Pediatric emergency care
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Pediatric emergency care · Dec 1992
Comparative StudyIron absorption from chewable vitamins with iron versus iron tablets: implications for toxicity.
The medical literature contains few, if any, reports of severe iron (Fe) poisonings from ingestion of chewable multivitamins with iron. One possible explanation for this observation is that iron from multivitamins is more poorly absorbed than iron from iron tablets. To compare iron absorption from multivitamins with iron absorption from ferrous fumarate tablets, male adult volunteers were given 6 mg of elemental Fe/kg body weight as chewable multivitamins with iron or as crushed ferrous fumarate tablets in a crossover study. ⋯ Statistical analyses demonstrated increased and more rapid absorption of Fe from the multivitamin preparation. These results suggest that iron is well absorbed from chewable multivitamins with iron and should theoretically have the potential for producing serious toxicity when taken in overdose. The reasons that such toxicity is not commonly seen clinically are discussed, and a plan for further investigation of this issue is proposed.
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Pediatric emergency care · Dec 1992
Aeromedical transport services accepting pediatric patients and their abidance by published guidelines.
The number of aeromedical transport services accepting pediatric patients (ATSP) in the United States has increased greatly over the past decade. Most aeromedical transport services are primarily designed for adults but will also transport children. ⋯ This survey of 65 ATSP and their abidance by the major AAP guidelines showed that two thirds of the ATSP were based at facilities with pediatric tertiary care capabilities; most ATSP were not directed by pediatric critical care (PCC) or pediatric emergency care (PEC) specialists; most transport team personnel were not trained in PCC or PEC; most ATSP had specific protocols for different clinical situations; most ATSP had separate equipment appropriate for pediatric patients; and there was little variation in transport team composition based on different clinical situations. In summary, all ATS surveyed transported children, but few were aware of the AAP guidelines, and only one in 65 was in complete abidance with the recommendations.
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The charts of 370 children under the age of two years who presented to a pediatric emergency department between September 1988 and August 1989 were reviewed. Twenty-seven patients (7% of the total) had injuries associated with child safety seat (CSS) misuse. Thirteen were infants and toddlers injured as motor vehicle occupants when improperly restrained--CSS harness not properly connected (8), use of an improper device (3), and CSS not anchored to the car seat (2). ⋯ Nine patients were hospitalized. Injuries associated with CSS misuse may be more common than previously recognized and can result in significant injury. Educational efforts should focus on correct usage.