Pediatrics
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Randomized Controlled Trial Clinical Trial
The safety of acetaminophen and ibuprofen among children younger than two years old.
Recently ibuprofen has been introduced as a nonprescription analgesic/antipyretic for use in children. ⋯ The risk of serious adverse clinical events among children <2 years old receiving short-term treatment with either acetaminophen or ibuprofen suspension was small and did not vary by choice of medication. These data do not provide any information on the safety of these medications when used for prolonged periods or when used together, regardless of duration.
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Prognostication is central to developing treatment plans and relaying information to patients, family members, and other health care providers. The degree of confidence or certainty that a health care provider has in his or her mortality risk assessment is also important, because a provider may deliver care differently depending on their assuredness in the assessment. We assessed the performance of nurse and physician mortality risk estimates with and without weighting the estimates with their respective degrees of certainty. ⋯ The level of medical training correlated with the provider's ability to predict mortality risk. The higher the level of certainty associated with the mortality prediction, the more accurate the prediction; however, high levels of certainty did not guarantee accurate predictions. Measures of certainty should be considered when assessing the performance of mortality risk estimates or other subjective outcome predictions.
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1) To determine whether clinical signs of brain injury are sensitive indicators of intracranial injury (ICI) in head-injured infants. 2) To determine whether radiographic imaging of otherwise asymptomatic infants with scalp hematoma is a useful means of detecting cases of ICI. 3) To determine whether head-injured infants without signs of brain injury or scalp hematoma may be safely managed without radiographic imaging. ⋯ Clinical signs of brain injury are insensitive indicators of ICI in infants. A substantial fraction of infants with ICI will be detected through radiographic imaging of otherwise asymptomatic infants with significant scalp hematomas. Asymptomatic infants older than 3 months of age who have no significant scalp hematoma may be safely managed without radiographic imaging.
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Practice Guideline Guideline
Emergency preparedness for children with special health care needs. Committee on Pediatric Emergency Medicine. American Academy of Pediatrics.
Children with special health care needs are those who have, or are at risk for, chronic physical, developmental, behavioral, or emotional conditions and who also require health and related services of a type or amount not usually required by typically developing children. Formulation of an emergency care plan has been advocated by the Emergency Medical Services for Children (EMSC) program through its Children With Special Heath Care Needs Task Force. Essential components of a program of providing care plans include use of a standardized form, a method of identifying at-risk children, completion of a data set by the child's physicians and other health care professionals, education of families, other caregivers, and health care professionals in use of the emergency plan, regular updates of the information, 24-hour access to the information by authorized emergency health care professionals, and maintenance of patient confidentiality.