Pediatric emergency care
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Pediatric emergency care · Feb 2020
The Use, Safety, and Efficacy of Olanzapine in a Level I Pediatric Trauma Center Emergency Department Over a 10-Year Period.
Olanzapine is a second-generation antipsychotic increasingly used in emergency medicine for many indications. Literature on its use in children is sparse. Our objectives were to describe the use, safety, and efficacy of olanzapine in pediatric emergency patients. ⋯ Olanzapine seems safe when used for a variety of conditions in pediatric emergency patients. It may be effective for acute agitation, primary headache, and gastrointestinal complaints.
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Pediatric emergency care · Feb 2020
Use of Chest Computed Tomography for Blunt Pediatric Chest Trauma: Does It Change Clinical Course?
Given the concern for radiation-induced malignancy in children and the fact that risk of severe chest injury in children is low, the risk/benefit ratio must be considered in each child when ordering a computed tomography (CT) scan after blunt chest trauma. ⋯ Our study suggests that chest CT scans frequently serve as confirmatory diagnostic tools and in the pediatric blunt chest trauma patient and can be withheld in many cases without hindering the management of an injured child.
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Pediatric emergency care · Feb 2020
Randomized Controlled TrialThe Effect of External Thermomechanical Stimulation and Distraction on Reducing Pain Experienced by Children During Blood Drawing.
This study aimed to investigate the sole and combined effects of external thermomechanical stimulation and distraction in pain relief of children during blood drawing. This is a randomized clinical trial. The sample consisted of 218 children aged 6 to 12 years who were randomly assigned to 4 groups: group 1 received no intervention, group 2 received external thermomechanical stimulation using Buzzy, group 3 received distraction via DistrACTION Cards, and group 4 received a combination of both external thermomechanical stimulation and distraction. ⋯ When the 3 study groups were compared with the control group, all 3 groups had significantly lower pain levels than the control group (P < 0.001). The lowest pain level was measured in the combined condition (Buzzy and DistrACTION Cards). The mean score of the device group was lower than the distraction group.
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Pediatric emergency care · Feb 2020
Utility of Postreduction Radiographs After Fluoroscopy-Guided Reduction and Casting of Uncomplicated Pediatric Forearm Fractures.
The aim of the study was to determine efficacy of performing postreduction radiographs in managing uncomplicated pediatric forearm fractures after reduction and casting under fluoroscopic guidance. ⋯ Performance of postreduction radiographs in children with uncomplicated pediatric forearm fractures that are reduced and casted under fluoroscopy has little clinical utility and contributes to increased radiation exposure, patient health care cost, and time spent in the ED. Patients with mid-shaft forearm fractures involving both radius and ulna (especially if angulated or displaced) are at risk for unacceptable reduction after casting and may be the target group in which performing post reduction radiographs has potential benefit.
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Pediatric emergency care · Feb 2020
Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.
The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. ⋯ Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.