Pediatric emergency care
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Pediatric emergency care · Mar 2023
Review Case ReportsFactors Associated With Low Procedural Pain Scores Among 1- to 5-Year-Old Patients Undergoing Facial Laceration Repair.
Our objectives were to quantify pain experienced by young children undergoing facial laceration repair and identify factors associated with low procedural pain scores. ⋯ The majority of 3- to 5-year-old patients were able to undergo facial laceration repair without restraint, sedation, or anxiolytics and with low mean distress scores. Our findings suggest that children's risk of experiencing moderate and severe distress during facial and scalp laceration repair may be reduced by prioritizing wound closure by expert-level clinicians, ensuring effective lidocaine-epinephrine-tetracaine application, avoiding restraint, and concealing needles from patient view.
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Pediatric emergency care · Mar 2023
A Qualitative Systematic Review of Pediatric Patient and Caregiver Perspectives on Pain Management for Vaso-Occlusive Episodes in the Emergency Department.
The primary objective of this study is to describe the experiences of pediatric patients with sickle cell disease (SCD) and their caregivers who have presented to the emergency department (ED) for management of vaso-occlusive pain events. ⋯ There are multiple opportunities to improve management for vaso-occlusive pain events in the ED, including education of health care providers about SCD and complications, partnership between patients/caregivers and providers, and efforts to reduce the impact of systemic racism on health care delivery.
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Pediatric emergency care · Jan 2023
ReviewLipid Emulsion Treatment for Drug Toxicity Caused by Nonlocal Anesthetic Drug in Pediatric Patients: A Narrative Review.
Lipid emulsion (LE) has been used to treat children with cardiovascular collapse induced by toxic doses of nonlocal anesthetics with high lipid solubility. We aimed to analyze case reports on LE administration for resuscitation of toxicity induced by these drugs in pediatric patients. ⋯ Lipid emulsion treatment may be effective in ameliorating intractable cardiovascular depression when systemic toxicity caused by drugs, including cardiac sodium channel blockers, is unresponsive to supportive treatments.
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Pediatric emergency care · Dec 2022
ReviewAdolescent Confidentiality and Consent in an Emergency Setting.
The adolescent population comprises a large volume of emergency department visits each year. A recent study showed that 20% of the ambulatory care visits of adolescent patients aged 15 to 25 years were made to the emergency department. This specific population often has poor access to health care and often is a vulnerable population, causing medical care to be a challenge. The purpose of this article was to review the standard practice and the specific laws regarding confidentiality and consent when treating an adolescent patient to provide the best possible care and treatment. ⋯ Patient confidentiality and informed consent are complex and complicated topics when dealing with the pediatric patient. Although some laws may vary state to state, there are specific details regarding adolescent confidentiality and informed consent that every provider should be aware of. The adolescent population is more likely to seek emergency care if the visit is confidential and the patient feels a sense of trust. Although it is important for providers to respect patient confidentiality when treating adolescents, it is also important for providers to encourage adolescents to confide in their parents regarding health issues.
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Pediatric emergency care · Nov 2022
ReviewDirect Oral Anticoagulant Reversal in the Pediatric Emergency Department.
Direct oral anticoagulants have been used in the adult population for years and are being used more frequently in pediatrics. Direct oral anticoagulants are chosen preferentially because they do not require close outpatient monitoring, have an equal or better safety profile, and are easy for patients to take. ⋯ Given their differing mechanisms, they require alternate medications for proper reversal when concerned about overdose of life-threatening bleeds. This review will outline the most commonly used direct oral anticoagulants in pediatric populations and the supporting (mainly adult) data available for proper reversal of these medications in times of need.