Pediatric emergency care
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Pediatric emergency care · Jun 2010
Randomized Controlled Trial Comparative StudyKetamine/midazolam versus etomidate/fentanyl: procedural sedation for pediatric orthopedic reductions.
Orthopedic reductions are commonly performed procedures requiring sedation in the pediatric emergency department (PED). Ketamine is a widely used agent for pediatric procedural sedation, but its use may present difficulties in select populations, such as those with psychiatric diagnoses. In such a case, alternative agents that are safe and effective are needed. Etomidate is a commonly used induction agent for rapid-sequence intubation in the PED. Several retrospective and few prospective studies support etomidate's safety and efficacy in pediatric procedural sedation. ⋯ This is a small study that strongly suggests that, for pediatric orthopedic reductions, K/M is more effective at reducing observed distress than E/F, although both provide equal procedural amnesia. With its significantly shorter sedation and recovery times, E/F may be more applicable for procedural sedation for shorter, simpler procedures in the PED.
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Pediatric emergency care · Mar 2010
Randomized Controlled Trial Multicenter StudyRepeat dosing of albuterol via metered-dose inhaler in infants with acute obstructive airway disease: a randomized controlled safety trial.
Airway obstruction and bronchial hyperactivity often times lead to emergency department visits in infants. Inhaled short-acting beta2-agonist bronchodilators have traditionally been dispensed to young children via nebulizers in the emergency department. Delivery of bronchodilators via metered-dose inhalers (MDIs) in conjunction with holding chambers (spacers) has been shown to be effective. ⋯ Cumulative dosing with albuterol HFA 180 microg or 360 microg via MDI-spacer and face mask in children younger than 2 years did not result in any significant safety issues and improved MTASS by at least 48%.
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Pediatric emergency care · Feb 2010
Randomized Controlled TrialToward improving the diagnosis and the treatment of adolescent pelvic inflammatory disease in emergency departments: results of a brief, educational intervention.
To assess the utility of an abbreviated teaching tool (ATT) in improving emergency medicine pediatricians' knowledge of the diagnosis and the treatment of pelvic inflammatory disease (PID). ⋯ Although the overall PID knowledge in our sample was low, the physicians with access to a 1-page teaching tool summarizing the CDC treatment recommendations for PID performed significantly better when asked questions involving PID treatment as compared with providers with access to the CDC Web site. Further studies should investigate whether access to a similar tool can improve patient care.
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Pediatric emergency care · Oct 2009
Randomized Controlled TrialHigh-fidelity medical simulation as a technique to improve pediatric residents' emergency airway management and teamwork: a pilot study.
High-fidelity medical simulation is a technique used for training residents. Simulation is used to teach procedural skills and teamwork. There are limited data on the efficacy of this educational technique. We hypothesize that simulation is effective for teaching pediatric residents airway skills and teamwork. ⋯ This study supports simulation-enhanced educational strategies for improving performance and teamwork skills. This technique is effective in teaching pediatric residents airway skills and teamwork fundamentals required to efficiently manage an acute airway situation.
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Pediatric emergency care · Sep 2009
Randomized Controlled Trial Comparative StudyEffectiveness of fever education in a pediatric emergency department.
This study was designed to assess the impact of a brief educational video shown to parents during an emergency department visit for minor febrile illnesses. We hypothesized that a video about home management of fever would reduce medically unnecessary return emergency department visits for future febrile episodes. ⋯ A brief standardized video about home management of fever improved caregiver knowledge of fever but did not decrease emergency department use or increase medical necessity for subsequent febrile episodes.