Arch Pediat Adol Med
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Arch Pediat Adol Med · Jul 1996
Comparative StudyRole of the primary care provider in expediting care of children with acute appendicitis.
To assess the role of the primary care provider (PCP) in the diagnosis and treatment of acute appendicitis in children by determining whether there were differences in the treatment and outcome of children whose parents contacted the PCP before taking the child to the hospital compared with those who did not. ⋯ Children with appendicitis whose parents contacted the PCP before arrival at the hospital were less likely to have appendiceal perforation than those whose parents did not call the PCP, irrespective of insurance status. Children whose parents called the PCP before arrival at the hospital during the weekend were operated on more promptly than were children whose parents did not call the PCP. Contact with the PCP was associated with more expeditious care of children with acute appendicitis.
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Arch Pediat Adol Med · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialIntramuscular ketamine is superior to meperidine, promethazine, and chlorpromazine for pediatric emergency department sedation.
To compare ketamine hydrochloride (KET) with combined meperidine hydrochloride, promethazine hydrochloride, and chlorpromazine hydrochloride (MPC) for pediatric emergency department sedation with respect to onset, duration, and efficacy. ⋯ Ketamine has a faster onset and results in more rapid discharge from the pediatric emergency department while providing for less patient distress during procedures. Ketamine is also associated with greater physician satisfaction than MPC.
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Arch Pediat Adol Med · Jul 1996
Levels of consciousness and ventilatory parameters in young children during sedation with oral midazolam and nitrous oxide.
To determine the ventilatory effects and levels of consciousness achieved during sedation with the combination of oral midazolam and inhaled nitrous oxide. ⋯ The combination of oral midazolam, 0.5 mg/kg, and up to 60% inhaled N2O caused mild ventilatory depression in some children and resulted in a progression from conscious to deep sedation beginning at 30% N2O. When using this particular combination of sedatives, practitioners should monitor each child's mental status continuously and adhere to the appropriate published guidelines for the monitoring and management of such patients.
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Arch Pediat Adol Med · Jul 1996
Case ReportsPediatric trauma documentation. Adequacy for assessment of child abuse.
To determine how frequently information considered necessary for identification of potential cases of child abuse or neglect was adequately documented in cases of pediatric trauma. ⋯ Documentation of pediatric trauma remains inadequate to differentiate accidental trauma from abuse. Inadequately explained or repeated injuries in children must be reported as suspected child abuse and neglect, and those reports should include well-documented histories and physical examinations by the physician involved.
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Arch Pediat Adol Med · Jul 1996
Drinking on campus. Undergraduate intoxication requiring emergency care.
To (1) determine the incidence of undergraduate graduate students with alcohol intoxication who presented to our emergency department (ED), (2) examine the demographic correlates of the students, and (3) look at associated injuries that were sustained by the students. ⋯ Alcohol intoxication that requires emergency care is not uncommon among college students, and many students with alcohol intoxication present to the ED following a fall. Freshmen are particularly likely to present for care in an ED.