Pediatric emergency care
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Pediatric emergency care · Oct 1997
Comparative StudyFactors influencing termination of resuscitative efforts in children: a comparison of pediatric emergency medicine and adult emergency medicine physicians.
To examine factors that influence termination of resuscitative efforts (TORE) and compare pediatric emergency medicine (PEM) and general emergency medicine (GEM) physicians regarding TORE in children. ⋯ 1) Several laboratory and clinical factors significantly influence physician's decisions regarding TORE; 2) regardless of setting, time of pulselessness does appear to be an influential factor in determining when to terminate resuscitation in children for most physicians; 3) PEM physicians are more likely to terminate resuscitative efforts than are GEM physicians if return of spontaneous circulation is not achieved by 25 minutes; 4) a significant number of PEM and GEM physicians do not use high dose epinephrine in accordance with current PALS recommendations.
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Pediatric emergency care · Oct 1997
Comparative StudyComparison of self-inflating bags with anesthesia bags for bag-mask ventilation in the pediatric emergency department.
To compare bag-mask ventilation performed by emergency department (ED) personnel using anesthesia bags (AB) and self-inflating bags (SIB). ⋯ Compared to SIB use for bag-mask ventilation in an ED, AB use resulted in more ventilation failures, no advantage in preventing excessive airway pressures, and less confidence among operators. The SIB should be the first choice for bag-mask ventilation in the ED, with attention to maximize oxygen delivery.
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Pediatric emergency care · Oct 1997
Case Reports"Cloniderm" toxicity: another manifestation of clonidine overdose.
We present a case of accidental transdermal clonidine toxicity in a six-year-old child who was applying a clonidine patch intermittently to her dermis in the mistaken assumption that it was an adhesive bandage. Although the child appeared to be drug toxic, she repeatedly denied ingestion of any substances to family, paramedics, and hospital staff but was not initially questioned regarding dermal exposure. In dealing with drug toxic states in which the differential diagnosis includes drugs available as transdermal delivery systems, the evaluation should include questions regarding possible dermal exposure and a thorough skin examination.
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Pediatric emergency care · Aug 1997
Miniature C-arm imaging: an in vitro study of detecting foreign bodies in the emergency department.
Recently, we have had clinical success detecting foreign bodies (FBs) using a mobile C-arm fluoroscopic device. This study tests its utility to detect FBs of differing densities in soft tissue. ⋯ This device accurately detects metal, gravel and glass. Radiolucent (wood) and semiradiopaque (plastic) FBs could not be located reliably. Clinical trials would define utility of this device in saving time, money and radiation exposure.