Objective A randomized controlled trial compared a reusable device combining cold and vibration to standard care for pediatric venous access pain relief. Methods Pediatric emergency department patients received either the placed 5 10 cm proximally throughout venipuncture or control (primarily vapocoolant spray). Block randomization of with without lidocaine cream already in place ensured equal allocation both intervention groups. Pain was measured via self- parent-report using 0- 10-point...

The lack of a widely used, validated measure limits pediatric nausea management. goal this study was to create and validate pictorial scale with regular incremental levels between scores depicting increasing intensity.A 0 10 6 faces (the Baxter Retching Faces [BARF] scale) developed in 3 stages. BARF emergency department patients vomiting healthy undergoing day surgery procedures. Patients were presented visual analog scales for pain, the Pain Scale-Revised, scale. receiving opioid...

To assess the effects of procedural techniques, local anesthetic use, and postgraduate training level on lumbar puncture (LP) success rates.In this prospective observational study, medical students residents ("trainees") reported techniques used for infant LPs in an urban teaching emergency department. Data year, patient position, draping, total trainee numbers attempts, timing stylet removal were collected. Logistic regression analysis was to identify predictors successful LP, with defined...

Summary Background: Pentobarbital and propofol are commonly used to sedate children undergoing magnetic resonance imaging (MRI). The Pediatric Sedation Research Consortium (PSRC) was created in 2003 improve pediatric sedation process outcomes. Objective: To use PSRC records compare the effectiveness, efficiency adverse events of vs pentobarbital for MRI. Methods: aged 6 months years who were primarily sedated with either i.v. or included. Participating investigators obtained institutional...

Objective To determine whether initiating saline nasal irrigation after COVID-19 diagnosis reduces hospitalization and death in high-risk outpatients compared with observational controls, if irrigant composition impacts severity. Methods Participants 55 older were enrolled within 24 hours of a + PCR test between September December 21, 2020. Among 826 screened, 79 participants randomly assigned to add 2.5 mL povidone-iodine 10% or sodium bicarbonate 240 isotonic twice daily for 14 days. The...

Infrared thermal detection systems (ITDSs) have been used with limited success outside the United States to screen for fever during recent outbreaks of novel infectious diseases. Although ITDSs are fairly accurate in detecting adults, there is little information about their utility children.In a pediatric emergency department, we compared temperatures children (<18 years old) measured using 3 (OptoTherm Thermoscreen, FLIR ThermoVision 360, and Thermofocus 0800H3) standard, age-appropriate...

Objective: To compare efficacy, sedation duration, and adverse events after administration of etomidate or pentobarbital for diagnostic computed tomography (CT) scans. Methods: A cohort children sedated CT scans between July 2004 October 2005 was identified from a prospectively generated Pediatric Sedation Research Consortium database. The 24 institutions record consecutive data on Web-based tool. This study included all patients American Society Anesthesiologists (ASA) class I II, 6 months...

Objectives Mechanoreceptor and noxious thermal inhibitory stimulation modulate pain conduction but have not been clinically tested in combination. Our objectives were to determine whether a vibrating cold device decreased adult venipuncture on 10 cm visual analog scale more than no intervention, compared with vapocoolant analgesia versus intervention. Methods The design was prospective randomized crossover clinical trial. Thirty healthy volunteers the study or One nurse attempted cannulation...

Lumbar punctures (LPs) are common emergency department (ED) procedures. Few pediatric studies exist to define training, guide practice, or indicate preferred methods for infants. While pain control is recommended, no recent prevalence of analgesic use since the advent topical anesthetics. We surveyed academic ED physicians assess training and technique preferences highlight usage.A total 398 were randomly selected from 621 e-mail accessible members AAP Section on Pediatric Emergency...

The purpose of this study was to determine whether placing Eutectic Mixture Local Anesthetics (EMLA) at emergency department (ED) triage improves venipuncture success. Emergency nurses prospectively identified patients aged 0-18 years assessed have 50% or greater chance needing while in the department. Identified received EMLA no intervention according randomized 24-h blocks. Data were collected on need for venipuncture, success (defined as obtaining access one attempt), and duration...

Abstract Purpose: To determine core body temperature variations in children undergoing MRI exams on 1.5 Tesla (T) and 3T magnetic field strengths with without propofol sedation. Materials Methods: Temporal artery temperatures were prospectively collected 400 consecutive patients or 3.0T scans. A cumulative logistic regression model was created using age, weight, protocol, sedation status, pre‐MRI strength to assess risk of change. Results: For complete pre‐ post‐MRI data, mean did not...

Abstract Importance SARS-CoV-2 enters the nasopharynx to replicate; nasal irrigation soon after diagnosis could reduce viral load and inhibit furin cleavage necessary for cell entry, thereby reducing morbidity mortality. Objective To determine whether initiating COVID-19 reduces hospitalizations death in high-risk outpatients, irrigant composition impacts severity. Design Unblinded randomized clinical trial of two protocols older outpatients PCR positive SARS-CoV-2, with an observational arm...

Scald burns to the feet and lower extremities in children are described literature as often resulting from forced immersions. This report illustrates 3 cases of whose distribution historical factors identify them accidental. The location these accidental is similar those found inflicted injury, but patterns were indicative flowing water burns, not Burns locations may be confused with abuse. Medical providers need aware information that enable distinguish 2 causes. Effective caregiver...

Background Little is known regarding the effect of different emergency department (ED) practice models on computed tomography (CT) and ultrasound (US) utilization for suspected appendicitis in ED through potential inpatient hospital stay. Objectives Examination rates CT US at 2 pediatric EDs (PEDs) admission: an academic affiliated tertiary PED (site A) compared with a private care B). Methods All visits ICD-9 (International Classification Diseases, Ninth Revision) chief complaint abdominal...

Effective non-opioid pain management is of great clinical importance. The objective this pilot study was to evaluate the effectiveness multimodal mechanical stimulation therapy on low back pain.11 female and 9 male patients aged 22-74 years (Mean 41.9 years, SD 11.04) receiving physical rehabilitation for acute (12) or chronic (8) chose heat (9) ice (11) accompany a 20-minute session (M-Stim) (Registered with Clinicaltrials.gov NCT04494841.) M-Stim delivered in 12 possible repeating "therapy...