Abstract:
OBJECTIVE:The objectives of this study were: 1) to determine whether obtaining intraosseous (IO) blood samples was practical during cardiopulmonary resuscitation (CPR), and 2) to compare the acid-base status (pH and partial pressure of CO2 (PCO2) of venous and IO blood during CPR. DESIGN:A prospective repeated measure study. SETTING:An animal laboratory at a university medical center. INTERVENTIONS:Nine mixed breed piglets (mean weight 43 kg) were anesthetized, tracheotomized, and placed on a ventilator (Siemens 900C Elema, Sweden). Placement of a pulmonary artery catheter was done via a surgical incision in the neck. An IO cannula was then placed in the tibial marrow cavity. The animals were positioned under a mechanical thumper (Thumper, Michigan Instruments, Grand Rapids, MI) for chest compressions. Blood gases were analyzed during steady state (baseline) after five minutes of ventricular fibrillation and during CPR at seven, nine, 11, 13, 15 and 18 minutes. MAIN RESULTS:Blood samples for acid-base analysis were easily obtained from the IO sites during all sampling times. Mixed venous blood was slightly more acidic than IO blood, especially at 13, 15, and 18 minutes. However, there were no significant differences in pH and Pco2 values between IO and central venous (CV) gases at all time intervals except the PCO2. At nine minutes, a significant difference (P < 0.006) was found in PCO2 (59 +/- 4 vs 47 +/- 5 torr) for the CV versus IO sample, respectively. As the duration of CPR progressed, the differences in PCO2 between IO and CV sites were clinically relevant (though not statistically significant). CONCLUSION:Obtaining blood from the IO site is practical during CPR. The divergence in values as CPR progresses suggests that, during longer periods of CPR, IO blood may reflect local acidosis and yield lower PCO2 and higher pH values that CV blood. This finding may limit the usefulness of IO blood to judge acid base status as CPR progresses.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Kissoon N,Idris A,Wenzel V,Murphy S,Rush Wdoi
10.1097/00006565-199708000-00002subject
Has Abstractpub_date
1997-08-01 00:00:00pages
250-3issue
4eissn
0749-5161issn
1535-1815journal_volume
13pub_type
杂志文章abstract:OBJECTIVES:The aim of this study was to increase education and awareness among pediatric practitioners of possibility of simultaneous hemophagocytic lymphohistiocytosis and Kikuchi-Fujimoto disease/Kikuchi disease occurring in the pediatric population and the diagnostic dilemma it can present. We describe a case presen...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000560
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001262
更新日期:2020-08-01 00:00:00
abstract::Subcutaneous granuloma annulare is an inflammatory lesion occurring in otherwise healthy children. We present 3 pediatric patients with different diagnostic-therapeutic paths depending on the ward they were referred to. The lesions regress spontaneously, and medical or surgical treatments are generally not necessary. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000591
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To assess outcomes between 2 groups of patients receiving ketamine for procedural sedations in our pediatric emergency department. Our hypothesis is that there is no difference in the number of adverse events in ketamine sedations with and without morphine pretreatment. METHODS:This was a retrospective cohor...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000221339.26873.14
更新日期:2006-06-01 00:00:00
abstract::Radial neck fractures in children are not uncommon. Most are minimally displaced or nondisplaced. Severely displaced fractures or angulated radial neck fractures in children often have poor outcomes, especially if not reduced, and even after open reduction. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000235839.44449.36
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To assess whether Web-based teaching is at least as effective as traditional classroom didactic in improving the proficiency of pediatric novice learners in the image acquisition and interpretation of pneumothorax and pleural effusion using point-of-care ultrasound (POCUS). METHODS:We conducted a randomized ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001482
更新日期:2020-07-01 00:00:00
abstract:ABSTRACT:A child with acute abdomen with gross hematuria occasionally visits the emergency department (ED). Usually, such a condition is subject to differential diagnosis for stones, injuries, or sometimes malignancies in the urinary tract. Here we introduce an unusual case of a 9-year-old girl who presented to ED with...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001527
更新日期:2021-01-01 00:00:00
abstract::The Pediatric Assessment Triangle (PAT) has become the cornerstone for the Pediatric Education for Prehospital Professionals course, sponsored by the American Academy of Pediatrics. This concept for emergency assessment of children has been taught to more than 170,000 health care providers worldwide. It has been incor...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181d6db37
更新日期:2010-04-01 00:00:00
abstract::The objective of this study was to examine the appropriateness of utilization of an urban pediatric emergency department (ED) by children who had a pediatrician and factors relating to whether the pediatrician was called before an ED visit. This was done prospectively and randomly in an urban teaching hospital pediatr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199402000-00004
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the patterns of ceftriaxone use in an urban pediatric emergency department (PED) and to determine if overuse exists based on published guidelines for management of febrile infants. METHODS:We conducted a retrospective study of 229 young febrile patients who received ceftriaxone between January 1 ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200208000-00007
更新日期:2002-08-01 00:00:00
abstract::The object of this study was to review and delineate the presenting complaints, signs, symptoms, and Emergency Department (ED) management of pediatric heart transplant recipients who presented to Loma Linda University Medical Center's (LLUMC) Emergency Department. A retrospective chart review was made of all of the pe...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199512000-00006
更新日期:1995-12-01 00:00:00
abstract::The unique characteristics of the pediatric population expose them to errors in the emergency department (ED) with few standard practices for the safety of care. Young children and high-acuity patients are at increased risk of adverse events both in the prehospital and ED settings. We provide an overview of the proble...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000278393.32752.9f
更新日期:2007-06-01 00:00:00
abstract::The following cases describe children who presented to the emergency department (ED) with a constellation of symptoms consistent with delirium. In each case, there was no identified inciting cause (eg, fever, medications) other than the presence of influenza. All children had variable workups, with 2 children undergoi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001175
