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Measurement Tool: Faces Pain Scale - Revised for children 4 years of age and older
International Association for the Study of Pain
International Association for the Study of Pain
Scores are from the left to the right (for the child): 0, 2, 4, 6, 8, 10 (0 for no pain at all and 10 for very, very much in pain).
Scores are from the left to the right (for the child): 0, 2, 4, 6, 8, 10 (0 for no pain at all and 10 for very, very much in pain).
Acute Procedural Pain: Paediatric Recommendations and Implementation Toolkits
The Canadian Association of Paediatric Health Centres, Knowledge Exchange Network
The Canadian Association of Paediatric Health Centres, Knowledge Exchange Net...
Objective: This overview is intended to summarize the systematic reviews of interventions studied to decrease paediatric pain that are currently available in the Cochrane Library. Given their unique physiology, research relevant to the management of newbo
Objective: This overview is intended to summarize the systematic reviews of interventions studied to decrease paediatric pain that are currently available in the Cochrane Library. Given their unique physiology, research relevant to the management of newbo
Bottom Line Recommendations: Pain Treatment (2022)
Evidence Repository: Pain Treatment (2022)
For a list of references that were used in the creation of this resource, see Evidence Repository: Pain Treatment (2022)
For a list of references that were used in the creation of this resource, see Evidence Repository: Pain Treatment (2022)
Chart: WHO pain wall chart for waiting rooms
World Health Organization
World Health Organization
Is your child in pain? The doctor can help. As for pain treatment!
Is your child in pain? The doctor can help. As for pain treatment!
Bottom Line Recommenation: Optimal pain relief for pediatric MSK injury.
Korownyk C, Young J, Michael Allan G
Korownyk C, Young J, Michael Allan G
Evidence suggests that ibuprofen provides better single-agent relief than acetaminophen or codeine, and is at least equivalent to both acetaminophen with codeine and morphine for acute injury pain, with fewer adverse events.
Evidence suggests that ibuprofen provides better single-agent relief than acetaminophen or codeine, and is at least equivalent to both acetaminophen with codeine and morphine for acute injury pain, with fewer adverse events.
Bottom Line Recommendations: Procedural Pain (2022)
Clinical Pathway: ED Pathway for Evaluation/Treatment of Febrile Young Infant (0-56 Days Old)
Scarfone R, Gala R, Murray A, Funari MK, Lavelle J, Bell L
Scarfone R, Gala R, Murray A, Funari MK, Lavelle J, Bell L
The clinical pathway for treating and evaluating febrile infants is built upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia.
The clinical pathway for treating and evaluating febrile infants is built upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia.
Dosing Chart: Analgesic starting dosages for children
World Health Organization
World Health Organization
Analgesic starting doses for children.
Analgesic starting doses for children.
Opioids- Information for Clinicians
Recommandations de base: Prise en charge de la douleur (2022)
Samina Ali, Amy Drendel, Corrie Chumpitazi, Naveen Poonai
Samina Ali, Amy Drendel, Corrie Chumpitazi, Naveen Poonai
French bottom line recommendations for the treatment of pain. Published online January 18, 2023.
French bottom line recommendations for the treatment of pain. Published online January 18, 2023.
Clinical Practice Guideline: AboutKidsHealth: Tools for measuring pain
Stinson, J
Stinson, J
Objectives: To assess the level of pain felt by children through the use of pain scales and other measurement tools such as behavioural and composite measures.
Objectives: To assess the level of pain felt by children through the use of pain scales and other measurement tools such as behavioural and composite measures.
Clinical Practice Guideline: Pain-Less Practice: Techniques to Reduce Procedural Pain and Anxiety in Pediatric Acute Care
Olsen, K, Weinberg, E
Olsen, K, Weinberg, E
Purpose: This article introduces the concept of a PainLESS Practicean evidence-based, tiered approach to procedural pain and anxiety management in acute care
Purpose: This article introduces the concept of a PainLESS Practicean evidence-based, tiered approach to procedural pain and anxiety management in acute care
Clinical Practice Guideline: Good practice in postoperative and procedural pain management
Association of Paediatric Anaesthetists of Great Britain and Ireland
Association of Paediatric Anaesthetists of Great Britain and Ireland
This themed issue starts with an outstanding review of the history of Pediatric Regional Anesthesia (PRA), written by an equally outstanding second-wave pioneer and promoter of this particular facet of pediatric anesthesia, Professor Emeritus Kester Brown
This themed issue starts with an outstanding review of the history of Pediatric Regional Anesthesia (PRA), written by an equally outstanding second-wave pioneer and promoter of this particular facet of pediatric anesthesia, Professor Emeritus Kester Brown
Clinical Practice Guideline: Evidenced-based clinical practice guideline for management of newborn pain
Spence K, Henderson-Smart D, New K, Evans C, Whitelaw J, Woolnough R
Spence K, Henderson-Smart D, New K, Evans C, Whitelaw J, Woolnough R
Aim: To facilitate the uptake of evidence and to reduce the evidence practice gap for management of newborn pain through the development of a clinical practice guideline.
Aim: To facilitate the uptake of evidence and to reduce the evidence practice gap for management of newborn pain through the development of a clinical practice guideline.
Clinical Practice Guideline: Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline
Taddio A, Appleton M, Bortolussi R, Chambers C, Dubey V, Halperin S, Hanrahan A, Ipp M, Lockett D, MacDonald N, Midmer D, Mousmanis P, Palda V, Pielak K, Rid...
Taddio A, Appleton M, Bortolussi R, Chambers C, Dubey V, Halperin S, Hanrahan...
Our objective was to develop a clinical practice guideline, based on systematic reviews of the literature, as interpreted by experts, to assist clinicians in managing procedure-related pain and distress among children undergoing vaccine injections.
Our objective was to develop a clinical practice guideline, based on systematic reviews of the literature, as interpreted by experts, to assist clinicians in managing procedure-related pain and distress among children undergoing vaccine injections.
Clinical Practice Guideline: The recognition and assessment of acute pain in children
Royal College of Nursing
Royal College of Nursing
The guideline is aimed at a range of professional groups, patients and carers who may be involved in the assessment and management of childrens pain. The primary aims of this guideline are to: identify reliable and valid measures of pain intensity appropr
The guideline is aimed at a range of professional groups, patients and carers who may be involved in the assessment and management of childrens pain. The primary aims of this guideline are to: identify reliable and valid measures of pain intensity appropr
Clincal Practice Guideline: Prevention and Management of Procedural Pain in the Neonate: An Update
Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine
Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine
Purpose: This statement updates previous recommendations with new evidence on the prevention, assessment, and treatment of neonatal procedural pain.
Purpose: This statement updates previous recommendations with new evidence on the prevention, assessment, and treatment of neonatal procedural pain.
Clinical Practice Guideline: Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures.
Trottier ED,Dor-Bergeron MJ,Chauvin-Kimoff L,Baerg K,Ali S.
Trottier ED,Dor-Bergeron MJ,Chauvin-Kimoff L,Baerg K,Ali S.
Purpose: This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical procedures
Purpose: This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical procedures
Managing acute pain in children presenting to the emergency department without opioids
Corrie E Chumpitazi1,Cindy Chang2,Zaza Atanelov3,Ann M Dietrich4,Samuel Hiu-Fung Lam5,Emily Rose6,Tim Ruttan7,Sam Shahid8,Michael J Stoner9,Carmen Sulton10,M...
Corrie E Chumpitazi1,Cindy Chang2,Zaza Atanelov3,Ann M Dietrich4,Samuel Hiu-F...
Clinical Practice Guideline: Needle-Related or Minor Procedural Pain in Pediatric Patients
ENA Clinical Practice Guideline Committee; ENA Board of Directors Liaisons:; Methodologist:; Staff Liaisons:; Administrative Staff:
ENA Clinical Practice Guideline Committee; ENA Board of Directors Liaisons:; ...
