J Emerg Med
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Blood samples may be collected subsequent to the establishment of a working i.v. line. When collected incorrectly, such blood samples can yield spurious results of serum electrolyte and chemistry determinations. We present such a case and, further, show that serum chemistry values can be altered by contamination with i.v. fluids in the emergency patient and that such alterations can be of sufficient magnitude to affect treatment. Recommendations are given regarding aspiration of blood samples from working i.v. lines to minimize the risk of spurious measurements.
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The objective of this study was to determine the efficacy of the rectal administration of dextrose in raising the serum glucose in a hypoglycemic rat model. A randomized, prospective, controlled experimental study was performed using 18-h fasted, acutely anesthetized Harlan Sprague-Dawley rats made hypoglycemic by the intravenous infusion of insulin at 3 U/kg/h for 2 h. At 1 h into the infusion, study rats received 1, 2, or 3 g/kg of 50% dextrose solution infused into the rectum using a balloon tipped catheter. ⋯ In general, portal venous values were greater than arterial after rectal dextrose. The greatest increase was seen 30 min after dextrose by rectum in animals receiving 3 g/kg. A 50% dextrose administered by rectum in hypoglycemic rats is absorbed in quantities sufficient to raise BG in the arterial and portal circulation.
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Cephalhematomas rarely lead to serious complications such as infection, osteomyelitis and skull fractures. However, we present a newborn infant with hyperkalemia in the context of a serious complication believed to be caused by hemolysis of a large cephalhematoma. The patient was treated with urgent peritoneal dialysis and discharged with a successful outcome. In conclusion, neonates with massive cephalhematoma should be closely examined in terms of bilirubin counts as well as electrolyte counts.
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To survey parents regarding use of child restraint devices (CRD) and knowledge of CRD recommendations, parents of children < or = 14 years of age presenting to an emergency department (ED) provided demographic data and answered questions regarding the family's restraint use and their understanding of CRD recommendations. Three hundred thirteen adults completed surveys, providing data on 541 children. Decreasing restraint use was reported with advancing child age. ⋯ No variables were associated with correct answers. In conclusion, CRD use decreases with increasing child age. In this study, many parents were unaware of CRD recommendations.