Pediatric emergency care
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Pediatric emergency care · Feb 2013
Randomized Controlled TrialKetamine and atropine for pediatric sedation: a prospective double-blind randomized controlled trial.
Sedation in children can be a challenge for emergency physicians, which demands for selecting an effective medication with few complications and good analgesic effects. This study has been performed to evaluate the adverse effects of ketamine while using either atropine or placebo in emergency departments. ⋯ Atropine added to ketamine significantly reduces hypersalivation without producing any adverse effects on the procedure duration or success rate.
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Pediatric emergency care · Jan 2013
Randomized Controlled TrialCryotherapeutic topical analgesics for pediatric intravenous catheter placement: ice versus vapocoolant spray.
Intravenous catheter placement is one of the most common sources of pain for children in inpatient settings. We sought to compare the efficacy of 2 cryotherapeutic treatments for this procedure: vapocoolant spray versus topical ice pack. ⋯ Vapocoolant spray may be more effective than ice as an analgesic for IV insertion. Subjects were more satisfied with vapocoolant spray. Neither agent caused a decrease in successful IV insertion rates.
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Pediatric emergency care · Jan 2013
Randomized Controlled TrialEfficacy of intravenous lidocaine to reduce pain and distress associated with propofol infusion in pediatric patients during procedural sedation.
Research suggests that young children experience an increased incidence and severity of discomfort during propofol infusion. Evaluations of varied interventions to reduce or eliminate this discomfort with adult subjects suggest that premedication with intravenously administered lidocaine (0.5 mg/kg) offers the best overall effectiveness. ⋯ Our data do not support using lidocaine pretreatment to alleviate pain/discomfort in pediatric patients during propofol infusion.
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Pediatric emergency care · Dec 2012
Randomized Controlled Trial Comparative StudyA randomized controlled trial to engage in care of adolescent emergency department patients with mental health problems that increase suicide risk.
In pediatric emergency departments (EDs), adolescents at risk for suicide often escape detection and successful referral for outpatient mental health care. ⋯ When adolescents are identified in the ED with previously unrecognized mental health problems that increase suicide risk, a brief motivational and barrier-reducing intervention improves linkage to outpatient mental health services.
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Pediatric emergency care · Dec 2012
Randomized Controlled Trial Comparative StudyA randomized comparison of nitrous oxide versus intravenous ketamine for laceration repair in children.
Ketamine is used intramuscularly or intravenously as a sedative when repairing the skin lacerations of children in many emergency departments (EDs). Nitrous oxide (N(2)O) has the advantages of being a sedative agent that does not require a painful injection and that offers shallower levels of sedation and a rapid recovery of mental state. We evaluated the clinical usefulness of N(2)O compared with intravenous ketamine when used for the repair of lacerations in children in the ED. ⋯ Nitrous oxide inhalation was preferable to injectable ketamine for pediatric patients because it is safe, allows for a faster recovery, maintains sufficient sedation time, and does not induce unnecessarily deep sedation.