Pediatric emergency care
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Pediatric emergency care · Jul 2009
Randomized Controlled Trial Comparative StudyA randomized clinical trial of lidocaine gel for reducing infant distress during urethral catheterization.
The purpose of this study was to determine whether a lidocaine-enhanced lubricant that was used topically and instilled into the urethra decreased infants' distress that was associated with catheterization. ⋯ The use of topical and intraurethral lidocaine resulted in a lower distress when compared with a topical lubricant, at a level approaching significance for global distress. When a subsection of the total distress score that measured infant cry was evaluated, the difference between the intraurethral lidocaine group and the group without intraurethral instillation was statistically significant. Although the results are promising, intraurethral lidocaine did not fully alleviate discomfort associated with urethral catherization. The use of lidocaine is suggested for pediatric patients undergoing urethral catherization; however, evaluation of additional agents and techniques for further decreasing pain is also warranted.
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Pediatric emergency care · Jul 2009
Randomized Controlled Trial Comparative StudyBackslab versus nonbackslab for immobilization of undisplaced supracondylar fractures: a randomized trial.
Immobilization of supracondylar fractures of the humerus, for 1 to 4 weeks in a backslab or a collar and cuff, produces good functional outcomes. This study assesses the pain associated with these 2 forms of immobilization. ⋯ For supracondylar fractures, use of an above-elbow posterior slab produces shorter duration of pain and reduces the time taken to become active again.
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Pediatric emergency care · Jul 2009
Case ReportsTo remove or not remove...asymptomatic sewing needle within hepatic right lobe in an infant.
The ingestion or accidental insertion of foreign bodies is extremely rare before 6 months of age. We report the case of a 3-month-old infant with a sewing needle into the right hepatic lobe, without symptoms. The extraction was performed through laparotomy. The issue is revisited, and the decision making tree is discussed.
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Pediatric emergency care · Jul 2009
Case ReportsRecurrent coagulopathy with delayed significant bleeding after crotaline envenomation.
Report of delayed significant coagulopathy, thrombocytopenia, and bleeding after Crotaline envenomation. ⋯ If coagulopathy or thrombocytopenia recurs, retreatment with CroFab should be considered to prevent significant bleeding.