Pediatric emergency care
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Pediatric emergency care · Apr 2002
Comparative StudyColor Doppler sonography and scintigraphy of the testis: a prospective, comparative analysis in children with acute scrotal pain.
To compare testicular color Doppler sonography with testicular scintigraphy in differentiating between surgical and nonsurgical conditions of the pediatric testis, and to evaluate the role of testicular color Doppler sonography in the pediatric population. ⋯ Color Doppler sonography and scintigraphy show similar sensitivity for the diagnosis of testicular torsion. A small number of false-negative cases can occur with either modality. The two studies may provide complementary information in indeterminate cases.
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Pediatric emergency care · Apr 2002
Randomized Controlled Trial Comparative Study Clinical TrialComparison of two benzodiazepines used for sedation of children undergoing suturing of a laceration in an emergency department.
(1) To determine if oral diazepam (POD) is as effective in sedating children less than 6 years of age for laceration repair as oral midazolam (POM) or intranasal midazolam (INM); and (2) To determine if patients stayed longer in the department after sedation when given POD for sedation. ⋯ The oral route of delivery of POM and POD was better tolerated than INM. POM and INM were more effective at sedation than POD, but there was no clinical difference between any groups for time to sedation or time to discharge. More patients in the POM group had side effects after leaving the department. POD may be an alternative to POM, but a higher dose may be required, possibly with longer recovery times.
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Airway management is an important aspect of pediatric emergency care. Prompt, effective airway access can mean the difference between a good outcome and disability or death. Optimal management requires an understanding of the differences between children and adults with respect to airway anatomy and physiology and response to medications to facilitate airway access. ⋯ This review details a logical and practical approach to the uncomplicated pediatric airway. Emphasis is also placed on recognition of the difficult airway and methods to render the difficulty less daunting. Good judgment and the appropriate skills are the prerequisites for success.
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Pediatric emergency care · Apr 2002
Commercial airline travel decreases oxygen saturation in children.
To investigate the degree of oxygen saturation decline occurring in children during prolonged commercial air travel. ⋯ Oxygen saturation declines significantly during commercial airline travel with reduced aircraft cabin pressure and concomitant reduced cabin PO2. We did not observe an "acclimation" of oxygenation as the length of travel increased; rather, the oxygen saturation decline worsened, although it may be partially a result of the lower cabin PO2. Although there were no clinically noticeable ill effects at the level of oxygen saturation decline in these relatively healthy passengers, patients with preexisting anemia or cardiopulmonary disease are likely to experience greater degrees of clinical compromise with similar degrees of oxygen saturation decline.