Pediatric emergency care
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Pediatric emergency care · May 2010
Multicenter Study Comparative StudyBenchmarks for the emergency department care of children with asthma, bronchiolitis, and croup.
The objectives of this study were (1) to measure the 2005 performance of freestanding children's hospital emergency departments (EDs) in the care of children with asthma, bronchiolitis, and croup (ABC) using 5 clinical quality indicators and (2) to construct achievable benchmarks for 7 clinical quality indicators of ED care for children with ABC for 2005. ⋯ Variation exists among freestanding children's hospitals in the ED care for ABC, but the performance is better than previously reported national averages. We report achievable benchmarks for ED care based on objective clinical quality indicators.
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Pediatric emergency care · May 2010
Comparative StudyParental fever attitude and management: influence of parental ethnicity and child's age.
The objective was to study parental fever management and attitude toward fever from the perspective of the child's ethnicity and age. ⋯ For most children in our population, the use of antipyretics was justified, as the majority of our children visiting the PED for an acute febrile episode are young infants, in particular with a high degree of fever and accompanying symptoms. We confirm and extend previous findings of ethnicity influencing parental fever management.
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Pediatric emergency care · May 2010
Comparative StudyEndotracheal tube cuff pressures in pediatric patients intubated before aeromedical transport.
Prolonged endotracheal tube cuff pressures (ETTCPs) greater than 30 cm H2O can cause complications. With increasing utilization of cuffed endotracheal tubes (ETTs) in pediatric patients comes the risk of overinflation. We evaluated the incidence of elevated ETTCP in pediatric patients intubated with cuffed ETTs, transported by a critical-care transport service and attempted to identify whether elevated ETTCP was associated with factors such as patient demographics, diagnostic category, and intubator credentials. ⋯ A significant number of pediatric patients transported by a critical-care transport service had elevated ETTCP. Furthermore, there was no clear risk factor for elevated cuff pressures. This is further evidence that cuff pressures should be measured in all patients. Further research should focus on the effect of educational intervention and on the possible clinical results of elevated ETTCPs.
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Pediatric emergency care · May 2010
Case ReportsIsoniazid-induced status epilepticus in a pediatric patient after inadequate pyridoxine therapy.
Isoniazid (INH) is an effective treatment for tuberculosis and among the most common causes of drug-induced seizures in the United States. Isoniazid intoxication produces a characteristic clinical syndrome including seizures, metabolic acidosis, and, in severe cases, respiratory depression and coma. ⋯ As soon as possible after INH overdose is suspected or diagnosed, pyridoxine should be administered in a dose approximately equal to the estimated amount of INH ingested regardless of the age of the patient.