growing population of emergency department patients with a specialized set of problems not traditionally part of the training for emergency medicine (EM) physicians. ⋯ There seems to be a mismatch between the growing need for ACHD emergency care and the current state of this topic in both GEM residency and PEM fellowship training programs.
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Pediatric emergency care · Dec 2006
Pharmacologic treatment of acute pediatric methamphetamine toxicity.
To report our experience with the use of benzodiazepines and haloperidol for sedation of pediatric patients with acute methamphetamine poisoning. ⋯ In this case series of pediatric patients poisoned with methamphetamine, parenteral benzodiazepines and haloperidol were used to control agitation. No serious adverse effects were observed from the use of these agents.
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Pediatric emergency care · Dec 2006
Case ReportsBathing suit mesh entrapment: an unusual case of penile injury.
Penile injury is a rare chief complaint in the pediatric emergency department. The most common penile injuries are iatrogenic or postsurgical complications, blunt trauma, tourniquet injuries, fractures, and zipper injuries. We report a series of 3 cases of penile foreskin entrapment within the mesh lining of bathing suits as a new, recognized form of penile injury.