Clinical Practice Guideline: AAOS clinical practice guideline: the treatment of pediatric diaphyseal femur fractures
Kocher, MS, Sink, EL, Blasier, RD, Luhmann, SJ, Mehlman, CT, Scher, DM, Matheney, T & Sanders, JO
Kocher, MS, Sink, EL, Blasier, RD, Luhmann, SJ, Mehlman, CT, Scher, DM, Mathe...
This is a summary of the recommendations in the AAOS clinical practice guideline, The Treatment of Pediatric Diaphyseal Femur Fractures.
This is a summary of the recommendations in the AAOS clinical practice guideline, The Treatment of Pediatric Diaphyseal Femur Fractures.
Guidelines: Agitation Treatment for Pediatric Emergency Patients
Hilt RJ, Woodward TA, Henderson SW, Jellinek MS
Hilt RJ, Woodward TA, Henderson SW, Jellinek MS
Guideline based on a review of the existing literature & review of expert opinions for the management of agitated children in an emergency department setting.
Guideline based on a review of the existing literature & review of expert opinions for the management of agitated children in an emergency department setting.
Guidelines: Evaluation and Treatment of Functional Constipation in Infants and Children: Evidence-based Recommendations from ESPGHAN and NASPGHAN
Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, Staiano A, Vandenplas Y, Benninga MA; European Society for Pediatric Gastroenterology, He...
Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, Staiano A...
This evidence-based guideline provides recommendations for the evaluation and treatment of children withfunctionalconstipation to standardize and improve their quality of care. In addition, 2 algorithms were developed, one for the infants under 6 months of age and the other for older infants and children.
This evidence-based guideline provides recommendations for the evaluation and treatment of children withfunctionalconstipation to standardize and improve their quality of care. In addition, 2 algorithms were developed, one for the infants under 6 months of age and the other for older infants and children.
Clinical Practice Guideline: Treatment of Pediatric Diaphyseal Femur Fractures
Jevsevar DS & Shea K
Jevsevar DS & Shea K
This is an AAOS clinical guideline on the treatment of pediatric diaphyseal femur fractures (PDFF).
This is an AAOS clinical guideline on the treatment of pediatric diaphyseal femur fractures (PDFF).
Clinical Practice Guidelines: The treatment of pediatric supracondylar humerus fractures
Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman CT, Scherl S, Goldberg M, Turkelson CM, Wies JL, Boyer K, American Academy of Or...
Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman ...
Based on the best current evidence and a systematic review of published studies, 14 recommendations have been created to guide clinical practice and management of supracondylar fractures of the humerus in children.
Based on the best current evidence and a systematic review of published studies, 14 recommendations have been created to guide clinical practice and management of supracondylar fractures of the humerus in children.
Clinical Practice Guidelines: The treatment of pediatric supracondylar humerus fractures: Evidence-Based Guideline and Evidence Report
Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman CT, Scherl S, Goldberg M, Turkelson CM, Wies JL, Boyer K; American Academy of Or...
Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman ...
This clinical practice guideline is based on a systematic review of published studies on the treatment of supracondylar fractures of the humerus in children. In addition to providing practice recommendations, this guideline highlights gaps in the literature and areas that require future research.
This clinical practice guideline is based on a systematic review of published studies on the treatment of supracondylar fractures of the humerus in children. In addition to providing practice recommendations, this guideline highlights gaps in the literature and areas that require future research.
Clinical Practice Guidelines: Treatment of Distal Radius Fractures: Guideline and Evidence Report
Lichtman DM, Randipsingh RR, Boyer MI, Putnam MD, Ring D, Slutsky DJ, Taras JS
Lichtman DM, Randipsingh RR, Boyer MI, Putnam MD, Ring D, Slutsky DJ, Taras JS
This an an AAOS clinical guideline for pediatric distal radial fractures.
This an an AAOS clinical guideline for pediatric distal radial fractures.
Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology
Halperin JJ, Shapiro ED, Logigian E, Belman AL, Dotevall L, Wormser GP, Krupp L, Gronseth G, Bever CT Jr; Quality Standards Subcommittee of the American Acad...
Halperin JJ, Shapiro ED, Logigian E, Belman AL, Dotevall L, Wormser GP, Krupp...
Provides evidence-based recommendations on the treatment of nervous system Lyme disease and post-Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens preferred for different manifestations of nervous system Lyme disease? 3) What duration of therapy is needed?
Provides evidence-based recommendations on the treatment of nervous system Lyme disease and post-Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens preferred for different manifestations of nervous system Lyme disease? 3) What duration of therapy is needed?
The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America
Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, Krause PJ, Bakken JS, Strle F, Stanek G, Bockenstedt L, Fish D, Dumler JS, Nadelma...
Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, Kr...
Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis.
Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis.
Consensus statement: Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts consensus statement.
Shen K, Yang Y, Wang T, et al.
Shen K, Yang Y, Wang T, et al.
This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections. The present consensus statement summarizes current strategies on diagnosis, treatment, and prevention of 2019-nCoV infection in children.
This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections. The present consensus statement summarizes current strategies on diagnosis, treatment, and prevention of 2019-nCoV infection in children.
Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society
Glauser T, Shinnar S, Gloss D, Alldredge B, Arya R, Bainbridge J, et al.
Glauser T, Shinnar S, Gloss D, Alldredge B, Arya R, Bainbridge J, et al.
To analyze efficacy, tolerability and safety data for anticonvulsant treatment of children and adults with convulsive status epilepticus and use this analysis to develop an evidence-based treatment algorithm.
To analyze efficacy, tolerability and safety data for anticonvulsant treatment of children and adults with convulsive status epilepticus and use this analysis to develop an evidence-based treatment algorithm.
The treatment of convulsive status epilepticus in children
Appleton R, Choonara I, Martland T, Phillips B, Scott R, Whitehouse W.
Appleton R, Choonara I, Martland T, Phillips B, Scott R, Whitehouse W.
There is currently little agreement between hospital protocols when treating convulsive status epilepticus in children, and a working party has been set up to produce a national evidence based guideline for treating this condition. This four step guideline is presented in this paper. Its effectiveness will be highlighted and its use audited in a number of centres.
There is currently little agreement between hospital protocols when treating convulsive status epilepticus in children, and a working party has been set up to produce a national evidence based guideline for treating this condition. This four step guideline is presented in this paper. Its effectiveness will be highlighted and its use audited in a number of centres.
The Expert Consensus Guideline Series. Treatment of behavioral emergencies
Allen, M. H., G. W. Currier, D. H. Hughes, M. Reyes-Harde, J. P. Docherty and E. Expert Consensus Panel for Behavioral
Allen, M. H., G. W. Currier, D. H. Hughes, M. Reyes-Harde, J. P. Docherty and...
Cochrane Summary: Sweet-tasting solutions for needle-related pain in infants up to one year of age
Kassab M, Foster JP, Foureu M, Fowle C
Kassab M, Foster JP, Foureu M, Fowle C
The use of needles that break the skin and cause pain is a common practice around the world with babies aged between one month and 12 months (Appendix 4). In thisreviewwe were interested in whether giving babies sugar-based solutions to taste when the nee
The use of needles that break the skin and cause pain is a common practice around the world with babies aged between one month and 12 months (Appendix 4). In thisreviewwe were interested in whether giving babies sugar-based solutions to taste when the nee
Cochrane Summary: Psychological interventions for needle-related procedural pain and distress in children and adolescents
Birnie KA, Noel M, Chambers CT, Uman LS, Parker JA
Birnie KA, Noel M, Chambers CT, Uman LS, Parker JA
To assess the efficacy of psychological interventions for needlerelated procedural pain and distress in children and adolescents.
To assess the efficacy of psychological interventions for needlerelated procedural pain and distress in children and adolescents.