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:To describe a case series of 4 children who developed acute rhabdomyolysis as a complication of acute respiratory failure secondary to status asthmaticus. METHODS:A retrospective review of all children who were admitted to our pediatric intensive care unit (PICU) with status asthmaticus from November 1998 t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000230711.81646.7a
更新日期:2006-08-01 00:00:00
abstract::Hip pain and fever in children include a broad differential. Most concerning is the possible diagnosis of a septic joint, which carries significant morbidity. We describe the case of a 13-year-old boy with fever and hip pain who was referred to the emergency department with concern for septic hip. The etiology was lat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000328
更新日期:2015-01-01 00:00:00
abstract::Fructose-1,6-diphosphatase (FDPase) enzyme deficiency is a rare inherited metabolic disease. Affected patients usually present with metabolic crisis including hypoglycemia, acidosis, ketonuria, and hyperuricemia. A previously healthy 8-month-old male infant presented with fever, vomiting, and hypoactivity. He had tach...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823b412d
更新日期:2011-12-01 00:00:00
abstract::Hereditary angioedema is a disorder characterized by decreased levels or function of complement C1 esterase inhibitor. Symptoms in children generally consist of recurrent episodes of soft tissue swelling. On rare occasion, it can cause airway edema which may lead to airway obstruction. A case is presented of a child p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000150985.81109.0d
更新日期:2005-01-01 00:00:00
abstract::We present the case of a 9-year-old female who presented after minor blunt abdominal trauma during a sporting event. On focused assessment with sonography for trauma, she was found to have an incidental renal mass, which was ultimately diagnosed as a renal cell carcinoma. In this report, we focus on the use of bedside...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000242
更新日期:2014-10-01 00:00:00
abstract::There are numerous immediate and delayed complications associated with endotracheal intubation. Tracheal rupture is a rare complication whose diagnosis is often delayed. This can result in significant morbidity and mortality. We present a case of therapeutic misadventure resulting in a significant tracheal rupture in ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000279
更新日期:2015-11-01 00:00:00
abstract::We report an unusual case of deep vein thrombosis following minor trauma in an adolescent who presented with a swollen, tender, lower extremity. Work-up consisted of a venogram which demonstrated occlusion of the deep venous system in the proximal leg. The patient was hospitalized for intravenous heparin followed by o...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198906000-00008
更新日期:1989-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to measure the impact of a simple parent health literacy intervention on emergency department and primary care clinic usage patterns. METHODS:Study participants consisted of parents who brought their children to the Harbor-UCLA Medical Center pediatric emergency department for nonur...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181ab78c7
更新日期:2009-07-01 00:00:00
abstract::Pediatric rapid sequence intubation is a skill of great importance to emergency medicine physicians. Developing a systematic strategy for approaching an emergent airway aids in the proper handling of this event. This paper is a review of the current recommendations for pediatric rapid sequence intubation including cur...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000125667.58561.62
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess which knowledge deficits and dietary habits in an urban pediatric emergency department (ED) population are risk factors for obesity. METHODS:This cross-sectional study in an urban pediatric ED used a modified version of the Diet and Health Knowledge Survey, an in-perso...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181f39879
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVES:National guidelines for routine pediatric acute asthma care recommend providing corticosteroids, and discourage routinely obtaining chest radiographs (CXRs) and using antibiotics. We examined rates of adherence to all 3 of these aspects during emergency department (ED) visits and compared performance between...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001706
更新日期:2019-01-07 00:00:00
abstract::These cases demonstrate a few of the presentations that may occur with new onset oncologic problems. While the transport phase of these children's care was not extraordinary, the development and management of the clinical issues might have been influenced by earlier interventions. Would the outcome of Case 1 have been...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199612000-00019
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVES:Vascular injury in pediatric trauma patients is uncommon but associated with a reported mortality greater than 19% in some series. The purpose of this study was to characterize pediatric major vascular injuries (MVIs) and analyze mortality at a high-volume combined adult and pediatric trauma center. METHODS...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001642
更新日期:2018-10-17 00:00:00
abstract:BACKGROUND:Few studies have addressed the presentation and clinical impact of pediatric pelvic fractures. We sought to describe pediatric blunt trauma patients with pelvic fracture (PF) and to evaluate the sensitivity and specificity of physical examination at presentation for diagnosis. METHODS:Retrospective analysis...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200102000-00004
更新日期:2001-02-01 00:00:00
abstract::We report an extremely rare case of homicidal lithium battery ingestion in a neonate hitherto unreported in the medical literature. Although a definitive diagnosis was initially missed in the baby, the patient survived with no complications whatsoever even after retention of the said foreign body for 10 days. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31825d23df
更新日期:2012-07-01 00:00:00
abstract::This study was designed to determine the general characteristics, training expectations, and career goals of those individuals entering Pediatric Emergency Medicine Fellowships in 1992 through the NRMP Pediatric Emergency Medicine Match. A 20-item questionnaire was developed and sent to those individuals who successfu...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199212000-00006
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVE:This review examines the screening instruments that are in existence today to identify commercially sexually exploited children. The instruments are compared and evaluated for their feasibility of use in an emergency department setting. METHODS:Four electronic databases were searched to identify screening in...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001020
更新日期:2017-12-01 00:00:00