Abstract:
OBJECTIVES:We hypothesized that the use of ultrasound guidance would improve the success rate of peripheral intravenous catheter placement in pediatric patients with difficult access in a pediatric emergency department (ED). Our secondary hypotheses were that ultrasound guidance would reduce the number of attempts, the number of needle redirections, and the overall time to catheter placement. METHODS:This was a prospective randomized study of pediatric ED patients younger than 10 years old requiring intravenous access, presenting between August 2006 and May 2007. Inclusion criteria were 2 unsuccessful traditional attempts at peripheral intravenous access or history of difficult access. Exclusion was critical illness or instability. Patients were randomized to undergo peripheral intravenous catheter placement using continued traditional approaches or real-time, dual-operator ultrasound-guided technique. Measured outcomes were success of cannulation, number of attempts, number of needle redirections, and overall time to catheter placement. RESULTS:Fifty patients were enrolled, with 25 patients randomized to each group. The overall success rates for the ultrasound-guided group were 80% and for the traditional-attempts group, 64%, with a difference in proportions of 16% (95% confidence interval, -9% to 38%, P = 0.208). The ultrasound-guided group required less overall time (6.3 vs 14.4 minutes, difference of -8.1 minutes [95% confidence interval, -12.5 to -3.6], P = 0.001), fewer attempts (median, 1 vs 3; P = 0.004), and fewer needle redirections (median, 2 vs 10; P G 0.0001) than traditional approaches. CONCLUSIONS:In a sample of pediatric ED patients with difficult access, ultrasound-guided intravenous cannulation required less overall time, fewer attempts, and fewer needle redirections than traditional approaches.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Doniger SJ,Ishimine P,Fox JC,Kanegaye JTdoi
10.1097/PEC.0b013e31819a8946subject
Has Abstractpub_date
2009-03-01 00:00:00pages
154-9issue
3eissn
0749-5161issn
1535-1815journal_volume
25pub_type
杂志文章,随机对照试验abstract::Anaphylaxis is a life-threatening, severe, generalized, or systemic hypersensitivity reaction. The incidence of anaphylaxis is increasing especially in pediatric age. Our aim in this study was to investigate the knowledge and attitudes of the physicians on the diagnosis and treatment of anaphylaxis. METHODS:A questio...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002064
更新日期:2020-02-24 00:00:00
abstract:BACKGROUND:Evaluation of a child with POC/OC is complicated due difficulties in physical examination and risks of imaging by computed tomography. METHOD:Retrospective review of children 0-16 years admitted to the pediatric emergency department for POC/OC from 2009 to 2019. RESULTS:Ten years study period, 243 children...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002083
更新日期:2020-03-19 00:00:00
abstract:OBJECTIVE:This study examined whether the withdrawal of over-the-counter cough and cold medication labeled for use in children younger than 2 years in October 2007 and the warning against use of the products in children younger than 4 years in October 2008 affected cough and cold medication ingestions by young children...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3182587b0c
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of and to identify factors associated with prolonged emergency department length-of-stay (ED-LOS) for admitted children. METHODS:Data were from the 2001-2006 National Hospital Ambulatory Medical Care Survey. The primary outcome was prolonged ED-LOS (defined as total ED time >8 hour...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820943e4
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Interfacility transfers occur frequently and often involve critically ill patients. Clear communication at the time of patient referral is essential for patient safety. OBJECTIVES:The objective of this work was to study whether a standardized inter-emergency department (ED) transfer communication template f...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318289d7c1
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:To evaluate changes in imaging practices for pediatric head trauma after publication of the Pediatric Emergency Care Applied Research Network (PECARN) guidelines, explore areas for quality improvement regarding neuroradiology referrals. We also sought to determine the prevalence of incidental findings discov...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002124
更新日期:2020-06-12 00:00:00
abstract:OBJECTIVE:Establishing intravenous access in children is often challenging for health professionals. Multiple attempts at peripheral intravenous cannulation (PIVC) cause increased pain and delayed delivery of therapy. Our objective was to synthesize and evaluate the best evidence for novel interventions designed to imp...
journal_title:Pediatric emergency care
pub_type: 杂志文章,meta分析,评审
doi:10.1097/PEC.0b013e3182999bcd
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. METHODS:We analyzed data from the National Pediatric Readines...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001920
更新日期:2019-11-13 00:00:00
abstract::A combined retrospective and prospective analysis of infants 60 days of age or less evaluated for fever (greater than or equal to 38.3 degrees C) or history of fever who received chest roentgenogram over a one-year period was performed to determine whether clinical characteristics were predictive of pneumonia. Of the ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198909000-00001
更新日期:1989-09-01 00:00:00
abstract::Penetrating head injuries are rare in children, with most injuries being accidental as a result of unsupervised use of sharp objects by young children. We present the case of a 4-year-old boy brought to our emergency department with a nail embedded through a wooden board and into his skull. The nail was determined to ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318271ff3b
更新日期:2012-11-01 00:00:00
abstract::A 5-year-old female with Charcot-Marie-Tooth neuropathy and a history of constipation presented to the emergency department with a new blistering buttocks rash, which was initially concerning for nonaccidental burn. Upon further investigation, it was found that Ex-Lax had been given to the patient for constipation. Th...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001498
更新日期:2019-07-01 00:00:00
abstract:INTRODUCTION:To determine whether a delineation of suicide attempt severity via toxic ingestion distinguishes adolescents in terms of needs for medical and psychosocial support. METHODS:Cross-sectional study performed between 1995 through 1997 in which 92 adolescents, mean age 15.6 years, presented to an urban pediatr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000134925.08868.42
更新日期:2004-07-01 00:00:00
abstract::Inconsolable crying is a disturbing symptom in young infants. The following is a case report of an infant who presented with inconsolable crying caused by a corneal abrasion. Corneal abrasion should be considered when inconsolable crying appears in an otherwise asymptomatic infant. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198912000-00012
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Forearm fractures are common injuries in children. Displaced and angulated fractures usually require reduction. Ultrasound diagnosis and guided reduction offer several potential advantages: (1) the procedure does not involve ionizing radiation; (2) compared with fluoroscopy units, the newer ultrasound units ...
journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章
doi:10.1097/PEC.0b013e318128f85d
更新日期:2007-08-01 00:00:00
abstract::Ménétrier disease is a protein-losing gastroenteropathy, characterized clinically by nonspecific gastrointestinal symptoms and generalized edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. Distinct from its adult counterpart, Ménétrier disease of childhood usually remits spontaneou...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e3181887e89
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVES:Pediatricians routinely advise parents to seek immediate medical attention if their young infant develops a fever. Many parents rely on palpation to assess their child's temperature. Our objective was to determine the prevalence and accuracy of parental palpation for fever in young infants. METHODS:We enrol...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31819dac6
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:Urgent medical evaluation is recommended for patients with sickle cell disease (SCD) and fever. Clear recommendations exist regarding certain aspects of treatment, but other areas lack evidence. We determined practice variation for children with SCD presenting with fever to the emergency department (ED). ME...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000001569
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:Effective leadership and teamwork are imperative during pediatric cardiopulmonary resuscitations (CPR). The initial phase of pediatric CPR, termed the "first 5 minutes," has significant care delivery gaps in both leadership and team performance. The aim of the study was to describe the performance data of em...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001923
更新日期:2019-12-13 00:00:00
abstract:OBJECTIVES AND METHODS:The aim of the present retrospective, cross-sectional, descriptive study was to determine the characteristics of febrile 3- to 36-month-old children who were admitted to the emergency department (ED) with the chief complaint of fever and returned with the same complaint within 72 hours (returning...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823a3e86
更新日期:2011-12-01 00:00:00
abstract::As the field of pediatric procedural sedation continues to expand, so does the exploration of medications that have a role in such invasive and noninvasive procedures. One such medication that has emerged during the last decade is dexmedetomidine, a drug approved for use in the adult intensive care setting. Its role i...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e3182495e1b
更新日期:2012-03-01 00:00:00
abstract::Anticoagulation for thromboembolic disease and bleeding, the main complication of anticoagulation therapy, are uncommon but are potentially life- or limb-threatening conditions that may present in the pediatric emergency department. Thromboembolic disease in children usually occurs as a complication of vascular access...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e31820461b1
更新日期:2011-01-01 00:00:00
abstract:PURPOSE:To determine the rate, immediate treatment, and outpatient management for anaphylaxis in patients receiving care in a pediatric emergency department (ED). METHODS:This is a retrospective cross-sectional descriptive study of patients (21 years or younger) who received care for anaphylaxis for a 5-year period in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181ce2e1c
更新日期:2010-02-01 00:00:00
abstract::Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initi...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000817
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To determine the proportion of true-positive blood culture results in children presenting to the ED with suspected appendicitis. To describe the current practice of obtaining blood cultures in children with suspected appendicitis. METHODS:We performed a 2-year retrospective health record review of all child...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000877
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Documentation of use of octylcyanoacrylate adhesives in a pediatric emergency department with reference to patient selection, complications, and parent satisfaction. DESIGN:Retrospective and concurrent chart review of the first 100 patients on which 2-octylcyanoacrylate (2-OCA, Dermabonda) was used in a pedi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200010000-00005
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Amitriptyline ingestion is an important cause of poisoning morbidity and mortality in Turkey and other countries. In contrast to adults, data concerning amitriptyline intoxication in children are limited. The purpose of this study was to investigate amitriptyline intoxication findings in the pediatric popula...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002055
更新日期:2020-03-02 00:00:00
abstract::Baclofen is a muscle relaxant used in both adults and children with neuromuscular disorders to control spasticity. In children, relatively few cases of overdose have been previously reported. We report two cases of baclofen overdose occurring in two siblings. One sibling with cerebral palsy was being treated with bacl...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-200104000-00008
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To evaluate which treatment could be effective in the emergency department (ED) for children with migraine and status migrainosus, we carried out a qualitative systematic review of randomized controlled trials (RCTs) that evaluated treatment that could be used for those conditions. METHODS:Databases (Cochran...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e31816ed047
更新日期:2008-05-01 00:00:00
abstract::Ultrasonography can be useful in the evaluation of children with abdominal complaints and may be the initial imaging modality in patients presenting with a newly recognized abdominal mass. Hepatoblastoma is an uncommon cause of acute abdominal pain in children and can rarely metastasize to the heart through vascular i...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001629
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:The time window for possible salvage and survival of a torsed testicle is commonly thought to be 6 to 8 hours. However, survival of torsed testicles with or without subsequent atrophy is known to occur outside that critical time window. In this article, we performed a systematic review of the English literat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001287
更新日期:2019-12-01 00:00:00