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
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
Implementing the 2016 American Academy of Pediatrics Guideline on Brief Resolved Unexplained Events: The Parent's Perspective.
A "brief resolved unexplained event" refers to sudden alterations in an infant's breathing, color, tone, or responsiveness that prompt the parent or caregiver to seek emergency medical care. A recently published clinical practice guideline encourages discharging many of these infants home from the emergency department if they have a benign presentation. The goal is to avoid aggressive inpatient investigations of uncertain benefit. The present research explored parents' reactions to the prospect of returning home with their infant following such an event. ⋯ Successful implementation of the 2016 guideline will require close attention to the parent's point of view. Otherwise, parental resistance is likely to compromise clinicians' best efforts.
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Few prospective studies have assessed the occurrence of radiographic pneumonia in young febrile infants. We analyzed factors associated with radiographic pneumonias in febrile infants 60 days or younger evaluated in pediatric emergency departments. ⋯ Radiographic pneumonias were uncommon, often had viruses detected, and were associated with ill appearance, but few other predictors, in febrile infants 60 days or younger.
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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.