Cochrane Summary: Breastfeeding or breast milk for procedural pain in neonates
Shah PS, Herbozo C, Aliwalas LL, Shah VS
Shah PS, Herbozo C, Aliwalas LL, Shah VS
Breastfeeding provides pain relief for newborn babies undergoing painful procedures. Medicine for pain relief is commonly given for major painful procedures, but may not be given for minor painful procedures such as blood sampling (by heel prick orvenepun
Breastfeeding provides pain relief for newborn babies undergoing painful procedures. Medicine for pain relief is commonly given for major painful procedures, but may not be given for minor painful procedures such as blood sampling (by heel prick orvenepun
Cochrane Summary: Local anaesthesia (numbing medicine) that is directly applied to the skin can provide pain control for repair of skin lacerations
Tayeb BO, Eidelman A, Eidelman CL, McNicol ED, Carr DB
Tayeb BO, Eidelman A, Eidelman CL, McNicol ED, Carr DB
To assess whether benefits of noninvasive topical anaesthetic application occur at the expense of decreased analgesic efficacy. To compare the efficacy of various singlecomponent or multicomponent topical anaesthetic agents for repair of dermal laceration
To assess whether benefits of noninvasive topical anaesthetic application occur at the expense of decreased analgesic efficacy. To compare the efficacy of various singlecomponent or multicomponent topical anaesthetic agents for repair of dermal laceration
Cochrane Summary: Sweet taste to ease injection needle pain in children aged one to 16 years
Harrison D, Yamada J, Adams-Webber T, Ohlsson A, Beyene J, Stevens B
Harrison D, Yamada J, Adams-Webber T, Ohlsson A, Beyene J, Stevens B
This is an updated version of the original Cochrane review published in Issue 10, 2011: Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years. We re-ran the search in October 2014. Review question: Do swe
This is an updated version of the original Cochrane review published in Issue 10, 2011: Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years. We re-ran the search in October 2014. Review question: Do swe
Cochrane Summary: Skin-to-skin care with newborns cuts down procedural pain
Johnston C, Campbell-Yeo M, Disher T, Benoit B, Fernandes A, Streiner D, Inglis D, Zee R
Johnston C, Campbell-Yeo M, Disher T, Benoit B, Fernandes A, Streiner D, Ingl...
The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedures in neonates compared to no intervention, sucrose or other analgesics, or additions to simple SSC such as rocking; and to determine the effects of t
The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedures in neonates compared to no intervention, sucrose or other analgesics, or additions to simple SSC such as rocking; and to determine the effects of t
Cochrane Summary: Nonpharmacological management of infant and young child procedural pain
Pillai Riddell RR, Racine NM, Gennis HG, Turcotte K, Uman LS, Horton RE, Ahola Kohut S, Hillgrove Stuart J, Stevens B, Lisi DM
Pillai Riddell RR, Racine NM, Gennis HG, Turcotte K, Uman LS, Horton RE, Ahol...
We examined 13 different types of commonly investigated non-pharmacological treatments (excluding breastmilk, sucrose, and music) to determine theirefficacyfor pain reactions after an acutely painful procedure (right after the needle ('pain reactivity') a
We examined 13 different types of commonly investigated non-pharmacological treatments (excluding breastmilk, sucrose, and music) to determine theirefficacyfor pain reactions after an acutely painful procedure (right after the needle ('pain reactivity') a
Cochrane Summary: Helium-oxygen (heliox) treatment for children with croup
Moraa I, Sturman N, McGuire TM, van Driel ML,
Moraa I, Sturman N, McGuire TM, van Driel ML,
Objective: To examine the effect of heliox compared to oxygen or other active interventions, placebo, or no treatment, on relieving signs and symptoms in children with croup as determined by a croup score and rates of admission and intubation.
Objective: To examine the effect of heliox compared to oxygen or other active interventions, placebo, or no treatment, on relieving signs and symptoms in children with croup as determined by a croup score and rates of admission and intubation.
Cochrane Summary: Pain relievers for children with acute middle ear infection
Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoiseaux RA
Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoise...
Objective: Our primary objective was to assess the effectiveness of paracetamol (acetaminophen) or NSAIDs, alone or combined, compared with placebo or no treatment in relieving pain in children with AOM. Our secondary objective was to assess the effectiveness of NSAIDs compared with paracetamol in children with AOM.
Objective: Our primary objective was to assess the effectiveness of paracetamol (acetaminophen) or NSAIDs, alone or combined, compared with placebo or no treatment in relieving pain in children with AOM. Our secondary objective was to assess the effectiveness of NSAIDs compared with paracetamol in children with AOM.
Cochrane Summary: Sucrose for analgesia in newborn infants undergoing painful procedures
Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A
Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A
The secondary objectives were to determine the safety of SSC care for relieving procedural pain in infants; and to compare the SSC effect in different postmenstrual age subgroups of infants.
The secondary objectives were to determine the safety of SSC care for relieving procedural pain in infants; and to compare the SSC effect in different postmenstrual age subgroups of infants.
Cochrane Overview: The Cochrane Library and procedural pain in children: an overview of reviews
Curtis S, Wingert A, Ali S
Curtis S, Wingert A, Ali S
Objective: To summarize Cochrane reviews assessing the effects of various interventions used for pain in non-neonatal children undergoing painful medical procedures.
Objective: To summarize Cochrane reviews assessing the effects of various interventions used for pain in non-neonatal children undergoing painful medical procedures.
Cochrane Summary: Treatment for the neurological complications of Lyme disease
Cadavid D, Auwaerter PG, Rumbaugh J, Gelderblom H
Cadavid D, Auwaerter PG, Rumbaugh J, Gelderblom H
Objective: To assess the effects of antibiotics for the treatment of Lyme neuroborreliosis (LNB).
Objective: To assess the effects of antibiotics for the treatment of Lyme neuroborreliosis (LNB).
Summary: In children with bacterial meningitis, does the addition of dexamethasone to an antibiotic treatment regimen result in a better clinical outcome than the antibiotic regimen alone?: Part A: Evidence-based answer and summary
Fox JL
Fox JL
Objective: To determine the efficacy of adjuvant dexamethasone therapy in paediatric bacterial meningitis.
Objective: To determine the efficacy of adjuvant dexamethasone therapy in paediatric bacterial meningitis.
Cochrane Summary: Surgical treatment for forearm fractures in children (fractures involving the shafts of the radius and ulna)
Abraham A, Kumar S, Chaudhry S, Ibrahim T
Abraham A, Kumar S, Chaudhry S, Ibrahim T
Fractures of the shafts of the forearm bones in children are common injuries and occur after a fall on an outstretched hand. There are two bones in the forearm: the radius and the ulna. After a fall either one or both bones may fracture. The shape of forearm bones are important for the twisting motion of the hand, such as in receiving change from a shop keeper with an open palm (supination) or turning a key in a door (turning the palm facing down - pronation). Treatment of the forearm fracture aims to restore the shape of the bones such that supination and pronation ability is restored. The first stage of treatment involves manipulating (setting) the bones to the correct shape. This is usually done under anaesthesia. The second stage involves stabilising the fractured bones either with a plaster cast (conservative treatment) or metal implants (surgical treatment). This review aimed to examine the evidence from randomised controlled trials comparing conservative versus surgical methods and trials comparing different surgical methods for treatment of these fractures. We hoped to find which are the best methods in terms of function and complications. In spite of a thorough search we found no evidence from properly conducted studies to help inform decisions on treatment of these fractures.
Fractures of the shafts of the forearm bones in children are common injuries and occur after a fall on an outstretched hand. There are two bones in the forearm: the radius and the ulna. After a fall either one or both bones may fracture. The shape of forearm bones are important for the twisting motion of the hand, such as in receiving change from a shop keeper with an open palm (supination) or turning a key in a door (turning the palm facing down - pronation). Treatment of the forearm fracture aims to restore the shape of the bones such that supination and pronation ability is restored. The first stage of treatment involves manipulating (setting) the bones to the correct shape. This is usually done under anaesthesia. The second stage involves stabilising the fractured bones either with a plaster cast (conservative treatment) or metal implants (surgical treatment). This review aimed to examine the evidence from randomised controlled trials comparing conservative versus surgical methods and trials comparing different surgical methods for treatment of these fractures. We hoped to find which are the best methods in terms of function and complications. In spite of a thorough search we found no evidence from properly conducted studies to help inform decisions on treatment of these fractures.
