Pediatric emergency care
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Pediatric emergency care · Jun 2021
Randomized Controlled TrialSedoanalgesia Versus Infraclavicular Block for Closed Reduction of Pediatric Forearm Fracture in Emergency Department: Prospective Randomized Study.
Procedural sedoanalgesia is commonly used in pediatric patients in the emergency department (ED) for interventional procedures, diagnosis, and treatment. However, this method causes serious systemic complications, such as respiratory and cardiac depression. To minimize these complications, ultrasound-guided regional anesthesia methods have been used in recent years. We aimed to compare the use of procedural sedoanalgesia (PSA) and infraclavicular block (ICB) in the pain management of pediatric patients who underwent closed reductions of forearm fractures. ⋯ Ultrasound-guided ICB is a safe and effective method in the management of pain during closed reduction of forearm fracture in pediatric patients in EDs. It can be used safely in emergency rooms and has a high level of both parental and operator satisfaction.
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Pediatric emergency care · Jun 2021
Randomized Controlled TrialA Randomized Single-Blinded Simulation-Based Trial of a Novel Method for Fluid Administration to a Septic Infant.
For children presenting in shock, American College of Critical Care Medicine guidelines recommend 3 boluses of intravenous fluids during initial resuscitation, but these are often not met. This study aims to compare a novel device LifeFlow, to established manual methods for rapid fluid delivery in a simulated environment. ⋯ LifeFlow allowed for faster fluid administration rate and thus could be the preferred technique for rapid fluid resuscitation in pediatrics patients. Further investigations should explore the reproducibility of these results using this device in real patients in multiple centers.
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Pediatric emergency care · May 2021
Randomized Controlled TrialAnalgesic Efficacy of Intranasal Ketamine Versus Intranasal Fentanyl for Moderate to Severe Pain in Children: A Prospective, Randomized, Double-Blind Study.
This study aimed to compare analgesic efficacy of intranasal (IN) ketamine to IN fentanyl for moderate to severe pain in children in a pediatric emergency department. ⋯ There was insufficient power to support the analgesic noninferiority of IN ketamine at a dose of 1 mg/kg compared with IN fentanyl at a dose of 1.5 μg/kg in children experiencing painful conditions at 20 minutes after administration. Intranasal ketamine was found to be inferior to IN fentanyl in relieving pain at 10 minutes and was found to have significantly greater rates of sedation and dizziness.
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Pediatric emergency care · Mar 2021
Randomized Controlled Trial Multicenter StudyChange in Cardiopulmonary Resuscitation Performance Over Time During Simulated Pediatric Cardiac Arrest and the Effect of Just-in-Time Training and Feedback.
Effective cardiopulmonary resuscitation (CPR) is critical to ensure optimal outcomes from cardiac arrest, yet trained health care providers consistently struggle to provide guideline-compliant CPR. Rescuer fatigue can impact chest compression (CC) quality during a cardiac arrest event, although it is unknown if visual feedback or just-in-time training influences change of CC quality over time. In this study, we attempt to describe the changes in CC quality over a 12-minute simulated resuscitation and examine the influence of just-in-time training and visual feedback on CC quality over time. ⋯ There was no significant drop in CC depth over a 12-minute cardiac arrest scenario with 2 team members providing compressions.
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Pediatric emergency care · Mar 2021
Randomized Controlled TrialEfficacy of Veinlite PEDI in Pediatric Peripheral Intravenous Access: A Randomized Controlled Trial.
A total of 112 pediatric patients were enrolled in the study. Children who presented to the emergency department aged 1 to 10 years old were randomly assigned to the Veinlite PEDI (Veinlite) group or standard of care (SoC) group. The primary outcome measure was first attempt success. Secondary outcome measures were number of intravenous (IV) attempts and time to peripheral intravenous catheter (PIC) placement. ⋯ The use of new technology in the Veinlite PEDI (TransLite, Sugar Land, Tex), to assist with peripheral IV access in children, improves the first time success rate for IV access. Improved visualization of veins also reduced the number of attempts and the time required for PIC placement. These results suggest that the new technology of the Veinlite results in better PIC access than Veinlite transilluminaton device with white light.