Pediatric emergency care
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Pediatric emergency care · Jun 2013
Randomized Controlled Trial Comparative StudyComparison of cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations.
We sought to compare cosmetic outcomes, complication rates, and patient/caregiver satisfaction of absorbable versus nonabsorbable sutures in children. ⋯ Caregiver VAS scores showed NI of FAC, which were also preferred by the caregivers. However, NI for FAC could not be demonstrated by blinded physicians with respect to cosmetic outcomes.
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Pediatric emergency care · Jun 2013
Randomized Controlled Trial Comparative StudyUsing video discharge instructions as an adjunct to standard written instructions improved caregivers' understanding of their child's emergency department visit, plan, and follow-up: a randomized controlled trial.
Previous studies demonstrate that patients often have difficulty understanding their discharge instructions. Video discharge instructions have the potential to mitigate factors such as illiteracy and limited physician time, which may affect comprehension. Our goal is to determine if adding video discharge instructions affects caregivers' understanding of their child's emergency department (ED) visit, plan, and follow-up. ⋯ Brief video discharge instructions improved caregiver knowledge both in the ED and 2 to 5 days after discharge compared with written discharge instructions alone. Caregiver satisfaction with video discharge instructions was also greater than with written discharge instructions.
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Pediatric emergency care · May 2013
Randomized Controlled Trial Comparative StudyA randomized controlled trial of cast versus splint for distal radial buckle fracture: an evaluation of satisfaction, convenience, and preference.
Buckle fractures are inherently stable and at low risk for displacement. These advantages allow for treatment options that may create confusion for the practitioner. Accepted immobilization methods include circumferential cast, plaster or prefabricated splint, and soft bandaging. Despite mounting evidence for splinting, the questions of pain, preference, satisfaction, and convenience offer a challenge to changing practice. The purposes of this study were (1) to compare cast versus splint for distal radial buckle fractures in terms of parental and patient satisfaction, convenience, and preference and (2) to compare pain reported for cast versus splint. ⋯ With the exception of pain reported in the emergency department being higher for the splinted group, all other measures, including convenience, satisfaction, and preference, showed a clear trend favoring splints at almost every time period in the study. This study provides additional evidence that splinting is preferable to casting for the treatment of distal radial buckle fractures.
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Pediatric emergency care · May 2013
Randomized Controlled Trial Comparative StudySitting or tilt position for infant lumbar puncture does not increase ultrasound measurements of lumbar subarachnoid space width.
The objective of this study was to determine whether subarachnoid space width at the site of lumbar puncture in infants changed between 3 positions: flat lateral decubitus, 45-degree tilt, and sitting. ⋯ The subarachnoid space width did not significantly change between the 3 positions. An increase in lumbar puncture success rate with sitting or tilt position could be due to other factors such as increased cerebrospinal fluid pressure, increased interspinous space widening, or improved identification of landmarks.
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Pediatric emergency care · May 2013
Randomized Controlled Trial Comparative StudyUsing the pediatric emergency department to deliver tailored safety messages: results of a randomized controlled trial.
This study aimed to evaluate the impact of a computer kiosk intervention on parents' self-reported safety knowledge as well as observed child safety seat, smoke alarm use, and safe poison storage and to compare self-reported versus observed behaviors. ⋯ These results add to the limited literature on the impact of computer tailoring home safety information. Knowledge gains were evident 4 months after intervention. Discrepancies between observed and self-reported behavior are concerning because the quality of a tailored intervention depends on the accuracy of participant self-reporting. Improved measures should be developed to encourage accurate reporting of safety behaviors.