Annals of emergency medicine
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To identify the frequency of violence and the perception of safety in pediatric emergency departments. ⋯ Pediatric EDs are not immune to the problem of violence. Efforts must be directed to increase safety through better security, more efficient patient care, and aggression management training.
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Comparative Study
Evaluation of SaO2 as a predictor of outcome in 280 children presenting with acute asthma.
To evaluate the initial measurement of arterial oxygen saturation (SaO2) as a predictor of outcome in acute childhood asthma compared with other factors of past and present asthma history. ⋯ We have shown that in acute childhood asthma, the initial level of SaO2 reflects severity as it predicts the likelihood of poor outcome. This predictive quality of SaO2 is independent of current or past clinical factors.
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To determine whether omitting neuroimaging in the primary assessment of patients with minor head injuries in the emergency department is safe. ⋯ We found it safe to exclude neuroimaging in the primary assessment of patients with minor head injuries in the ED, and to rely instead on clinical criteria.
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Randomized Controlled Trial Comparative Study Clinical Trial
Validation of diphenhydramine as a dermal local anesthetic.
Although diphenhydramine has been recommended as an alternate local anesthetic for patients claiming allergy to lidocaine, no prior placebo-controlled evaluations of diphenhydramine for dermal anesthesia have been performed. We sought to determine the relative efficacy of diphenhydramine compared to saline placebo and lidocaine. ⋯ In this study of 24 adult volunteers, diphenhydramine 1% was as effective as lidocaine 1% for achieving dermal local anesthesia, although injection was more painful. Although no clinically important complications were noted in our study, the safety of diphenhydramine remains to be established, especially in areas with poor collateral perfusion (eg, digits, pinna, and nose).
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To delineate the diagnoses of children who required emergency intubation, to ascertain which medications were used, and to describe the complications of intubation and their association with the choice of medications. DESIGN, SETTING, AND TYPE OF PARTICIPANTS: Three-year retrospective study of 60 intubations of critically ill pediatric patients by pediatric emergency physicians in the emergency department setting. ⋯ Rapid-sequence protocols with paralysis facilitate intubations in the complex pediatric patient in the ED setting.