Cochrane Overview: The Cochrane Library and the treatment of croup in children: an overview of reviews
Bjornson, C, Russell, K, Foisy, M, Johnson, D,
Bjornson, C, Russell, K, Foisy, M, Johnson, D,
Objective: To synthesize the evidence currently in the Cochrane Database of Systematic Reviews (CDSR) related to the clinical effectiveness and applicability of four treatments for croup - glucocorticoids, epinephrine, heliox and humidified air.
Objective: To synthesize the evidence currently in the Cochrane Database of Systematic Reviews (CDSR) related to the clinical effectiveness and applicability of four treatments for croup - glucocorticoids, epinephrine, heliox and humidified air.
Treatment of severe blunt pancreatic lesions in children
Haugaard MV, Wettergren A, Hillings JG, Gluud C, Penninga L,
Haugaard MV, Wettergren A, Hillings JG, Gluud C, Penninga L,
This review shows that strategies regarding non-operative versus operative treatment of severe blunt pancreatic trauma in children are not based on randomised clinical trials.
This review shows that strategies regarding non-operative versus operative treatment of severe blunt pancreatic trauma in children are not based on randomised clinical trials.
Synthesis of Systematic Reviews: Treatment of Childhood Constipation: a synthesis of systematic reviews and meta-analyses
Southwell BR
Southwell BR
In 2016, treatment of childhood constipation was extensively reviewed by Rome IV. This review covers meta-analyses and evidence for treatment of paediatric constipation since 2016 and new emerging treatments.
In 2016, treatment of childhood constipation was extensively reviewed by Rome IV. This review covers meta-analyses and evidence for treatment of paediatric constipation since 2016 and new emerging treatments.
Cochrane Systematic Review: Antidepressants for the treatment of abdominal pain-related functional gastrointestinal disorders in children and adolescents
Kaminski A, Kamper A, Thaler K, Chapman A, Gartlehner G
Kaminski A, Kamper A, Thaler K, Chapman A, Gartlehner G
OBJECTIVES: The primary objectives were to conduct a systematic review to evaluate the efficacy and safety of antidepressants for the treatment of abdominal pain-related FGIDs in children and adolescents.
OBJECTIVES: The primary objectives were to conduct a systematic review to evaluate the efficacy and safety of antidepressants for the treatment of abdominal pain-related FGIDs in children and adolescents.
Systematic Review: Vapocoolant spray versus placebo spray/no treatment for reducing pain from intravenous cannulation: A meta-analysis of randomized controlled trials.
Zhu Y,Peng X,Wang S,Chen W,Liu C,Guo B,Zhao L,Gao Y,Wang K,Lou F.
Zhu Y,Peng X,Wang S,Chen W,Liu C,Guo B,Zhao L,Gao Y,Wang K,Lou F.
Objectives:The objective of our meta-analysis is to compare the effectiveness of vapocoolant spray and placebo spray/no treatment for pain reduction during intravenous cannulation.
Objectives:The objective of our meta-analysis is to compare the effectiveness of vapocoolant spray and placebo spray/no treatment for pain reduction during intravenous cannulation.
Systematic Review: Use Of Fibers in Childhood Constipation Treatment: systematic review with meta-analysis
Piccoli de Mello P,Eifer DA,Daniel de Mello E
Piccoli de Mello P,Eifer DA,Daniel de Mello E
To gather current evidence on the use of fiber for constipation treatment in pediatric patients.
To gather current evidence on the use of fiber for constipation treatment in pediatric patients.
Cochrane Systematic Review: Adjusting the pH of lidocaine for reducing pain on injection
Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R
Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R
OBJECTIVES: The objective of this review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in adults and children. We tested the hypothesis that adjusting the pH of lidocaine solution to a level closer to the physiologic pH reduces this pain.
OBJECTIVES: The objective of this review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in adults and children. We tested the hypothesis that adjusting the pH of lidocaine solution to a level closer to the physiologic pH reduces this pain.
Cochrane Systematic Review: Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery
Andreae MH, Andreae DA
Andreae MH, Andreae DA
OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of persistent pain six or 12 months after surgery.
OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of persistent pain six or 12 months after surgery.
Cochrane Systematic Review: Conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain
Almeida MO, Silva BN, Andriolo RB, Atallah AN, Peccin MS
Almeida MO, Silva BN, Andriolo RB, Atallah AN, Peccin MS
OBJECTIVES: To assess the effects (benefits and harms) of conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain.
OBJECTIVES: To assess the effects (benefits and harms) of conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain.
Cochrane Systematic Review: Pharmacotherapy for patellofemoral pain syndrome
Heintjes E, Berger MY, Bierma-Zeinstra SM, Bernsen RM, Verhaar JA, Koes BW
Heintjes E, Berger MY, Bierma-Zeinstra SM, Bernsen RM, Verhaar JA, Koes BW
OBJECTIVES: This review aims to summarise the evidence of effectiveness of pharmacotherapy in reducing anterior knee pain and improving knee function in people with PFPS.
OBJECTIVES: This review aims to summarise the evidence of effectiveness of pharmacotherapy in reducing anterior knee pain and improving knee function in people with PFPS.
Cochrane Systematic Review: Pharmacological interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood
Huertas-Ceballos AA, Logan S, Bennett C, Macarthur C, Martin AE
Huertas-Ceballos AA, Logan S, Bennett C, Macarthur C, Martin AE
OBJECTIVES: To determine the effectiveness of medication for recurrent abdominal pain in school-age children.
OBJECTIVES: To determine the effectiveness of medication for recurrent abdominal pain in school-age children.
Cochrane Systematic Review: Oxcarbazepine for neuropathic pain
Zhou M, Chen N, He L, Yang M, Zhu C, Wu F
Zhou M, Chen N, He L, Yang M, Zhu C, Wu F
OBJECTIVES: To determine the benefits and harms of oxcarbazepine for different forms of neuropathic pain.
OBJECTIVES: To determine the benefits and harms of oxcarbazepine for different forms of neuropathic pain.
Cochrane Systematic Review: EMLA and Amethocaine for reduction of children's pain associated with needle insertion
Lander JA, Weltman BJ, So SS
Lander JA, Weltman BJ, So SS
OBJECTIVES: To compare the topical anaesthetics amethocaine and an eutectic mixture of local anaesthetics (EMLA) in terms of anaesthetic efficacy, ease of needle insertion and adverse events when used for intravenous cannulation and venipuncture in children.
OBJECTIVES: To compare the topical anaesthetics amethocaine and an eutectic mixture of local anaesthetics (EMLA) in terms of anaesthetic efficacy, ease of needle insertion and adverse events when used for intravenous cannulation and venipuncture in children.
Cochrane Systematic Review: Hydromorphone for acute and chronic pain
Quigley C
Quigley C
OBJECTIVES: This review explores and assesses the evidence for the efficacy of hydromorphone in the management of pain.
OBJECTIVES: This review explores and assesses the evidence for the efficacy of hydromorphone in the management of pain.
Cochrane Systematic Review: Local anaesthetic sympathetic blockade for complex regional pain syndrome
Stanton TR, Wand BM, Carr DB, Birklein F, Wasner GL, O'Connell NE
Stanton TR, Wand BM, Carr DB, Birklein F, Wasner GL, O'Connell NE
OBJECTIVES: To assess the efficacy of LASB for the treatment of pain in CRPS and to evaluate the incidence of adverse effects of the procedure.
OBJECTIVES: To assess the efficacy of LASB for the treatment of pain in CRPS and to evaluate the incidence of adverse effects of the procedure.
