Pediatric emergency care
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Pediatric emergency care · Apr 1995
Randomized Controlled Trial Clinical TrialEfficacy of oral ketamine for providing sedation and analgesia to children requiring laceration repair.
A prospective, double-blind, placebo-controlled, randomized clinical trial was conducted to study the efficacy of oral ketamine for providing sedation and analgesia to children during laceration repair. Thirty children between the ages of one and seven years with lacerations that required suturing were randomly assigned to receive either oral ketamine (10 mg/kg) or an identically flavored placebo syrup prior to suturing. Patients were assessed by means of a tolerance score reflecting behavioral correlates of perceived pain at the time of both lidocaine injection and suturing. ⋯ The ketamine-treated group also achieved a significantly greater degree of sedation (P = 0.012). No significant respiratory or circulatory adverse effects were seen in either group, although 26% of patients who received ketamine experienced minor, transient adverse effects. We conclude that oral ketamine in a dose of 10 mg/kg provides effective sedation and analgesia to young children undergoing wound repair.
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Pediatric emergency care · Apr 1995
Fellowship training in pediatric emergency medicine for graduates of emergency medicine residencies.
Candidates for fellowship training in Pediatric Emergency Medicine may be residency-trained in pediatrics or emergency medicine. The fellows who are emergency medicine-trained have different needs than those with pediatric training. Training programs for these individuals should focus on normal and abnormal development, behavioral pediatrics, pediatric subspecialties, and resuscitation of newborns and children. ⋯ All fellowships should include research methodology and protected time for research activities. Because of the variability in training, fellows with residency training in emergency medicine should receive a core curriculum with the remainder of the training time tailored to meet their specific training needs in pediatrics. This report offers a template for this training.
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Pediatric emergency care · Apr 1995
Radiology practices in emergency departments associated with pediatric residency training programs.
To examine the current radiology practices in academic emergency departments (EDs) serving children, a postal survey was done of 116 directors of EDs that serve as routine teaching sites for pediatric residents. One hundred three ED directors (89%) completed the survey, representing 75 pediatric-only EDs and 28 combined pediatric/adult EDs. Thirty-four of these EDs offer a pediatric emergency medicine fellowship. ⋯ Overnight, pediatric cervical spine studies are cleared, at times, solely by emergency attending physicians in 46% and by emergency house staff in 4%. Only 18% of programs have a daily or weekly ED radiograph review with radiologists. An ED atlas of common radiographic variants or a pediatric radiology textbook is available in 69% of EDs.(ABSTRACT TRUNCATED AT 250 WORDS)