Arch Pediat Adol Med
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Arch Pediat Adol Med · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialLidocaine for lumbar punctures. A help not a hindrance.
To determine whether premedication for lumbar puncture (LP) with lidocaine hinders collection of cerebrospinal fluid (CSF) through either increased number of attempts or increased incidence of traumatic punctures. ⋯ Premedication with lidocaine for an LP does not binder the ease of obtaining CSF. The clinical relevance of a greater number of traumatic LPs in the lidocaine-treated group is questionable because this finding is negated when traumatic is defined as more than 10,000 x 10(6)/L CSF red blood cells. Based on these results, we advocate premedication with a local anesthetic when an LP is performed in the pediatric emergency department.
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Arch Pediat Adol Med · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialIntramuscular ketamine is superior to meperidine, promethazine, and chlorpromazine for pediatric emergency department sedation.
To compare ketamine hydrochloride (KET) with combined meperidine hydrochloride, promethazine hydrochloride, and chlorpromazine hydrochloride (MPC) for pediatric emergency department sedation with respect to onset, duration, and efficacy. ⋯ Ketamine has a faster onset and results in more rapid discharge from the pediatric emergency department while providing for less patient distress during procedures. Ketamine is also associated with greater physician satisfaction than MPC.
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Arch Pediat Adol Med · May 1996
Randomized Controlled Trial Clinical TrialEducational interventions to alter pediatric emergency department utilization patterns.
To test the hypothesis that educating parents about use of their primary care provider and providing information about common pediatric illnesses will reduce visits to the pediatric emergency department (PED). ⋯ A one-time educational intervention in the PED does not alter long-term emergency department utilization habits. More extensive education and greater availability of primary care providers may be needed to decrease use of the PED for minor illness.
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Arch Pediat Adol Med · May 1996
Randomized Controlled Trial Clinical TrialEfficacy of topical anesthesia in children.
To compare the efficacy of three formulations of a topical anesthetic solution composed of various concentrations of tetracaine hydrochloride, adrenaline (epinephrine), and cocaine hydrochloride (TAC), and to compare the cost of the topical anesthetic solutions with the cost of lidocaine infiltration. ⋯ The application of a TAC solution containing 4% cocaine is as effective as a TAC solution containing 11.8% cocaine. Use of the 4% solution decreases the cost of the agent. Adrenaline is a necessary ingredient in the anesthetic solution.
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Arch Pediat Adol Med · May 1996
Randomized Controlled Trial Clinical TrialAnti-inflammatory therapy reduces wheezing after bronchiolitis.
To evaluate whether early anti-inflammatory therapy with nebulized cromolyn sodium or budesonide reduces wheezing after bronchiolitis. ⋯ Early anti-inflammatory therapy with nebulized cromolyn sodium or budesonide reduces the number of wheezing episodes and hospital admissions after bronchiolitis. Children with atopy are at high risk of subsequent wheezing episodes, and they particularly benefit from anti-inflammatory therapy.