Pediatric emergency care
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Pediatric emergency care · Feb 2000
Randomized Controlled Trial Multicenter Study Clinical TrialHistory and radiographic findings associated with clinically suspected radial head subluxations.
To determine: 1) physician practices regarding the use of radiographs for radial head subluxations (RHS), 2) the prevalence of missed fractures in children with a clinical diagnosis of RHS, 3) the relative risk of a fracture with a nonclassic history for mechanism of injury for RHS, and 4) radiographic findings associated with RHS that are difficult to reduce. ⋯ 1) Physicians tend to order radiographs for elbow injuries they initially perceive to be radial head subluxations when attempts at reduction fail. 2) In our study, fractures in children who presented with the classic flexed elbow/pronated wrist position were rare. 3) The relative risk of a fracture in children with a nonclassic history for mechanism of injury was not significant. 4) An isolated finding of a posterior fat pad in a child with RHS that is difficult to reduce was not associated with a fracture in our small sample of children with radiographic findings.
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Pediatric emergency care · Feb 2000
Randomized Controlled Trial Clinical TrialChloral hydrate versus midazolam for sedation of children for neuroimaging: a randomized clinical trial.
The comparative safety and efficacy of chloral hydrate and midazolam for sedation of children has not been adequately studied. ⋯ We conclude that, in these doses, oral chloral hydrate may provide more effective sedation than midazolam for brief neuroimaging studies in young children.
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Pediatric emergency care · Jun 1999
Randomized Controlled Trial Clinical TrialEffect of ketorolac in pediatric sickle cell vaso-occlusive pain crisis.
Ketorolac is a parenteral, nonsteroidal analgesic that does not have a narcotic's risks of respiratory depression, hypotension, or dependence. Its usefulness in providing pain relief in pediatric patients with acute vaso-occlusive crisis of sickle cell disease has not been studied to date. ⋯ We were unable to demonstrate a synergistic analgesic effect for ketorolac in the treatment of pain from acute vaso-occlusive crisis in pediatric sickle cell disease. Further investigations involving larger samples of sickle cell patients may be needed to further define a role for ketorolac in the acute management of sickle cell vaso-occlusive pain.
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Pediatric emergency care · Dec 1998
Review Randomized Controlled Trial Clinical TrialUse of topical lidocaine in pediatric laceration repair: a review of topical anesthetics.
To determine whether application of topical aqueous lidocaine to a laceration attenuates the pain from the subsequent lidocaine injection in children. ⋯ For children, soaking a simple laceration with 1% lidocaine does not decrease pain from the subsequent lidocaine injection.
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Pediatric emergency care · Oct 1998
Randomized Controlled Trial Clinical TrialPrilocaine-phenylephrine topical anesthesia for repair of mucous membrane lacerations.
To compare the effectiveness of prilocaine-phenylephrine (Prilophen), a new topical anesthetic that does not contain cocaine, to that of lidocaine infiltration during repair of lacerations on or near mucous membranes in children. ⋯ Prilophen is a new topical anesthetic alternative to lidocaine infiltration for closure of lacerations on or near mucous membranes, where use of tetracaine-adrenaline-cocaine is contraindicated. The performance of Prilophen was rated by two of the observer groups as statistically inferior to that of lidocaine infiltration; however, the differences in pain scores were small and may not be clinically significant. Further investigation of this new topical anesthetic is warranted.