Cochrane Systematic Review: Non-pharmacological management of infant and young child procedural pain
Pillai Riddell RR, Racine NM, Turcotte K, Uman LS, Horton RE, Din Osmun L, Ahola Kohut S, Hillgrove Stuart J, Stevens B, Gerwitz-Stern A
Pillai Riddell RR, Racine NM, Turcotte K, Uman LS, Horton RE, Din Osmun L, A...
OBJECTIVES: To assess the efficacy of non-pharmacological interventions for infant and child (up to three years) acute pain, excluding breastmilk, sucrose, and music. Analyses accounted for infant age (preterm, neonate, older) and pain response (pain reactivity, pain-related regulation).
OBJECTIVES: To assess the efficacy of non-pharmacological interventions for infant and child (up to three years) acute pain, excluding breastmilk, sucrose, and music. Analyses accounted for infant age (preterm, neonate, older) and pain response (pain reactivity, pain-related regulation).
Cochrane Systematic Review: NSAIDS or paracetamol, alone or combined with opioids, for cancer pain
McNicol E, Strassels SA, Goudas L, Lau J, Carr DB
McNicol E, Strassels SA, Goudas L, Lau J, Carr DB
OBJECTIVES: To assess the effects of NSAIDs, alone or combined with opioids, for the treatment of cancer pain.
OBJECTIVES: To assess the effects of NSAIDs, alone or combined with opioids, for the treatment of cancer pain.
Cochrane Systematic Review: Oral morphine for cancer pain
Wiffen PJ, Wee B, Moore RA
Wiffen PJ, Wee B, Moore RA
OBJECTIVES: To determine the efficacy of oral morphine in relieving cancer pain, and assess the incidence and severity of adverse effects.
OBJECTIVES: To determine the efficacy of oral morphine in relieving cancer pain, and assess the incidence and severity of adverse effects.
Cochrane Systematic Review: Pharmacologic interventions for treating phantom limb pain
Alviar MJ, Hale T, Dungca M
Alviar MJ, Hale T, Dungca M
OBJECTIVES: This review aims to summarize the evidence of effectiveness of pharmacologic interventions in treating PLP.
OBJECTIVES: This review aims to summarize the evidence of effectiveness of pharmacologic interventions in treating PLP.
Cochrane Systematic Review: Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age
Kassab M, Foster JP, Foureur M, Fowler C
Kassab M, Foster JP, Foureur M, Fowler C
OBJECTIVES: To determine the effectiveness of sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age compared with no treatment, placebo, other sweet-tasting solutions, or pharmacological or other non-pharmacological pain-relieving methods.
OBJECTIVES: To determine the effectiveness of sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age compared with no treatment, placebo, other sweet-tasting solutions, or pharmacological or other non-pharmacological pain-relieving methods.
Cochrane Systematic Review: Diclofenac for acute pain in children
Standing JF, Savage I, Pritchard D, Waddington M
Standing JF, Savage I, Pritchard D, Waddington M
OBJECTIVES: 1) Assess the efficacy of diclofenac for acute pain in children. 2) Assess the safety of diclofenac for short-term use in children. 3) Identify gaps in the evidence to direct future research.
OBJECTIVES: 1) Assess the efficacy of diclofenac for acute pain in children. 2) Assess the safety of diclofenac for short-term use in children. 3) Identify gaps in the evidence to direct future research.
Cochrane Systematic Review: Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children
Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoiseaux RA
Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoise...
Objective: Our primary objective was to assess the effectiveness of paracetamol (acetaminophen) or NSAIDs, alone or combined, compared with placebo or no treatment in relieving pain in children with AOM. Our secondary objective was to assess the effectiveness of NSAIDs compared with paracetamol in children with AOM.
Objective: Our primary objective was to assess the effectiveness of paracetamol (acetaminophen) or NSAIDs, alone or combined, compared with placebo or no treatment in relieving pain in children with AOM. Our secondary objective was to assess the effectiveness of NSAIDs compared with paracetamol in children with AOM.
Systematic Review: Effectiveness of Probiotics in Children with Functional Abdominal Pain Disorders and Functional Constipation: A Systematic Review
Wegh CAM,Benninga MA,Tabbers MM
Wegh CAM,Benninga MA,Tabbers MM
The objective of this study was to investigate the effect of probiotics on functional abdominal pain disorders (FAPD) and functional constipation (FC).
The objective of this study was to investigate the effect of probiotics on functional abdominal pain disorders (FAPD) and functional constipation (FC).
Systematic Review: A systematic review of vapocoolants for reducing pain from venipuncture and venous cannulation in children and adults
Hogan ME, Smart S, Shah V, Taddio A
Hogan ME, Smart S, Shah V, Taddio A
Our aim was to systematically review the literature regarding the analgesic effectiveness of vapocoolants in children and adults.
Our aim was to systematically review the literature regarding the analgesic effectiveness of vapocoolants in children and adults.
Systematic Review: Pediatric clinical practice guidelines for acute procedural pain: a systematic review
Lee GY, Yamada J, Kyololo O, Shorkey A, Stevens B
Lee GY, Yamada J, Kyololo O, Shorkey A, Stevens B
Objective: To systematically review the quality of existing practice guidelines for acute procedural pain in children and provide recommendations for their use.
Objective: To systematically review the quality of existing practice guidelines for acute procedural pain in children and provide recommendations for their use.
Cochrane Systematic Review: Psychological interventions for needlerelated procedural pain and distress in children and adolescents
BirnieKA, NoelM, ChambersCT, UmanLS, ParkerJA
BirnieKA, NoelM, ChambersCT, UmanLS, ParkerJA
Objectives: To provide an update to our 2006 review assessing the efficacy of psychological interventions for needle-related procedural pain and distress in children and adolescents.
Objectives: To provide an update to our 2006 review assessing the efficacy of psychological interventions for needle-related procedural pain and distress in children and adolescents.
Review: Relief of pain and anxiety in pediatric patients in emergency medical systems
Fein JA, Zempsky WT, Cravero JP, Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine
Fein JA, Zempsky WT, Cravero JP, Committee on Pediatric Emergency Medicine an...
Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child's and family's reaction to current and futu
Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child's and family's reaction to current and futu
Cochrane Systematic Review: Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age
Kassab M, Foster JP, Foureur M, Fowler C
Kassab M, Foster JP, Foureur M, Fowler C
Objectives: To determine the effectiveness of sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age compared with no treatment, placebo, other sweet-tasting solutions, or pharmacological or other non-pharmacolo
Objectives: To determine the effectiveness of sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age compared with no treatment, placebo, other sweet-tasting solutions, or pharmacological or other non-pharmacolo
Cochrane Systematic Review: Breastfeeding or breast milk for procedural pain in neonates
Shah PS, Herbozo C, Aliwalas LL, Shah VS
Shah PS, Herbozo C, Aliwalas LL, Shah VS
Objectives: The primary objective was to evaluate the effectiveness of breastfeeding or supplemental breast milk in reducing procedural pain in neonates. The secondary objective was to conduct subgroup analyses based on the type of control intervention, g
Objectives: The primary objective was to evaluate the effectiveness of breastfeeding or supplemental breast milk in reducing procedural pain in neonates. The secondary objective was to conduct subgroup analyses based on the type of control intervention, g
Cochrane Systematic Review: Topical anaesthetics for pain control during repair of dermal laceration
TayebBO, EidelmanA, EidelmanCL, McNicolED, CarrDB
TayebBO, EidelmanA, EidelmanCL, McNicolED, CarrDB
Objectives: To compare the efficacy and safety of infiltrated local anaesthetics with those of topical local anaesthetics for repair of dermal lacerations and to evaluate the efficacy and safety of various single or multi-component topical anaesthetics to
Objectives: To compare the efficacy and safety of infiltrated local anaesthetics with those of topical local anaesthetics for repair of dermal lacerations and to evaluate the efficacy and safety of various single or multi-component topical anaesthetics to
Cochrane Systematic Review: Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years
Harrison D, Yamada J, Adams-Webber T, Ohlsson A, Beyene J, Stevens B
Harrison D, Yamada J, Adams-Webber T, Ohlsson A, Beyene J, Stevens B
Objectives: To determine the efficacy of sweet tasting solutions or substances for reducing needle-related procedural pain in children beyond one year of age.
