Pediatric emergency care
-
Pediatric emergency care · Oct 2008
Case ReportsIntrathecal baclofen withdrawal resembling serotonin syndrome in an adolescent boy with cerebral palsy.
Intrathecal baclofen (ITB) is increasingly being used to reduce spasticity among children with cerebral palsy, dystonia, and spinal cord injuries. However, complications such as withdrawal, which is a potentially life-threatening condition, can occur. Intrathecal baclofen withdrawal should be differentiated with autonomic dysreflexia, malignant hyperthermia, neuroleptic malignant syndrome, and serotonin syndrome. ⋯ He presented with agitation, diaphoresis, increasing spasticity, rigidity, jitteriness, hyperreflexia, clonus, tachycardia, hypertension, and rhabdomyolysis. Treatment consisted of emergent refilling of the pump, intravenous diazepam, and oral cyproheptadine. We also emphasize the importance of prompt recognition of ITB withdrawal among high-risk patients.
-
Pediatric emergency care · Sep 2008
Randomized Controlled Trial Comparative StudyOxycodone versus codeine for triage pain in children with suspected forearm fracture: a randomized controlled trial.
To compare the efficacy of pain reduction of triage oxycodone (O) versus codeine (C) to children with suspected forearm fractures. ⋯ Triage-administered O tended toward greater pain reduction compared with C in children with suspected forearm fractures. Although minor adverse effects occurred in both groups, itching occurred more in C. Identification of radiography as the most painful part of fracture evaluation underscores the need for early triage administration of analgesia for suspected fractures.