Clinical pediatrics
-
Clinical pediatrics · Dec 1983
Comparative Study Clinical Trial Controlled Clinical TrialRegional anesthesia during newborn circumcision. Effect on infant pain response.
A controlled, double-blind investigation was undertaken to determine whether regional anesthesia by dorsal penile nerve block (DPNB) could effectively minimize the pain and behavioral disruptions usually associated with newborn circumcision. Fifteen infants had DPNB with lidocaine, eight control infants had DPNB with saline, and eight additional control infants were circumcised without undergoing DPNB. Newborn distress was gauged by subjective observation, measurement of heart rate, and the percent of time spent crying in six sequential timed intervals during circumcision. ⋯ Infants who had DPNB with lidocaine cried 50 percent less during circumcision compared to combined controls (p less than 0.01). DPNB was easily administered, and there were no significant complications. Physicians who circumcise newborns have good reason to employ the technique of dorsal penile nerve block with lidocaine to minimize infant pain and distress.
-
Clinical pediatrics · Nov 1983
Decisions to withdraw life support in the neonatal intensive care unit.
Neonatal intensive care units may choose to selectively withdraw support in some neonates with severe brain damage. We offer suggestions for criteria for such withdrawal, and a review of 20 cases in which such a decision-making process occurred in our neonatal intensive care unit.
-
Clinical pediatrics · Nov 1983
The choking child--a life-threatening emergency. Evaluation of current recommendations.
Recently, there has been much controversy in the pediatric literature concerning the appropriate emergency treatment of the choking child. The current recommendations of the American Academy of Pediatrics suggest a series of back blows followed by several chest thrusts. ⋯ It is concluded that, although there are inadequacies in all of the existing research, there are no contraindications to the AAP recommendations. It is suggested that our focus, as pediatricians, should be on educating the lay public in the performance of a series of routine maneuvers that may be life-saving.
-
Clinical pediatrics · Sep 1983
Case ReportsRelapsing Neisseria meningitidis infection associated with C8 deficiency.
Infection due to serogroup Y of Neisseria meningitidis has many clinical manifestations, ranging from mild bacteremia to fatal sepsis and meningitis. N. meningitidis infection may coincide with several complement deficiencies. ⋯ In a review of the literature, recurrent infection occurred in six of 13 children with complement deficiency, four of whom had serotyping positive for N. meningitidis, group Y. Screening for complement deficiency is recommended for all children with meningococcal disease due to N. meningitidis, group Y, and for any child with recurrent infection due to any Neisseria species.