Speciality
Spotlight

 




 

Critical Medicine – Emergency Medicine

 

 





Paediatric
Emergency Medicine

     

  • HE Perry, MW Shannon, (Harvard Med School, Boston; Massachusetts’ Poison Control
    Ctr, Boston)


    Efficacy of Oral Versus Intravenous N-Acetylcysteine in Acetaminophen Overdose: Results of an Open-label, Clinial Trial.


    J Pediatr 132: 149-152, 1998.

     


    N-acetylcysteine is accepted as effective treatment for acetaminophen overdose, but its route and length of treatment are still under debate. The current guidelines recommend oral administration for 72 hours whereas an iv 5-hour protocol is being explored.

     


    The study concluded that intravenous therapy for 52 hours is just as effective as 72 hrs oral therapy with
    n-acetylcysteine. The advantage of i.v. route is that it does not induce emesis unlike oral therapy. Intravenous route also permits a shorter course of therapy. However, the cost-effectiveness of the 2 routes has not been compared, nor is the entire adverse affects profile in this study.

     

  • F Craig, J
    Stroobant, A Winrow, et al (Children’s Hosp,
    Lewisham; Kingston Gen Hosp; et al).


    Depth of Insertion of a Lumbar Puncture Needle.


    Arch Dis Child 77: 450, 1997.

     


    Unsuccessful attempts at Lumbar puncture in children lead to discomfort, increased risk of physiologic compromise, and reduced chances of obtaining an uncontaminated sample. The study recommends that there is a linear relation between the needle insertion depth and the patients height, which can be explained by the equation mean insertion depth =0.3cm x height (cm).

     


    These guidelines suggested by the authors though not exact, are better than having no guidelines at all. A faulty technique is not only contributory towards traumatic punctures, but also a prolonged hospital stay.

      


 



 

 

Speciality Spotlight

 

 

Paediatric Emergency Medicine
     

  • HE Perry, MW Shannon, (Harvard Med School, Boston; Massachusetts’ Poison Control Ctr, Boston)
    Efficacy of Oral Versus Intravenous N-Acetylcysteine in Acetaminophen Overdose: Results of an Open-label, Clinial Trial.
    J Pediatr 132: 149-152, 1998.
     
    N-acetylcysteine is accepted as effective treatment for acetaminophen overdose, but its route and length of treatment are still under debate. The current guidelines recommend oral administration for 72 hours whereas an iv 5-hour protocol is being explored.
     
    The study concluded that intravenous therapy for 52 hours is just as effective as 72 hrs oral therapy with n-acetylcysteine. The advantage of i.v. route is that it does not induce emesis unlike oral therapy. Intravenous route also permits a shorter course of therapy. However, the cost-effectiveness of the 2 routes has not been compared, nor is the entire adverse affects profile in this study.
     

  • F Craig, J Stroobant, A Winrow, et al (Children’s Hosp, Lewisham; Kingston Gen Hosp; et al).
    Depth of Insertion of a Lumbar Puncture Needle.
    Arch Dis Child 77: 450, 1997.
     
    Unsuccessful attempts at Lumbar puncture in children lead to discomfort, increased risk of physiologic compromise, and reduced chances of obtaining an uncontaminated sample. The study recommends that there is a linear relation between the needle insertion depth and the patients height, which can be explained by the equation mean insertion depth =0.3cm x height (cm).
     
    These guidelines suggested by the authors though not exact, are better than having no guidelines at all. A faulty technique is not only contributory towards traumatic punctures, but also a prolonged hospital stay.
      

 

 

By |2022-07-20T16:42:16+00:00July 20, 2022|Uncategorized|Comments Off on Pediatric Emergency Medicine

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