American journal of diseases of children (1960)
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Injuries associated with nonmotorized three-wheeled vehicles were prospectively evaluated through a standard questionnaire during the summer months at the emergency department of the Children's Hospital of Philadelphia, Pa. Forty-four children, including 32 boys, with a mean age of 3.77 years, reported such injuries. Most fell (36.4%), but a second vehicle was often involved. ⋯ Two patients were admitted; both had fractures, one of them had a concussion. Data from the US Consumer Product Safety Commission corroborate the epidemiology of these injuries. Recommendations of safety precautions with non-motorized three-wheeled vehicles are reviewed.
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Comparative Study
Comparison study of intraosseous, central intravenous, and peripheral intravenous infusions of emergency drugs.
Intraosseous infusion of emergency drugs is a lifesaving alternative to intravenous administration when intravenous access cannot be rapidly established. We studied the comparative pharmacokinetics of the following six emergency drugs and solutions: epinephrine hydrochloride, 0.01 mg/kg; sodium bicarbonate, 1 mEq/kg; calcium chloride, 10 mg/kg; hydroxyethyl starch, 10 mL/kg; 50% dextrose in water, 250 mg/kg; and lidocaine hydrochloride, 1 mg/kg. Studies were conducted in normotensive, anesthetized dogs, with three animals studied with each of the drugs or solutions and each animal being treated with all three routes of administration (central intravenous, peripheral intravenous, and intraosseous) in randomized sequence. ⋯ Time to placement of the needle varies with the skill and experience of the individual. With experience, all individuals could place the intraosseous needle in 60 seconds or less. The intraosseous route is comparable in effect to the central and peripheral intravenous routes of drug administration for epinephrine, sodium bicarbonate, hydroxyethyl starch, calcium chloride, 50% dextrose in water, and lidocaine and is a clinically feasible alternative when intravenous access will be critically delayed.