Pediatric emergency care
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Necrotizing fasciitis (NF) is a rare, rapidly progressive bacterial soft tissue infection with a high risk for morbidity and mortality. Although more common in adults, NF also affects the pediatric population. ⋯ The criterion standard for diagnosis and the mainstay of therapy are surgical debridement. Time to initiation and completion of therapy remains the most important factor in patient outcome, highlighting the importance of early recognition and intervention in this potentially devastating disease.
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Pediatric emergency care · Dec 2011
Multicenter Study Comparative Study Clinical TrialSafety of high-concentration nitrous oxide by nasal mask for pediatric procedural sedation: experience with 7802 cases.
Nitrous oxide is an effective sedative/analgesic for mildly to moderately painful pediatric procedures. This study evaluated the safety of nitrous oxide administered at high concentration (up to 70%) for procedural sedation. ⋯ Nitrous oxide can be safely administered at up to 70% concentration by nasal mask for pediatric procedural sedation, particularly for short (<15 minutes) procedures. Nitrous oxide seems safe for children of all ages.
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Pediatric emergency care · Dec 2011
Review Case ReportsThree faces of costal exostoses: case series and review of literature.
The 3 cases presented here involve 3 unusual and different complications of costal exostoses: spontaneous hemothorax, pneumothorax, and pericardial effusion. All of the cases presented with chest pain to the emergency department. ⋯ All but one of the patients required surgical intervention. Complications of costal exostoses are rare, but hemothorax, pneumothorax, and pericardial effusions can occur.
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Pediatric emergency care · Dec 2011
Randomized Controlled Trial Comparative StudyAn integration of vibration and cold relieves venipuncture pain in a pediatric emergency department.
A randomized controlled trial compared a reusable device combining cold and vibration to standard care for pediatric venous access pain relief. ⋯ The combination of cold and vibration decreased venipuncture pain significantly more than standard care without compromising procedural success. A device incorporating these elements could overcome the common barriers to needle procedure pain control.
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Pediatric emergency care · Dec 2011
Clinical TrialRemember the saphenous: ultrasound evaluation and intravenous site selection of peripheral veins in young children.
The primary objective of this study was to measure the width and depth of peripheral veins using bedside ultrasound in children younger than 3 years. Secondary objectives included the evaluation of other vein and patient characteristics that may affect intravenous (IV) site selection. Assessment of nursing preferences for peripheral IV site selection was performed. ⋯ In children younger than 3 years, the saphenous vein is larger than hand veins and is similar in size to antecubital veins, although marginal differences in depth exist. The sonographic findings of the saphenous vein and antecubital vein suggest that either should be considered a superior first choice for IV cannulation in this age group. Knowledge of these differences is important when choosing a site for peripheral IV placement. Future studies should evaluate peripheral IV success rates by vein type with or without ultrasound guidance.