Pediatric emergency care
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Pediatric emergency care · Oct 2008
Randomized Controlled TrialParental factors influence teen alcohol use after an emergency department visit.
To determine if parental factors are significant predictors of short-term adolescent drinking after an alcohol-related emergency department (ED) visit. ⋯ Parental factors may significantly influence subsequent adolescent drinking after an ED visit. These factors should be assessed when treating alcohol-positive teens, and parents should be advised to closely monitor their teens.
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Pediatric emergency care · Oct 2008
Randomized Controlled Trial Comparative StudyA prospective randomized controlled study of two fluid regimens in the initial management of septic shock in the emergency department.
To compare the impact of 40 mL/kg of fluid over 15 minutes followed by dopamine and further titration of therapy to achieve therapeutic goals (study protocol) versus 20 mL/kg over 20 minutes up to a maximum of 60 mL/kg over 1 hour followed by dopamine (control protocol) in septic shock. ⋯ There was no difference in the overall mortality, rapidity of shock resolution, or incidence of complications between the groups. The occurrence of hepatomegaly at 20 minutes following 40 mL/kg is of concern in settings with limited access to post-resuscitation ventilator care.
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Pediatric emergency care · Sep 2008
Randomized Controlled Trial Comparative StudyOxycodone versus codeine for triage pain in children with suspected forearm fracture: a randomized controlled trial.
To compare the efficacy of pain reduction of triage oxycodone (O) versus codeine (C) to children with suspected forearm fractures. ⋯ Triage-administered O tended toward greater pain reduction compared with C in children with suspected forearm fractures. Although minor adverse effects occurred in both groups, itching occurred more in C. Identification of radiography as the most painful part of fracture evaluation underscores the need for early triage administration of analgesia for suspected fractures.
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Pediatric emergency care · Aug 2008
Randomized Controlled TrialJet Injection of 1% buffered lidocaine versus topical ELA-Max for anesthesia before peripheral intravenous catheterization in children: a randomized controlled trial.
Peripheral intravenous (PIV) catheter insertion is a frequent, painful procedure that is often performed with little or no anesthesia. Current approaches that minimize pain for PIV catheter insertion have several limitations: significant delay for onset of anesthesia, inadequate anesthesia, infectious disease exposure risk from needlestick injuries, and patients' needle phobia. ⋯ J-Tip jet injection of 1% buffered lidocaine provided greater anesthesia than a 30-minute application of ELA-Max according to patient self-assessment of pain for children aged 8 to 15 years undergoing PIV catheter insertion.
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Pediatric emergency care · Mar 2008
Randomized Controlled TrialRandomized trial of a case management program for assault-injured youth: impact on service utilization and risk for reinjury.
The purposes of this study were to (1) assess receptiveness of families to violence prevention interventions initiated after an assault injury and (2) assess the effectiveness of a case management program on increasing service utilization and reducing risk factors for reinjury among assault-injured youth presenting to the emergency department. ⋯ Youth and parents were receptive to this violence prevention intervention initiated after an emergency department visit. This pilot case management program, however, did not increase service utilization or significantly reduce risk factors for injury. More intensive violence prevention strategies are needed to address the needs of assault-injured youths and their families.