Objectives: To determine the efficacy of sweet tasting solutions or substances for reducing needle-related procedural pain in children beyond one year of age.
Cochrane Systematic Review: Non-pharmacological management of infant and young child procedural pain
Pillai Riddell RR, Racine NM, Turcotte K, Uman LS, Horton RE, Din Osmun L, Ahola Kohut S, Hillgrove Stuart J, Stevens B, Gerwitz-Stern A
Pillai Riddell RR, Racine NM, Turcotte K, Uman LS, Horton RE, Din Osmun L, Ah...
Objectives: To assess the efficacy of non-pharmacological interventions for infant and child (up to three years) acute pain, excluding breastmilk, sucrose, and music. Analyses accounted for infant age (preterm, neonate, older) and pain response (pain reac
Objectives: To assess the efficacy of non-pharmacological interventions for infant and child (up to three years) acute pain, excluding breastmilk, sucrose, and music. Analyses accounted for infant age (preterm, neonate, older) and pain response (pain reac
Systematic Review: Music for pain and anxiety in children undergoing medical procedures: a systematic review of randomized controlled trials
Klassen JA, Liang Y, Tjosvold L, Klassen TP, Hartling L
Klassen JA, Liang Y, Tjosvold L, Klassen TP, Hartling L
Objective: The aim of this study was to conduct a systematic review of the efficacy of music therapy (MT) on pain and anxiety in children undergoing clinical procedures.
Objective: The aim of this study was to conduct a systematic review of the efficacy of music therapy (MT) on pain and anxiety in children undergoing clinical procedures.
Review: Clinical implications of unmanaged needle-insertion pain and distress in children
Kennedy RM, Luhmann J, Zempsky WT
Kennedy RM, Luhmann J, Zempsky WT
This review summarizes the evidence for the importance of managing pediatric procedural pain and methods for reducing venous access pain.
This review summarizes the evidence for the importance of managing pediatric procedural pain and methods for reducing venous access pain.
Review: Needle pain in children: contextual factors
Walco GA
Walco GA
Pediatric pain experiences result from a complex interplay of genetic, experiential, and developmental factors. These elements, as they relate to needle-stick procedures and other relevant painful phenomena, are explored in this article so that the contex
Pediatric pain experiences result from a complex interplay of genetic, experiential, and developmental factors. These elements, as they relate to needle-stick procedures and other relevant painful phenomena, are explored in this article so that the contex
Review: Pharmacologic approaches for reducing venous access pain in children
Zempsky WT
Zempsky WT
A variety of pharmacologic options are available to clinicians who want to provide effective and safe topical local anesthesia to children undergoing venous access procedures. These options can be distinguished on the basis of how they deliver active drug
A variety of pharmacologic options are available to clinicians who want to provide effective and safe topical local anesthesia to children undergoing venous access procedures. These options can be distinguished on the basis of how they deliver active drug
Systematic Review: Digital Technology Distraction for Acute Pain in Children: AMeta-analysis
Michelle Gates,Lisa Hartling,Jocelyn Shulhan-Kilroy,Tara MacGregor,Samantha Guitard,Aireen Wingert,Robin Featherstone,Ben Vandermeer,Naveen Poonai,Janeva Kir...
Michelle Gates,Lisa Hartling,Jocelyn Shulhan-Kilroy,Tara MacGregor,Samantha G...
Objective:To determine the effect of digital technology distraction on pain and distress in children experiencing acutely painful conditions or procedures.
Objective:To determine the effect of digital technology distraction on pain and distress in children experiencing acutely painful conditions or procedures.
Systematic Review: Clinical efficacy of virtual reality for acute procedural pain management: A systematic review and meta-analysis
Evelyn Chan, Samantha Foster , Ryan Sambell , Paul Leong
Evelyn Chan, Samantha Foster , Ryan Sambell , Paul Leong
There is no comprehensive, high-quality systematic review that specifically assesses the efficacy of virtual reality on acutely painful healthcare interventions, nor has there been any quantitative data synthesis on this topic. We therefore conducted a sy
There is no comprehensive, high-quality systematic review that specifically assesses the efficacy of virtual reality on acutely painful healthcare interventions, nor has there been any quantitative data synthesis on this topic. We therefore conducted a sy
Systematic Review: Sweet Solutions to Reduce Procedural Pain in Neonates: AMeta-analysis
Denise Harrison,Catherine Larocque,Mariana Bueno,Yehudis Stokes,Lucy Turner,Brian Hutton,Bonnie Stevens
Denise Harrison,Catherine Larocque,Mariana Bueno,Yehudis Stokes,Lucy Turner,B...
Objective: To review all trials evaluating sweet solutions for analgesia in neonates and to conduct cumulative meta-analyses (CMAs) on behavioral pain outcomes.
Objective: To review all trials evaluating sweet solutions for analgesia in neonates and to conduct cumulative meta-analyses (CMAs) on behavioral pain outcomes.
Cochrane Systematic Review: Breastfeeding for procedural pain in infants beyond the neonatal period
Harrison D, Reszel J, Bueno M, et al.
Harrison D, Reszel J, Bueno M, et al.
Objectives:To determine the effect of breastfeeding on procedural pain in infants beyond the neonatal period (first 28 days of life) up to one year of age compared to no intervention, placebo, parental holding, skin-to-skin contact, expressed breast milk,
Objectives:To determine the effect of breastfeeding on procedural pain in infants beyond the neonatal period (first 28 days of life) up to one year of age compared to no intervention, placebo, parental holding, skin-to-skin contact, expressed breast milk,
Cochrane Systematic Review: Nonpharmacological management of infant and young child procedural pain
Pillai RiddellRR, RacineNM, GennisHG, TurcotteK, UmanLS, HortonRE, Ahola KohutS, Hillgrove StuartJ, StevensB, LisiDM
Pillai RiddellRR, RacineNM, GennisHG, TurcotteK, UmanLS, HortonRE, Ahola Kohu...
Objectives: To assess the efficacy of non-pharmacological interventions for infant and child (up to three years) acute pain, excluding breastmilk, sucrose, and music. Analyses accounted for infant age (preterm, neonate, older) and pain response (pain reac
Objectives: To assess the efficacy of non-pharmacological interventions for infant and child (up to three years) acute pain, excluding breastmilk, sucrose, and music. Analyses accounted for infant age (preterm, neonate, older) and pain response (pain reac
Systematic Review: The effectiveness of virtual reality distraction for pain reduction:a systematic review
Kevin M Malloy , Leonard S Milling
Kevin M Malloy , Leonard S Milling
This article provides a comprehensive review of controlled research on the effectiveness of virtual reality (VR) distraction for reducing pain.
This article provides a comprehensive review of controlled research on the effectiveness of virtual reality (VR) distraction for reducing pain.
Efficacy of the Buzzy Device for Pain Management During Needle-related Procedures: A Systematic Review and Meta-Analysis
Ballard A, Khadra C, Adler S, Trottier ED, Le May S.
Ballard A, Khadra C, Adler S, Trottier ED, Le May S.
Objective:This systematic review and meta-analysis examined the effectiveness of the Buzzy device combining cold and vibration for needle-related procedural pain in children.
Objective:This systematic review and meta-analysis examined the effectiveness of the Buzzy device combining cold and vibration for needle-related procedural pain in children.
The role of inhaled methoxyflurane in acute pain management
Porter KM, Dayan AD, Dickerson S, Middleton PM.
Porter KM, Dayan AD, Dickerson S, Middleton PM.
Methoxyflurane is an inhaled analgesic administered via a disposable inhaler which has been used in Australia for over 40 years for the management of pain associated with trauma and for medical procedures in children and adults. Now available in 16 countr
Methoxyflurane is an inhaled analgesic administered via a disposable inhaler which has been used in Australia for over 40 years for the management of pain associated with trauma and for medical procedures in children and adults. Now available in 16 countr
Cochrane Systematic Review: Corticosteroids as standalone or add-on treatment for sore throat
Hayward G, Thompson MJ, Perera R, Glasziou PP, Del Mar CB, Heneghan CJ.
