Pediatric emergency care
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Pediatric emergency care · Apr 1992
Pediatric intramuscular injections: do you know the procedure and complications?
The practice of outpatient intramuscular antibiotic therapy for infants and children at risk for serious bacterial infections is an attractive alternative to hospitalization. The use of this alternative is likely to increase. Pediatric emergency physicians and pediatric residents at our institution were surveyed to determine their knowledge of intramuscular injection techniques. ⋯ A volume of 1 ml to be injected at one site was exceeded 10 (47%) times. Such practices increase the risk for infectious complications and neurovascular and muscle injuries. To avoid these complications, guidelines for pediatric intramuscular injections are presented.
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Pediatric emergency care · Feb 1992
Emergency department laboratory evaluation of children with seizures: dogma or dilemma?
Seizure is a common problem evaluated in pediatric emergency departments. Serum chemistry analysis is often performed as a routine part of the diagnostic evaluation of children who arrive in the ED with seizure. From this retrospective study, we sought to determine 1) how often serum electrolytes (Na, K, Cl, CO2), total calcium, magnesium, ammonia, and glucose chemistries were performed, 2) the frequency of abnormalities detected, and 3) whether abnormalities resulted in a change in patient care. ⋯ One hundred five of 308 (34%) were experiencing their first seizure. There was no difference in the likelihood of having a test ordered for children with a first seizure, regardless of seizure category. We concluded that 1) abnormal serum electrolytes, total calcium, magnesium, and glucose rarely cause seizure in children and 2) routine use of these tests in the ED is costly and does not contribute to seizure therapy.