Pediatric emergency care
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Pediatric emergency care · Mar 2008
Randomized Controlled TrialPediatric fingertip injuries: do prophylactic antibiotics alter infection rates?
Fingertip injuries are common in the pediatric population. Considerable controversy exists as to whether prophylactic antibiotics are necessary after repair of these injuries. Our goal was to compare the rate of bacterial infections among subgroups treated with and without prophylactic antibiotics. The study hypothesis was that infection rates were similar in the 2 groups. ⋯ This study suggests that routine prophylactic antibiotics do not reduce the rate of infection after repair of distal fingertip injuries.
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Pediatric emergency care · Mar 2008
Derivation of the DIVA score: a clinical prediction rule for the identification of children with difficult intravenous access.
To develop a clinical prediction rule that would be easy to apply and be useful for predicting success or failure of peripheral intravenous line insertion in children. ⋯ A clinical prediction rule that is easy to apply and is useful for predicting success or failure of peripheral intravenous insertion has been created. If externally validated, this DIVA score can be used to predict which children will have difficult intravenous access.
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A history of ethanol consumption combined with vomiting, anion gap metabolic acidosis, and altered mental status is consistent with a broad differential diagnosis, which requires a systematic approach. Alcoholic ketoacidosis is rare after binge drinking in the naïve individual and typically occurs in patients with heavy, chronic use. We present the case of an 11-year-old boy with acute ethanol intoxication and a clinical course that is most consistent with alcoholic ketoacidosis. Alcoholic ketoacidosis should be considered in the differential diagnosis of children with unexplained ketoacidosis when there is history or evidence of ethanol consumption combined with the appropriate clinical presentation.
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Pediatric emergency care · Mar 2008
Comparative StudyTertiary pediatric emergency department admission rates fall as waiting times increase.
To examine whether children in the same triage category presenting to a tertiary paediatric emergency department are more likely to be admitted to hospital if their wait is longer. ⋯ Predictably, but reassuringly, those patients waiting longer than the recommended category time are no more likely to get admitted and do not represent a grossly different subset of patients in terms of age and diagnosis. Further work is needed to identify, at the point of triage, the characteristics of children who are unlikely to deteriorate during their wait.