Pediatrics
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of topical anesthetics without cocaine to tetracaine-adrenaline-cocaine and lidocaine infiltration during repair of lacerations: bupivacaine-norepinephrine is an effective new topical anesthetic agent.
To compare the effectiveness of four topical anesthetics that do not contain cocaine with that of topical tetracaine-addrenaline-cocaine (TAC) and lidocaine infiltration during laceration repair in children. ⋯ Bupivanor is an effective alternative to TAC and lidocaine infiltration for local anesthesia during laceration repair, expecially on the face and scalp. The effectiveness of Bupivanor on the face is important, because it is here where TAC is most likely inadvertently to come into contact with mucous membranes and result in systemic toxicity. Because pain and distress scores did not take into consideration the pain associated with the initial injection of lidocaine, the findings of this study conservatively estimate Bupivanor's effectiveness, compared with lidocaine infiltration.
-
Multicenter Study Comparative Study
Comprehensive school-based health care: high school students' use of medical, mental health, and substance abuse services.
To explore adolescent students' use of school based health and medical care and mental health and substance abuse counseling services and to compare adolescents' patterns of use of medical, mental health, and substance abuse services located in school-based and traditional settings. ⋯ Adolescents attending SBHCs had higher rates of visits for health and medical care than adolescents using traditional sources of medical care. The proportions of student users of SBHC mental health and substance abuse counseling services were commensurate with the estimated prevalences of these problems in this country's adolescent population. In addition, the mean numbers of visits to mental health counselors in SBHCs compared favorably with adolescent visit rates for mental health services in other settings. Too little information is available about adolescent use of substance abuse services in non-school-based settings to make similar comparisons. In summary, adolescent users of SBHCs seemed to have a higher use of medical, mental health, and probably substance abuse counseling services than did adolescents in the general populations. These findings are consistent with the interpretation that SBHCs do enhance adolescents' access to care for medical, mental health, and substance abuse problems.