Pediatric emergency care
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Pediatric emergency care · Dec 1989
Comparative StudyInfluence of topical anesthesia on the sedation of pediatric emergency department patients with lacerations.
Local anesthetic infiltration of wounds causes pain which distresses children. A painless topical anesthetic solution containing tetracaine, adrenaline, and cocaine (TAC) may reduce this distress. We hypothesized that the use of TAC for anesthesia may reduce the utilization of sedation for laceration repair. ⋯ However, there was a significant reduction in the percent of patients with lacerations receiving DPT during the experimental period, from 12% to 7.6% (P less than 0.05). There were no significant differences in laceration frequency (119/mo and 116/mo), length (2.7 and 2.7 cm), location (85% and 93% total for face and digits), or complexity (64% and 63%) for preTAC and TAC periods, respectively. We conclude that TAC used for local anesthesia may reduce the need for sedation in PED patients with lacerations that require suturing.
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Pediatric emergency care · Sep 1989
Randomized Controlled Trial Clinical TrialThe impact of a didactic session on the success of feline endotracheal intubation by paramedics.
Clinical reports of endotracheal (ET) intubation of infants by paramedics suggest suboptimal success rates. Methods to improve the performance of paramedics in ET intubation should be explored. The small, anesthetized cat may be utilized to evaluate infant ET intubation performance. ⋯ Serious complications occurred in 50% of attempted intubations. There was a poor correlation between performance and measures of paramedic experience. Development of educational methods is required to improve infant ET intubation success and reduce complications.
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Pediatric emergency care · Sep 1989
Indications for chest roentgenogram in the febrile young infant.
A combined retrospective and prospective analysis of infants 60 days of age or less evaluated for fever (greater than or equal to 38.3 degrees C) or history of fever who received chest roentgenogram over a one-year period was performed to determine whether clinical characteristics were predictive of pneumonia. Of the 209 patients studied, 115 were reviewed prospectively and 94 retrospectively. ⋯ However, infants with the following nine factors did not have pneumonia; illness in the summer months; absence of cough, dyspnea, and respiratory distress (grunting/flaring/retracting); respiratory rate less than 60; absence of rales and decreased breath sounds; presence of normal color; and white blood cell count less than 19,000/mm3. We recommend that these clinical characteristics be utilized to determine whether chest roentgenogram is warranted in the young infant evaluated for fever.
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Pediatric emergency care · Jun 1989
Case ReportsIntraosseous drug administration: successful resuscitation from asystole.
The case of a seven-month-old infant presenting in full cardiac arrest and resuscitated utilizing a right tibial intraosseous access line is presented. The child who presented in asystole appears to be the first reported case of the successful use of the intraosseous route as the sole source of drug administration. Flow time from tibia to clinical cardiac response was noted to be less than three minutes, similar to those in animal arrest models.