Journal of accident & emergency medicine
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Comparative Study
An alternative to "brutacaine": a comparison of low dose intramuscular ketamine with intranasal midazolam in children before suturing.
To compare the use of low dose intramuscular ketamine with high dose intranasal midazolam in children before suturing. ⋯ Intranasal midazolam (0.5 mg/kg) effectively sedated the children in that none could remember the suturing. However a significant number still had to be restrained (86% v 14%). Intramuscular ketamine (2.5 mg/kg) produced dissociative anaesthesia in the majority of cases and was the preferred drug of nurse, doctor, and parent.
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To emphasise the value of computed tomography even in the absence of symptoms in a case of penetrating injury of the upper eyelid. ⋯ Computed tomography of orbit and brain is an important investigation, even in seemingly trivial eyelid injury, to reveal the full extent of the damage.
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To evaluate activities of a nurse led minor injuries unit based in a community hospital situated eight miles away from its sister district hospital in Crawley to demonstrate whether nurses can provide an alternative service. ⋯ With careful planning, adequate supervision, and support from multidisciplinary teams nurses can provide a worthwhile and effective service for a local community.