Pediatric emergency care
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Pediatric emergency care · Jun 2007
Pediatric emergency medicine physicians' current practices and beliefs regarding mental health screening.
Only 20% of children with mental health issues are identified and receiving appropriate treatment nationally. The emergency department (ED) may represent a significant opportunity to provide selective pediatric mental health screening to an at-risk population. ⋯ Routine PMI screening is conducted infrequently by most PEM physicians. Improved physician education/training and the development of a validated ED-specific mental health screening tool would assist PEM physicians in the early detection of PMI.
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Pediatric emergency care · Jun 2007
Comparative StudyEarly differentiation between dengue and septic shock by comparison of admission hemodynamic, clinical, and laboratory variables: a pilot study.
To compare the clinical, hemodynamic, and laboratory variables, treatment, and outcome in dengue shock syndrome (DSS) and septic shock (SS), with an aim to permit early differentiation at presentation to the emergency department. ⋯ Dengue shock syndrome is likely a distinct entity from SS with some overlapping features. The DSS patients are significantly less likely to have systemic inflammatory response syndrome, be tachycardic, and have a narrower pulse pressure at admission when compared with SS patients. Mental status is better preserved, and spontaneous clinical bleeding is more common in children with DSS compared with those in SS. These likely results from the predominantly vasodilatory state in SS versus vasoconstrictory state that is the initial response in DSS.
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Pediatric emergency care · Jun 2007
Multicenter StudyEvaluation of compliance with palivizumab recommendations in a multicenter study of young children presenting to the emergency department with bronchiolitis.
Monthly palivizumab injections from November to March decrease risk of respiratory syncytial virus (RSV)-related hospitalization during RSV season in high-risk infants born less than 35 weeks of gestation. Our objective was to investigate compliance with the American Academy of Pediatrics (AAP) recommendations for palivizumab prophylaxis among children who present to the emergency department (ED) with bronchiolitis. ⋯ According to parental report, only half of children presenting to the ED with bronchiolitis who met AAP criteria for palivizumab prophylaxis received this monoclonal antibody. Emergency department visits provide an untapped opportunity for staff to educate families and communicate with PCPs about RSV prophylaxis.
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Pediatric emergency care · Jun 2007
Comparative Study Controlled Clinical TrialEthyl chloride as a cryoanalgesic in pediatrics for venipuncture.
Ethyl chloride can be used as a cryoanalgesic, but with the availability of alternative and relatively safer topical analgesics, its use has decreased. However, it still has the advantage of being quicker to apply compared with other topical analgesics, making it ideal for use in the outpatient departments. We wanted to compare the effectiveness of ethyl chloride as an analgesic during venipuncture in children. ⋯ The use of ethyl chloride was as effective as topical anesthetics in preventing distress to children in venipuncture. However, in the appropriate situations, the use of NO could also be comfortable to the child if venipuncture was done by specialist pediatric phlebotomists.
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Pediatric emergency care · Jun 2007
Randomized Controlled Trial Comparative StudyComparison of intravenous terbutaline versus normal saline in pediatric patients on continuous high-dose nebulized albuterol for status asthmaticus.
To determine if the addition of intravenous terbutaline provides any clinical benefit to children with acute severe asthma already on continuous high-dose nebulized albuterol. ⋯ No outcome measures demonstrated statistical significance. Outcome measures revealed a trend toward improvement in the terbutaline group. Before recommending routine use of intravenous terbutaline for acute severe asthma, further study to determine safety and efficacy is necessary.