Pediatric emergency care
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Pediatric emergency care · Feb 2012
Randomized Controlled Trial Comparative StudyA comparison of amethocaine and liposomal lidocaine cream as a pain reliever before venipuncture in children: a randomized control trial.
Although the use of anesthetic creams before intravenous (IV) insertion has been shown to be both safe and effective in decreasing pain during IV cannulation, the use of any single agent based on efficacy is not yet considered the standard of care in children. We sought to compare a commonly used preparation, 4% liposomal lidocaine (Maxilene), with 4% amethocaine (Ametop), a newer agent with reportedly good efficacy and an intrinsic vasodilatory effect. ⋯ This study demonstrates that there is no difference between 4% amethocaine and 4% liposomal lidocaine in reducing pain associated with IV cannulation in children. Amethocaine confers no advantage in improving IV cannulation success rate over lidocaine. Both agents are associated with few local adverse skin reactions.
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Pediatric emergency care · Feb 2012
Randomized Controlled Trial Comparative StudyA randomized trial of enema versus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department.
This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment. ⋯ This pilot study suggests that disimpaction by enema may be superior to PEG for immediate relief of symptoms. Larger trials are needed to assess any advantage.
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Pediatric emergency care · Dec 2011
Randomized Controlled Trial Comparative StudyAn integration of vibration and cold relieves venipuncture pain in a pediatric emergency department.
A randomized controlled trial compared a reusable device combining cold and vibration to standard care for pediatric venous access pain relief. ⋯ The combination of cold and vibration decreased venipuncture pain significantly more than standard care without compromising procedural success. A device incorporating these elements could overcome the common barriers to needle procedure pain control.
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Pediatric emergency care · Aug 2011
Randomized Controlled Trial Comparative StudyEffect of a triage team on length of stay in a pediatric emergency department.
This study aimed to determine the impact of a triage team on patient length of stay (LOS) overall and by patient acuity in a pediatric emergency department (ED). ⋯ Overall, although we did not find a statistically significant decrease in the LOS with the use of a dedicated triage team, we did find statistically significant decreases in the stratified analysis for urgent, nonurgent patient, and discharged patients. An important reason statistical significance may not have been reached in this study may have been our hospital's current staffing model, and therefore, the use of a triage team as additional staffing versus reallocation of existing staffing may depend on an institution's current level of staffing and its ability to meet patient demand.
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Pediatric emergency care · Jul 2011
Review Randomized Controlled TrialUniversally poor outcomes of pediatric traumatic arrest: a prospective case series and review of the literature.
Few data are available on traumatic cardiopulmonary arrest in children. Efforts at resuscitation typically result in heavy utilization of finite resources with little understanding of which characteristics, if any, may be associated with success. The objectives of this study were to describe the outcome of children in traumatic cardiac arrest and to identify patients for whom aggressive resuscitation may or may not be warranted. ⋯ Children who had trauma resulting in cardiac arrest have universally poor outcomes, and survivors have severe neurological compromise. We are unable to identify a subset of patients for whom aggressive resuscitation is indicated. This is the largest prospective study of pediatric traumatic arrest to date.