Pediatric emergency care
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Pediatric emergency care · Dec 1994
Randomized Controlled Trial Comparative Study Clinical TrialA controlled trial of methylprednisolone in the early emergency department treatment of acute asthma in children.
Asthma continues to be a leading cause for pediatric hospitalizations. A study using high-dose intravenous (i.v.) steroids early in the emergency department (ED) care of adults with acute asthma reported a 60% reduction in hospitalization rate. Limited data are available for children. ⋯ No significant differences were found between the admission rates of the MP and P groups (41% MP vs 33% P, P = 0.44, chi 2, 95% CI for decrease in MP vs P groups -28 to +12%). The average hospital stay was shorter for those children treated with MP (79 hours vs 90 hours). We conclude that IV methylprednisolone given as an adjunct to routine ED care of children with acute asthma is unlikely to markedly reduce hospitalization rates.
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Pediatric emergency care · Dec 1994
Comparative StudyEvaluation of QBC Autoread performance in an emergency department setting.
The objective of the study was to examine the accuracy and clinical utility of technology using a quantitative buffy coat analysis in determining complete blood cell count results in an emergency department. A prospective observational study was done at an urban pediatric emergency department. One hundred ninety-one patients who had a complete blood cell count (CBC) ordered by the managing emergency physician from 11 AM to 3 AM participated. ⋯ The mean time for collection to QBC result was 17.3 +/- 11.6 minutes compared with 42.2 +/- 17.9 minutes for collection to CBC result. One hundred thirty-five clinical utility forms were completed by the managing physicians after a review of their patient's QBC result. In 20% of cases, physicians felt the QBC result would have shortened the patient's length of stay in the emergency department, and in 85% they felt the result confirmed their clinical impression.(ABSTRACT TRUNCATED AT 250 WORDS)
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Pediatric emergency care · Dec 1994
Management of moderate head injury in childhood: degree of consensus among Canadian pediatric emergency physicians.
The purpose of this study was to assess the degree of consensus among Canadian pediatric emergency physicians regarding the management of moderate head injury in children. A questionnaire regarding the management of moderate head injury in a child was developed, and it concentrated on indications for admission and policies regarding skull radiograph. The questionnaire was given to all pediatricians who are members of the Emergency Section of the Canadian Pediatric Society (n = 33) and who represent 15 Canadian pediatric emergency departments. ⋯ Agreement of more than 70% regarding indications for ordering a skull radiograph was achieved only for clinical suspicion of a depressed skull fracture. In conclusion, for the average child who is well after a loss of consciousness after a head injury lasting three minutes or less, the majority of respondents do not routinely admit the child or order a routine skull radiograph. A reasonable degree of consensus (70-80%) regarding ordering of skull radiographs and admission is based on clinical criteria.
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Pediatric emergency care · Dec 1994
Comment Letter Case ReportsA case of compartment syndrome following intraosseous infusions.
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Pediatric emergency care · Oct 1994
Case ReportsTransient erythroblastopenia of childhood presenting with shock and metabolic acidosis.
Transient erythroblastopenia of childhood is usually a benign, self-limiting underproduction of red blood cells that often goes undetected clinically. The patient presented here, however, required crystalloid boluses and red blood cell transfusion for treatment of shock and metabolic acidosis in the emergency department. The emergency physician must be alert to the patient presenting with severe anemia and procure extra pretransfusion blood samples for anemia studies when transfusion appears imminent. The need for red blood cell transfusion in such a patient must be expeditiously recognized and, when the need exists, transfusions should be started as quickly as possible.