Hayward G, Thompson MJ, Perera R, Glasziou PP, Del Mar CB, Heneghan CJ.
Objectives: To assess the clinical benefit and safety of corticosteroids for symptoms of sore throat in adults and children.
Objectives: To assess the clinical benefit and safety of corticosteroids for symptoms of sore throat in adults and children.
Cochrane Systematic Review: Once or twice daily versus three times daily amoxicillin with or without clavulanate for the treatment of acute otitis media
Thanaviratananich S, Laopaiboon M, Vatanasapt P.
Thanaviratananich S, Laopaiboon M, Vatanasapt P.
Objectives: To compare the effectiveness of one or two daily doses with three or four daily doses of amoxicillin, with or without clavulanate, for the treatment of AOM in children; and to compare complication rates and adverse reactions.
Objectives: To compare the effectiveness of one or two daily doses with three or four daily doses of amoxicillin, with or without clavulanate, for the treatment of AOM in children; and to compare complication rates and adverse reactions.
Cochrane Systematic Review: Symptomatic treatment of the cough in whooping cough
Bettiol S, Wang K, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A.
Bettiol S, Wang K, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A.
Objectives: To assess the effectiveness and safety of interventions to reduce the severity of paroxysmal cough in whooping cough in children and adults.
Objectives: To assess the effectiveness and safety of interventions to reduce the severity of paroxysmal cough in whooping cough in children and adults.
Cochrane Systematic Review: Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age
Haider BA, Lassi ZS, Ahmed A, Bhutta ZA.
Haider BA, Lassi ZS, Ahmed A, Bhutta ZA.
Objectives: To evaluate zinc supplementation, as an adjunct to antibiotics, in the treatment (clinical recovery) of pneumonia in children aged two to 59 months.
Objectives: To evaluate zinc supplementation, as an adjunct to antibiotics, in the treatment (clinical recovery) of pneumonia in children aged two to 59 months.
Cochrane Systematic Review: Combined inhaled anticholinergics and beta2-agonists for initial treatment of acute asthma in children
Griffiths B, Ducharme FM.
Griffiths B, Ducharme FM.
Objectives: To determine whether the addition of inhaled anticholinergics to SABAs provides clinical improvement and affects the incidence of adverse effects in children with acute asthma exacerbations.
Objectives: To determine whether the addition of inhaled anticholinergics to SABAs provides clinical improvement and affects the incidence of adverse effects in children with acute asthma exacerbations.
Cochrane Systematic Review: Early emergency department treatment of acute asthma with systemic corticosteroids
Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW.
Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW.
Objectives: To determine the benefit of treating patients with acute asthma with systemic corticosteroids within an hour of presenting to the emergency department (ED).
Objectives: To determine the benefit of treating patients with acute asthma with systemic corticosteroids within an hour of presenting to the emergency department (ED).
Cochrane Systematic Review: Early use of inhaled corticosteroids in the emergency department treatment of acute asthma
Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH.
Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH.
Objectives: To determine the benefit of ICS for the treatment of patients with acute asthma managed in the emergency department (ED).
Objectives: To determine the benefit of ICS for the treatment of patients with acute asthma managed in the emergency department (ED).
Cochrane Systematic Review: gastroesophageal reflux treatment for asthma in adults and children
Gibson PG, Henry RL, Coughlan JL.
Gibson PG, Henry RL, Coughlan JL.
Objectives: The objective of this review was to evaluate the effectiveness of treatments for gastroesophageal reflux in terms of their benefit on asthma.
Objectives: The objective of this review was to evaluate the effectiveness of treatments for gastroesophageal reflux in terms of their benefit on asthma.
Cochrane Systematic Review: gastroesophageal reflux treatment for prolonged non-specific cough in children and adults
Chang AB, Lasserson TJ, Gaffney J, Connor FL, Garske LA.
Chang AB, Lasserson TJ, Gaffney J, Connor FL, Garske LA.
Objectives: To evaluate the efficacy of GORD treatment on chronic cough in children and adults with GORD and prolonged cough that is not related to an underlying respiratory disease, i.e. non-specific chronic cough.
Objectives: To evaluate the efficacy of GORD treatment on chronic cough in children and adults with GORD and prolonged cough that is not related to an underlying respiratory disease, i.e. non-specific chronic cough.
Cochrane Systematic Review: Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma
Cates CJ, Welsh EJ, Rowe BH.
Cates CJ, Welsh EJ, Rowe BH.
Objectives: To assess the effects of holding chambers (spacers) compared to nebulisers for the delivery of beta(2)-agonists for acute asthma.
Objectives: To assess the effects of holding chambers (spacers) compared to nebulisers for the delivery of beta(2)-agonists for acute asthma.
Cochrane Systematic Review: Inhaled magnesium sulfate in the treatment of acute asthma
Powell C, Dwan K, Milan SJ, Beasley R, Hughes R, Knopp-Sihota JA, Rowe BH.
Powell C, Dwan K, Milan SJ, Beasley R, Hughes R, Knopp-Sihota JA, Rowe BH.
Objectives: To determine the efficacy of inhaled MgSO(4) administered in acute asthma on pulmonary functions and admission rates.Specific aims: To quantify the effects of inhaled MgSO(4) i) in addition to inhaled (2)-agonist, ii) in comparison to inhaled (2)-agonist alone or iii) in addition to combination treatment with inhaled (2) -agonist and ipratropium bromide.
Objectives: To determine the efficacy of inhaled MgSO(4) administered in acute asthma on pulmonary functions and admission rates.Specific aims: To quantify the effects of inhaled MgSO(4) i) in addition to inhaled (2)-agonist, ii) in comparison to inhaled (2)-agonist alone or iii) in addition to combination treatment with inhaled (2) -agonist and ipratropium bromide.
Cochrane Systematic Review: Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock
Sheikh A, Shehata YA, Brown SG, Simons FE
Sheikh A, Shehata YA, Brown SG, Simons FE
OBJECTIVES: To assess the benefits and harms of adrenaline (epinephrine) in the treatment of anaphylaxis.
OBJECTIVES: To assess the benefits and harms of adrenaline (epinephrine) in the treatment of anaphylaxis.
Cochrane Systematic Review: High-frequency ventilation versus conventional ventilation for treatment of acute lung injury and acute respiratory distress syndrome
Sud S, Sud M, Friedrich JO, Wunsch H, Meade MO, Ferguson ND, Adhikari NK
Sud S, Sud M, Friedrich JO, Wunsch H, Meade MO, Ferguson ND, Adhikari NK
OBJECTIVES: To determine clinical and physiological effects of high frequency oscillation (HFO) in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) compared to conventional ventilation.
OBJECTIVES: To determine clinical and physiological effects of high frequency oscillation (HFO) in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) compared to conventional ventilation.
Cochrane Systematic Review: Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation
Horsley A, Jones AM
Horsley A, Jones AM
OBJECTIVES: To assess the effectiveness and safety of different antibiotic regimens in people with cystic fibrosis experiencing an exacerbation, who are chronically infected with organisms of the Burkholderia cepacia complex.
OBJECTIVES: To assess the effectiveness and safety of different antibiotic regimens in people with cystic fibrosis experiencing an exacerbation, who are chronically infected with organisms of the Burkholderia cepacia complex.
Cochrane Systematic Review: Neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis
Jagannath VA, Asokan GV, Fedorowicz Z, Lee TW
Jagannath VA, Asokan GV, Fedorowicz Z, Lee TW
OBJECTIVES: To assess the effects of neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis.
OBJECTIVES: To assess the effects of neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis.
