Pediatric emergency care
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Antidotal therapy can be lifesaving in the management of poisoned children. Although supportive care is sufficient in many cases, a specific antidote can significantly reduce morbidity and mortality in a number of poisoning scenarios, and so the pediatric emergency medicine practitioner must be familiar with its indications for use, dosage and administration, and contraindications. A number of new antidotes have emerged in recent years. This review discusses the pediatric uses and limitations of intravenous N-acetylcysteine, octreotide, crotaline Fab antivenom, fomepizole, atropine and pralidoxime autoinjectors and provides some brief discussion on newer antidotes for which data is only starting to emerge.
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Pediatric emergency care · Jun 2006
Randomized Controlled Trial Comparative StudyVomiting of liquid corticosteroids in children with asthma.
Oral corticosteroids are an essential part of the management of children with acute asthma exacerbations. Vomiting is a frequently cited problem attributed to oral corticosteroids. A new formulation of prednisolone, Orapred, claims to have improved palatability that may decrease the incidence of vomiting. ⋯ In our study population, Orapred was associated with a significant less incidence of vomiting and better taste score compared to the generic prednisolone.
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Pediatric emergency care · Jun 2006
Comparative StudyAdverse events in pediatric ketamine sedations with or without morphine pretreatment.
To assess outcomes between 2 groups of patients receiving ketamine for procedural sedations in our pediatric emergency department. Our hypothesis is that there is no difference in the number of adverse events in ketamine sedations with and without morphine pretreatment. ⋯ We found no increase in the number of adverse events with morphine pretreatment in ketamine sedations for children. Prospective studies to validate these findings, including an effect of timing of analgesia administration, are warranted.
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Pediatric emergency care · Jun 2006
Clinical TrialImpact of a pediatric primary care office-based mock code program on physician and staff confidence to perform life-saving skills.
Previous studies have described that pediatric offices are ill-prepared for medical emergencies. Pediatric "mock codes" have been utilized to increase the emergency preparedness of inpatient medical units for several decades. These practice drills have been shown to both increase practitioners' confidence and decrease anxiety during actual resuscitations. Although the use of mock codes is recommended in the outpatient setting, these benefits have yet to be demonstrated for office-based practitioners. ⋯ The results of this study support the recommendation that mock codes should be performed in the pediatric primary care setting to improve practitioner confidence and decrease practitioner anxiety.
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Pediatric emergency care · Jun 2006
Decrease in emergency department length of stay as a result of triage pulse oximetry.
Many emergency departments do not perform pulse oximetry in triage, in spite of its potential for altering management decisions. We attempted to quantify the decrease in patient throughput time in a pediatric emergency department following the introduction of triage pulse oximetry. ⋯ Institution of triage pulse oximetry significantly decreases ED throughput times. Clinical exam alone is not a replacement for measurement of oxygen saturation.