Current opinion in pediatrics
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Lacerations account for a significant number of emergency department and urgent care clinic visits for pediatric patients. Children represent a unique challenge in repairing lacerations because of their developmental and behavioral characteristics, making rapidity, ease of performance, and minimal pain particularly desirable. ⋯ Topical administration of anesthetics such as tetracaine, adrenaline, and cocaine and lidocaine, epinephrine, and tetracaine offers the advantage of replacing lidocaine infiltration and provides an effective, safe, and painless alternative for local anesthesia. Finally, the introduction of cyanoacrylate tissues adhesives such as Histoacryl Blue (Trihawk International, Montreal, Canada) and Dermabond (Ethicon, Somerville, NJ) appear to be an ideal technique for laceration closure in children because they are easy and rapid to apply, are relatively painless, eliminate the need for suture removal, and provide an acceptable cosmetic result.
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Curr. Opin. Pediatr. · Oct 1997
Case ReportsEmergency Medical Treatment and Active Labor Act: legal concerns about private or managed care patients in the emergency department.
The Emergency Medical Treatment and Active Labor Act (EMTALA) was passed to prevent hospitals from refusing to care for an indigent patient in an emergency situation or transferring the patient before the emergency medical condition was stabilized. The act applies to all patients, whether or not they have insurance or belong to a managed care organization. At times, managed care organizations conflict with emergency departments on the treatment of children who present for care when life-threatening emergencies are not apparent. These conflicts frequently involve EMTALA with regards to medical screening examinations and transfer of patients from the emergency department to other facilities.