Pediatric emergency care
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Pediatric emergency care · Aug 2020
Intranasal Ketamine for Treatment of Acute Pain in Pediatrics: A Systematic Review.
Intranasal ketamine has not been well studied in acute pain treatment and does not have a recognized place in therapy in current practice guidelines for pediatric patients. Ketamine has a unique mechanism of action with a favorable side effect profile that may provide benefit to the pediatric population for acute pain. The purpose of this review is to summarize the evidence evaluating intranasal ketamine versus any other comparator for children who require acute pain treatment. ⋯ Intranasal ketamine was safe and effective in the 6 clinical studies included in this systematic review.
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To study the experience reported by pediatric patients when visiting a pediatric emergency department (PED). ⋯ The patient experience of children in our PED was positive, although some aspects should be improved such as offering entertainment in the waiting area, increasing privacy during the medical visit, and giving better explanations to the children.
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Pediatric emergency care · Aug 2020
New Oxidative Stress Markers Useful in the Diagnosis of Acute Appendicitis in Children: Thiol/Disulfide Homeostasis and the Asymmetric Dimethylarginine Level.
The aim of this study was to evaluate 2 new oxidative stress markers, thiol/disulfide homeostasis status and the asymmetric dimethylarginine (ADMA) level, in children with acute appendicitis (AA) and to evaluate their diagnostic utility. ⋯ Thiol/disulfide homeostasis and the ADMA level, together with certain other parameters, may be useful biomarkers of AA in children.
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Pediatric emergency care · Aug 2020
Use of Ondansetron for Vomiting After Head Trauma: Does It Mask Clinically Significant Traumatic Brain Injury?
We describe ondansetron use in children with head injury evaluated in pediatric emergency departments and its association with return visits and late diagnoses of intracranial injuries requiring intervention. ⋯ Ondansetron use during an initial emergency department visit for head trauma in children not requiring neuroimaging is associated with a higher likelihood of return within 72 hours and subsequent admission. There were no differences in rates of missed skull fractures, intracranial injury, intensive care admission, or operative intervention for groups who were and were not treated with ondansetron; however, this study was underpowered to detect significant differences in these categories. Future investigations with greater numbers would be required to confidently assess these critical differences.