Pediatric emergency care
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Pediatric emergency care · Aug 2007
Review Practice GuidelineEvidence-based guidelines for family presence in the resuscitation room: a step-by-step approach.
The benefits of family presence (FP) during resuscitation have been well documented in the literature for the past 20 years. However, many hospitals lack written guidelines to direct staff members during a resuscitation event. ⋯ The purpose of this paper is to provide evidence-based practice guidelines to offering FP during resuscitation in the emergency department. The guidelines illustrate a practical step-by-step approach that staff members can follow every time a patient is being evaluated and/or treated in the resuscitation room.
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Pediatric emergency care · Aug 2007
Randomized Controlled Trial Comparative StudyRandomized trial of single-dose intramuscular dexamethasone compared with prednisolone for children with acute asthma.
To compare the clinical efficacy of single-dose intramuscular (IM) dexamethasone phosphate to a 5-day course of oral prednisolone for the treatment of moderate asthma exacerbations in young children discharged from the emergency department (ED). ⋯ A single dose of IM dexamethasone showed no clinically meaningful difference in outcomes compared with a 5-day course of oral prednisolone for the treatment of moderate acute asthma exacerbations in young children who are discharged from the ED.
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Pediatric emergency care · Aug 2007
Randomized Controlled Trial Comparative StudyA randomized clinical trial of oral transmucosal fentanyl citrate versus intravenous morphine sulfate for initial control of pain in children with extremity injuries.
Extremity injury is a common condition that requires pain management in an emergency department. In pediatric patients, the most frequently used method of pain control is intravenous (IV) morphine sulfate. Oral transmucosal fentanyl citrate (OTFC) is a potential alternative to morphine, which may obviate the need to place an IV before addressing pain. ⋯ The use of OTFC can provide improved pain control when compared with IV morphine. The pain reduction starts 30 minutes after initiation of medication, and the effect is seen as far as 75 minutes after the initiation of analgesic medication. The study size was too small to make any statements concerning adverse effects; thus, further studies with larger sample sizes are needed to determine the use of OTFC.
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Pediatric emergency care · Aug 2007
ReviewControversies in the sequelae of pediatric mild traumatic brain injury.
Traumatic brain injury is a common occurrence in the pediatric population, and the majority of injuries are considered to be mild. There are varying definitions of mild traumatic brain injury. Classification systems for injury severity may include initial Glasgow Coma Scale, duration of loss of consciousness, and duration of posttraumatic amnesia. ⋯ The symptoms can occur in the areas of cognitive, somatic, and/or affective/emotional complaints. There continues to be controversy concerning the definition of mild traumatic brain injury, the significance of postconcussion syndrome, and the development of other posttraumatic neuropsychological changes. This article will review the literature on the sequelae of pediatric mild brain injury and discuss areas of controversy.
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Pediatric emergency care · Aug 2007
Comparative Study Clinical TrialDiagnosis and guided reduction of forearm fractures in children using bedside ultrasound.
Forearm fractures are common injuries in children. Displaced and angulated fractures usually require reduction. Ultrasound diagnosis and guided reduction offer several potential advantages: (1) the procedure does not involve ionizing radiation; (2) compared with fluoroscopy units, the newer ultrasound units are more portable; and (3) repeated studies can be obtained easily and quickly. ⋯ Bedside ultrasound performed by pediatric emergency medicine physicians is a reliable and convenient method of diagnosing forearm fractures in children. It is also useful in guiding the reduction of these fractures.