Pediatric emergency care
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Pediatric emergency care · Aug 2004
Randomized Controlled Trial Comparative Study Clinical TrialRandomized controlled comparison of cosmetic outcomes of simple facial lacerations closed with Steri Strip Skin Closures or Dermabond tissue adhesive.
To compare the short-term complications and long-term cosmetic outcomes of simple facial lacerations closed with 3M Steri Strip Skin Closures or Dermabond. ⋯ Steri Strip Skin Closures and Dermabond provide similar cosmetic outcomes for closure of simple facial lacerations. Steri Strip Skin Closure may represent a low-cost alternative for closure of simple facial lacerations.
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Pediatric emergency care · Aug 2004
Randomized Controlled Trial Comparative Study Clinical TrialEtomidate versus pentobarbital for sedation of children for head and neck CT imaging.
We compare etomidate to pentobarbital for sedation of children for head and neck computed tomography imaging. ⋯ At the dosing used in this study, pentobarbital is superior to etomidate when comparing success rates for sedation. However, among the successful sedations, the duration of sedation was shorter in the etomidate group than in the pentobarbital group. Pentobarbital is associated with more frequent side effects and parental concerns compared to etomidate.
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Pediatric emergency care · Aug 2004
Agreement among pediatric health care professionals with the pediatric Canadian triage and acuity scale guidelines.
To compare triage level assignment, using case scenarios, in a pediatric emergency department between registered nurses (RNs) and pediatric emergency physicians (PEPs) based on the Pediatric Canadian Triage and Acuity Scale (P-CTAS) guidelines. To compare triage level assignment of the RNs and PEPs to that done by a panel of experts using the same P-CTAS guidelines. ⋯ With the introduction of the P-CTAS, the level of agreement and accuracy of triage categorization remained moderate for both RNs and PEPs. The reliability of the P-CTAS needs to be further assessed and the requirements for revisions considered prior to its widespread use.
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Pediatric emergency care · Aug 2004
Comparative StudyChildren referred to an emergency department by an after-hours call center: complaint-specific analysis.
Approximately 20% of phone calls to after-hours call centers result in referrals to the emergency department (ED), but data regarding ED management and disposition are lacking. We sought to determine the acuity of illness of referred children as reflected by triage classifications and need for therapeutic interventions, diagnostic testing, and hospitalization, and to stratify the analysis of ED management and dispositions by chief complaints. ⋯ Children referred to the ED for illnesses related to the lower respiratory tract, principally wheezing, had illnesses of high acuity. On the other hand, current criteria for ED referral for children in the gastrointestinal, head, ears, eyes, nose, and throat, and upper respiratory tract categories result in the referral of many children with nonurgent problems. These data support a reassessment of current referral practices for children with these complaints.
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Pediatric emergency care · Aug 2004
Activated charcoal administration in a pediatric emergency department.
Activated charcoal is the commonest form of gastrointestinal decontamination offered to potentially poisoned children within United States emergency departments. Our aim was to describe this practice with regard to timing, route of administration, use of flavoring agents, and occurrence of adverse events other than vomiting. ⋯ Despite published guidelines, children treated in an emergency department rarely received charcoal within 1 hour of ingestion. Gastric tube administration of charcoal varies by age and is partly subjective in its application. We found no evidence that excipient flavoring of charcoal improved success of administration. Pulmonary aspiration of charcoal, although uncommon, should be considered when assessing the risk of therapy. We offer a report of symptomatic constipation from single-dose charcoal.