Pediatric emergency care
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Pediatric emergency care · Apr 2007
The use of local anesthetic techniques for closed forearm fracture reduction in children: a survey of academic pediatric emergency departments.
Although local anesthetic techniques (hematoma blocks, nerve blocks, intravenous regional anesthesia) for forearm fracture reduction are well described and commonly used in adults, it is unclear how often these techniques are used in children. ⋯ Local anesthetic techniques are used only occasionally by those surveyed. More studies examining the use of local anesthesia for forearm fractures in children are necessary to evaluate the need for more widespread use.
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Pediatric emergency care · Apr 2007
Pediatric Procedural Sedation in the Community Emergency Department: results from the ProSCED registry.
Emergency department procedural sedation practices for children have been reported for pediatric tertiary care centers. This report describes these same practice patterns and outcomes for community hospital-based general emergency physicians (EPs) in their treatment of pediatric patients. ⋯ Community EPs in the Procedural Sedation in the Community Emergency Department registry deliver safe and effective pediatric sedation using a broad selection of agents.
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Pediatric emergency care · Apr 2007
Case ReportsCardiotoxicity associated with accidental bupropion ingestion in a child.
Bupropion, an atypical antidepressant commonly used for depression and smoking cessation, is well known to cause seizures in both therapeutic use and overdose, but cardiac effects have been reported as minimal, usually sinus tachycardia. We describe an ingestion of bupropion estimated to be greater than 2 g by a 3-year-old boy that resulted in seizures. ⋯ The patient ultimately developed hypotension and bradycardia requiring cardiopulmonary resuscitation due to the effects of the bupropion combined with the complications of WBI. In contrast to previous literature, which showed few clinical effects aside from seizures from ingestion of bupropion by children, our case highlights the dangers of pediatric bupropion ingestion and highlights risks of WBI.
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Pediatric emergency care · Apr 2007
Guidelines to practice: the process of planning and implementing a pediatric sedation program.
Pediatric sedation practices vary among institutions and even within the same institution depending on providers and location. We planned to implement a pediatric procedural sedation program for a tertiary care pediatric emergency department to standardize sedation practices among emergency physicians. ⋯ Implementing a structured program facilitates guideline adherence. Adapting a flexible contextual planning model was successful in translating guidelines to practice where resources were limited, and the target audience was highly trained adult learners.
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Pediatric emergency care · Apr 2007
Parental administration of analgesic medication in children after a limb injury.
To document parental administration of analgesic medication to children with pain from acute limb injury before coming to the emergency department (ED). ⋯ Prehospital analgesic administration by parents is mainly nonpharmacological largely because of parental concern of interference with medical assessment or underestimating the child's pain. Parental concern of masking symptoms and parental perception of no pain in a child were significant factors in determining parental comfort level in using pharmacological analgesics.