Pediatric emergency care
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Pediatric emergency care · May 2021
Randomized Controlled TrialAnalgesic Efficacy of Intranasal Ketamine Versus Intranasal Fentanyl for Moderate to Severe Pain in Children: A Prospective, Randomized, Double-Blind Study.
This study aimed to compare analgesic efficacy of intranasal (IN) ketamine to IN fentanyl for moderate to severe pain in children in a pediatric emergency department. ⋯ There was insufficient power to support the analgesic noninferiority of IN ketamine at a dose of 1 mg/kg compared with IN fentanyl at a dose of 1.5 μg/kg in children experiencing painful conditions at 20 minutes after administration. Intranasal ketamine was found to be inferior to IN fentanyl in relieving pain at 10 minutes and was found to have significantly greater rates of sedation and dizziness.
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Pediatric emergency care · May 2021
Outcomes of Short Versus Long Leg Casts for Childhood Accidental Spiral Tibial CAST Fractures.
The objective of the current study was to analyze the outcomes of short versus long leg casts in the treatment of childhood accidental spiral tibial (CAST) fractures. ⋯ A short leg walking cast seems to be an effective and safe method of treatment for CAST fractures and could be considered as potentially preferable to long leg casts because of the added benefits of increased mobility and function. Follow-up to this preliminary study is warranted to better elucidate any differences in benefit between these treatment options, and clinical judgment should be used when considering immobilization options.
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Pediatric emergency care · May 2021
Resuscitation With Ringer's Lactate Compared With Normal Saline for Pediatric Diabetic Ketoacidosis.
The aims of this study were to describe the use of Ringer's lactate (LR) or normal saline (NS) for resuscitation among children with diabetic ketoacidosis (DKA) and compare the effect of fluid type on cost, length of stay, and rate of cerebral edema (CE). ⋯ Ringer's lactate was infrequently used for resuscitation of pediatric DKA patients. However, resuscitation with LR compared with NS was associated with lower total cost and rates of CE. Further investigation using patient-level clinical and laboratory data is needed to evaluate factors that drive cost and risk of CE development with each fluid.
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Pediatric emergency care · May 2021
Observational StudyCharacteristics of Emergency Department Presentations of Pediatric Poisoning Between 2011 and 2016: A Retrospective Observational Study in South Korea.
Pediatric poisoning represents a major preventable cause of morbidity. The epidemiology of pediatric poisoning differs by country and region. This study aimed to characterize pediatric poisoning in South Korea over the last 6 years and to discuss current regulations related to the causative agents involved in pediatric poisoning. ⋯ Over 6 years, the annual number of total poisoning cases and of accidental poisoning cases in particular increased despite a lack of change in the types of causative agents related to pediatric poisoning. This phenomenon may reflect failed preventative measures. Thus, the implementation of tailored preventative measures based on epidemiological data should be accelerated.
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Pediatric emergency care · May 2021
Factors Influencing Pediatric Emergency Department Visits for Low-Acuity Conditions.
Emergency department (ED) overcrowding is a growing problem, and pediatric patients are contributing. In this study, we aimed to determine which factors influence parents or guardians to choose the ED over their primary care physician (PCP). ⋯ There appears to be a common misperception that PCPs do not offer extended hours. In addition, the parent or guardian's perception of severity was oftentimes more serious than perceived by medical staff. These results suggest that improving health literacy among our patient population by educating them on PCP availability and capability, ancillary services offered by PCP, and appropriate usage of the ED could potentially reduce nonurgent ED visits.