Pediatric emergency care
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Pediatric emergency care · Jun 1996
Comparative StudyPediatric prehospital care: epidemiology of use in a predominantly rural state.
The objective of this study was to analyze, by retrospective review, the pediatric population utilizing emergency medical services (EMS) throughout Kentucky, with particular emphasis on differences between urban and rural areas. The source of the data used was from all prehospital runs in children less than 17 years of age reported in Kentucky in a computerized database to the state EMS branch. There were no interventions. ⋯ ALS procedures were infrequently performed, especially in younger patients, although the performance of these procedures did not prolong scene times. We conclude that educational initiatives for pediatric care in the prehospital setting should include assessment and stabilization of children, including appropriate procedures, both for ALS and BLS providers. Prehospital data should be linked with police reports and emergency department data to provide means of assessing the impact of prehospital services on outcome in pediatric patients.
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Pediatric emergency care · Jun 1996
Pediatric prehospital care provided by a physician-staffed emergency medical helicopter unit in Finland.
During an 18-month period ending on March 15, 1994, data on all patients treated by the Helsinki Area Emergency Medical Air Service (HEMS) in Southern Finland were collected. The HEMS operates a physician-staffed helicopter unit which is dispatched by alarm centers connected to a national 112 emergency phone system. Of 1481 emergency missions during the study period, 89 (8%) involved children less than 17 years old. ⋯ Cardiopulmonary resuscitation was initiated in nine patients. Ten patients were evacuated by helicopter, and 22 patients were transported by ground ambulance with a HEMS physician escort to the hospital. According to this study, the HEMS physician play an important role also in pediatric prehospital care in their operating area.
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Pediatric emergency care · Jun 1996
Clinical TrialUse of racemic epinephrine, dexamethasone, and mist in the outpatient management of croup.
This study aims to determine whether a subpopulation of children with croup, given mist and dexamethasone, can be treated with nebulized racemic epinephrine and safely discharged after observation in the emergency department. A prospective study was designed, enrolling children aged three months to six years with a clinical diagnosis of croup. Croup scores were assigned on arrival, after 30 minutes of saline mist, and 30, 120, and 240 minutes after nebulized racemic epinephrine. ⋯ Two patients could not be contacted. The 95% confidence interval for 0/38 patients with a negative outcome is (0-9.3%). We conclude that children with croup treated with dexamethasone and mist, receiving one nebulized racemic epinephrine treatment, can be discharged after a four-hour period of observation if they appear clinically well to an experienced physician, and if close follow-up can be established.
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Pediatric emergency care · Jun 1996
The utility of head computed tomographic scanning in pediatric patients with normal neurologic examination in the emergency department.
Head injury is a frequent cause of morbidity and mortality in pediatric trauma. Guidelines for obtaining computed tomographic (CT) scans in the child with mild head injury are poorly defined. This study investigated the utility of head CT scanning in the pediatric patient presenting with normal neurologic examination. ⋯ No clinical variables (seizure, LOC, vomiting, headache, confusion, irritability, sleepiness, amnesia) were associated with ICI (P > 0.05). In pediatric head trauma patients, with normal neurologic examinations in the ED, ICI occurs < 5% of the time and neurosurgery is needed in 1% of the cases. Commonly used clinical variables are not associated with ICI in these children.