Pediatric emergency care
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Pediatric emergency care · Sep 2007
Randomized Controlled TrialEffectiveness of oxycodone, ibuprofen, or the combination in the initial management of orthopedic injury-related pain in children.
Orthopedic injuries comprise a majority of the indications for analgesia in the emergency department. Oxycodone and ibuprofen have demonstrated efficacy for this indication, but no studies have compared these drugs in children. Our objective was to investigate the effectiveness of oxycodone, ibuprofen, or their combination for the management of orthopedic injury-related pain in children. ⋯ Oxycodone, ibuprofen, and the combination all provide effective analgesia for mild-to-moderate orthopedic injuries in children. Oxycodone or ibuprofen, alone, can be given, thereby avoiding the increase in adverse effects when given together.
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Pediatric emergency care · Aug 2007
Randomized Controlled Trial Comparative StudyRandomized trial of single-dose intramuscular dexamethasone compared with prednisolone for children with acute asthma.
To compare the clinical efficacy of single-dose intramuscular (IM) dexamethasone phosphate to a 5-day course of oral prednisolone for the treatment of moderate asthma exacerbations in young children discharged from the emergency department (ED). ⋯ A single dose of IM dexamethasone showed no clinically meaningful difference in outcomes compared with a 5-day course of oral prednisolone for the treatment of moderate acute asthma exacerbations in young children who are discharged from the ED.
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Pediatric emergency care · Aug 2007
Randomized Controlled Trial Comparative StudyA randomized clinical trial of oral transmucosal fentanyl citrate versus intravenous morphine sulfate for initial control of pain in children with extremity injuries.
Extremity injury is a common condition that requires pain management in an emergency department. In pediatric patients, the most frequently used method of pain control is intravenous (IV) morphine sulfate. Oral transmucosal fentanyl citrate (OTFC) is a potential alternative to morphine, which may obviate the need to place an IV before addressing pain. ⋯ The use of OTFC can provide improved pain control when compared with IV morphine. The pain reduction starts 30 minutes after initiation of medication, and the effect is seen as far as 75 minutes after the initiation of analgesic medication. The study size was too small to make any statements concerning adverse effects; thus, further studies with larger sample sizes are needed to determine the use of OTFC.
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Pediatric emergency care · Jul 2007
Randomized Controlled TrialA randomized trial to assess the efficacy of point-of-care testing in decreasing length of stay in a pediatric emergency department.
To compare the effect of point-of-care (POC) testing versus traditional laboratory methods on length of stay in a pediatric emergency department (ED). ⋯ Point-of-care testing can significantly decrease the length of stay in select pediatric patients in an ED setting. Point-of-care devices may prove to facilitate patient flow during busiest periods of service demand.
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Pediatric emergency care · Jun 2007
Randomized Controlled Trial Comparative StudyComparison of intravenous terbutaline versus normal saline in pediatric patients on continuous high-dose nebulized albuterol for status asthmaticus.
To determine if the addition of intravenous terbutaline provides any clinical benefit to children with acute severe asthma already on continuous high-dose nebulized albuterol. ⋯ No outcome measures demonstrated statistical significance. Outcome measures revealed a trend toward improvement in the terbutaline group. Before recommending routine use of intravenous terbutaline for acute severe asthma, further study to determine safety and efficacy is necessary.