Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized, controlled trial comparing a tissue adhesive with suturing in the repair of pediatric facial lacerations.
To compare the tissue adhesive Histoacryl Blue with suturing in the repair of pediatric facial lacerations. ⋯ Histoacryl Blue is a faster and less painful method of facial laceration repair that has cosmetic results similar to the use of sutures.
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To establish the frequency of use of pediatric emergency departments by adult patients and the spectrum of disease with which they present. ⋯ Adults frequently present to pediatric EDs for both minor and serious illnesses. Training in adult emergency medicine should be a part of all pediatric emergency medicine fellowship programs.
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Comparative Study
Does nasotracheal intubation increase complications in patients with skull base fractures?
To determine if the complications associated with skull base fractures are increased when nasotracheal intubation is performed in the field. ⋯ Patients with skull base fracture have a significant complication rate (25%). The complications associated with skull base fractures are not markedly increased by attempts at nasotracheal intubation in the field.
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In two separate incidents, two toddlers with no previous history of respiratory ailments presented to the emergency department of a children's hospital with progressive respiratory distress. Both children had unilateral lung findings on auscultation and initial chest radiographs that were consistent with a pneumothorax. ⋯ Nasogastric tube insertion relieved the respiratory distress of these two children. Recognition of the "acquired" congenital diaphragmatic hernia in the setting of extreme aerophagia or mild abdominal trauma may prevent unnecessary procedures during the resuscitation of children with acute respiratory distress and unilateral lung findings.
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To determine the accuracy of diagnosing appendicitis in the pediatric population by using graded compression ultrasonography. ⋯ Use of ultrasound to diagnose acute appendicitis was performed with a sensitivity of 85% and a specificity of 94%. This allows the same accuracy in children as has been reported with adults.