Articles: pediatrics.
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Randomized Controlled Trial Comparative Study Clinical Trial
Gastric residual volumes in critically ill paediatric patients: a comparison of feeding regimens.
This study examined the effect of gastric feeding regimens, either continuous or intermittent, on fourth hourly gastric residual volumes (GRV) in a group of critically ill paediatric patients where delayed gastric emptying is defined as a GRV greater than 5ml/kg. A randomised controlled trial was conducted in a tertiary paediatric intensive care unit (PICU), with 45 participants being randomly assigned to either the continuous (n=22) or intermittent (n=23) gastric feeding groups. Participants remained in the assigned group for the duration of the study and, fourth hourly, GRV were assessed to monitor the incidence of delayed gastric emptying. ⋯ The provision of enteral nutrition via the gastric route is a common treatment in the PICU, and GRV are frequently used as a measure of gastric tolerance. The result of this analysis provides some support for the theoretical definition of delayed gastric emptying being >5ml/kg. However, further work is required to confirm this finding and to determine its relevance when providing enteral nutrition to the critically ill paediatric patient.
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Randomized Controlled Trial Clinical Trial
Does the lateral chest radiograph help pediatric emergency physicians diagnose pneumonia? A randomized clinical trial.
To determine whether the addition of the lateral chest radiograph to the frontal view influences the pediatric emergency physician's diagnosis and management of patients with pneumonia. ⋯ The addition of the lateral chest radiograph to the frontal view did not improve the sensitivity or specificity of pediatric emergency physicians in their diagnosis of pneumonia in children.
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Randomized Controlled Trial Clinical Trial
Office preparedness for pediatric emergencies: a randomized, controlled trial of an office-based training program.
Many children enter the emergency medical system through primary care offices, yet these offices may not be adequately prepared to stabilize severely ill children. We conducted this study to evaluate the effectiveness of an office-based educational program designed to improve the preparation of primary care practices for pediatric emergencies. ⋯ The findings suggest that the intervention was well received and motivated practices to take concrete actions to prepare for pediatric emergencies.
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Arch Pediat Adol Med · Jul 2003
Randomized Controlled Trial Clinical TrialDoes telephone triage delay significant medical treatment?: Advice nurse service vs on-call pediatricians.
Advice nurse call centers are used to ensure access to medical advice, thereby potentially reducing the costs of health services. ⋯ The proportions of callers who sought unadvised medical care and who received unadvised significant care were not significantly different in the advice nurse and pediatrician groups. This suggests that advice nurses do not delay significant medical treatment when compared with pediatricians.
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Arch Pediat Adol Med · Mar 2003
Randomized Controlled Trial Clinical TrialEffect of an intervention standardization system on pediatric dosing and equipment size determination: a crossover trial involving simulated resuscitation events.
Pediatric medication dosing has been recognized as a high-error activity with the potential to cause serious harm. Few studies assess systems approaches to error reduction in pediatrics. ⋯ Color coding was associated with a significant reduction in deviation from recommended doses in simulated pediatric emergencies. Numerous potentially clinically significant deviations from recommended doses and equipment sizes were avoided. Future studies should measure impact in the real clinical setting.