Cochrane Systematic Review: Pharmacological treatment for Attention Deficit Hyperactivity Disorder (ADHD) in children with comorbid tic disorders
Pringsheim T, Steeves T
Pringsheim T, Steeves T
OBJECTIVES: To assess the effects of pharmacological treatments for ADHD on ADHD symptoms and tic severity in children with ADHD and comorbid tic disorders.
OBJECTIVES: To assess the effects of pharmacological treatments for ADHD on ADHD symptoms and tic severity in children with ADHD and comorbid tic disorders.
Cochrane Systematic Review: Identification of children in the first four years of life for early treatment for otitis media with effusion
Simpson SA, Thomas CL, van der Linden MK, Macmillan H, van der Wouden JC, Butler C
Simpson SA, Thomas CL, van der Linden MK, Macmillan H, van der Wouden JC, Bu...
OBJECTIVES: The aim of this review was to assess evidence from randomised controlled trials about the effect, on language and behavioural outcomes, of screening and treating children with clinically important OME in the first four years of their life. The focus was on the first four years of life because this is the time of most rapid language development. The consequences of hearing loss are likely to be most serious during this time. In addition, children of this age are least likely to be able to report or seek help for impaired hearing, particularly if these problems have a slow onset and are subtle.
OBJECTIVES: The aim of this review was to assess evidence from randomised controlled trials about the effect, on language and behavioural outcomes, of screening and treating children with clinically important OME in the first four years of their life. The focus was on the first four years of life because this is the time of most rapid language development. The consequences of hearing loss are likely to be most serious during this time. In addition, children of this age are least likely to be able to report or seek help for impaired hearing, particularly if these problems have a slow onset and are subtle.
Cochrane Systematic Review: Propofol versus thiopental sodium for the treatment of refractory status epilepticus
Prabhakar H, Bindra A, Singh GP, Kalaivani M. Propofol versus thiopental sodium for the treatment of refractory status epilepticus. Cochrane Database Syst R...
Prabhakar H, Bindra A, Singh GP, Kalaivani M. Propofol versus thiopental sod...
OBJECTIVES: To compare the efficacy, adverse effects, and short- and long-term outcomes of RSE treated with one of the two anaesthetic agents, thiopental sodium or propofol.
OBJECTIVES: To compare the efficacy, adverse effects, and short- and long-term outcomes of RSE treated with one of the two anaesthetic agents, thiopental sodium or propofol.
Cochrane Systematic Review: Treatment of Lennox-Gastaut syndrome
Hancock EC, Cross JH
Hancock EC, Cross JH
OBJECTIVES: To compare the effects of pharmaceutical therapies used to treat LGS in terms of control of seizures and adverse effects. Many people who suffer from this syndrome will already be receiving other antiepileptic medications at the time of their entry into a trial. However, for the purpose of this review we will only consider the effect of the single therapeutic agent being trialled (often as add-on therapy).
OBJECTIVES: To compare the effects of pharmaceutical therapies used to treat LGS in terms of control of seizures and adverse effects. Many people who suffer from this syndrome will already be receiving other antiepileptic medications at the time of their entry into a trial. However, for the purpose of this review we will only consider the effect of the single therapeutic agent being trialled (often as add-on therapy).
Cochrane Systematic Review: Adenosine versus intravenous calcium channel antagonists for the treatment of supraventricular tachycardia in adults
Holdgate A, Foo A
Holdgate A, Foo A
OBJECTIVES: To examine the relative effects of adenosine and calcium channel antagonists and, if possible, to determine which is most appropriate for the management of supraventricular tachycardia.
OBJECTIVES: To examine the relative effects of adenosine and calcium channel antagonists and, if possible, to determine which is most appropriate for the management of supraventricular tachycardia.
Cochrane Systematic Review: Anti-inflammatory treatment for carditis in acute rheumatic fever
Cilliers A, Manyemba J, Adler AJ, Saloojee H
Cilliers A, Manyemba J, Adler AJ, Saloojee H
OBJECTIVES: To assess the effects of anti-inflammatory agents such as aspirin, corticosteroids, immunoglobulin and pentoxifylline for preventing or reducing further heart valve damage in patients with acute rheumatic fever.
OBJECTIVES: To assess the effects of anti-inflammatory agents such as aspirin, corticosteroids, immunoglobulin and pentoxifylline for preventing or reducing further heart valve damage in patients with acute rheumatic fever.
Cochrane Systematic Review: Antibiotic treatment for travellers' diarrhoea
De Bruyn G, Hahn S, Borwick A. Antibiotic treatment for travellers' diarrhoea. Cochrane Database Syst Rev. 2000;(3):CD002242. Review. PubMed PMID: 10908534.
De Bruyn G, Hahn S, Borwick A. Antibiotic treatment for travellers' diarrhoe...
OBJECTIVES: The aims of this review were to assess the effects of antibiotics on traveller's diarrhoea in relation to duration of illness, severity of illness, and adverse effects of medications.
OBJECTIVES: The aims of this review were to assess the effects of antibiotics on traveller's diarrhoea in relation to duration of illness, severity of illness, and adverse effects of medications.
Cochrane Systematic Review: Physical methods versus drug placebo or no treatment for managing fever in children
Meremikwu M, Oyo-Ita A
Meremikwu M, Oyo-Ita A
OBJECTIVES: To evaluate the benefits and harms of physical cooling methods used for managing fever in children.
OBJECTIVES: To evaluate the benefits and harms of physical cooling methods used for managing fever in children.
Cochrane Systematic Review: Treatment of infantile spasms
Hancock EC, Osborne JP, Edwards SW
Hancock EC, Osborne JP, Edwards SW
OBJECTIVES: To compare the effects of single pharmaceutical therapies used to treat infantile spasms in terms of control of the spasms, resolution of the EEG, relapse rates, psychomotor development, subsequent epilepsy, side effects, and mortality.
OBJECTIVES: To compare the effects of single pharmaceutical therapies used to treat infantile spasms in terms of control of the spasms, resolution of the EEG, relapse rates, psychomotor development, subsequent epilepsy, side effects, and mortality.
Cochrane Systematic Review: Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury
Sahuquillo J, Arikan F
Sahuquillo J, Arikan F
OBJECTIVES: To assess the effects of secondary decompressive craniectomy (DC) on outcome and quality of life in patients with severe TBI in whom conventional medical therapeutic measures have failed to control raised ICP.
OBJECTIVES: To assess the effects of secondary decompressive craniectomy (DC) on outcome and quality of life in patients with severe TBI in whom conventional medical therapeutic measures have failed to control raised ICP.
Cochrane Systematic Review: Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia
Simpson E, Lin Y, Stanworth S, Birchall J, Doree C, Hyde C
Simpson E, Lin Y, Stanworth S, Birchall J, Doree C, Hyde C
OBJECTIVES: To assess the effectiveness of rFVIIa when used therapeutically to control active bleeding or prophylactically to prevent (excessive) bleeding in patients without haemophilia.
OBJECTIVES: To assess the effectiveness of rFVIIa when used therapeutically to control active bleeding or prophylactically to prevent (excessive) bleeding in patients without haemophilia.
Cochrane Systematic Review: Treatment of seizures in multiple sclerosis
Koch MW, Polman SK, Uyttenboogaart M, De Keyser J
Koch MW, Polman SK, Uyttenboogaart M, De Keyser J
OBJECTIVES: To evaluate the efficacy and safety of antiepileptic treatments in patients with MS.
OBJECTIVES: To evaluate the efficacy and safety of antiepileptic treatments in patients with MS.
Cochrane Systematic Review: Medical treatment for botulism
Chalk CH, Benstead TJ, Keezer M
Chalk CH, Benstead TJ, Keezer M
OBJECTIVES: To assess the effects of medical treatments on mortality, duration of hospitalization, mechanical ventilation, tube or parenteral feeding and risk of adverse events in botulism.
OBJECTIVES: To assess the effects of medical treatments on mortality, duration of hospitalization, mechanical ventilation, tube or parenteral feeding and risk of adverse events in botulism.
Cochrane Systematic Review: Salicylate for the treatment of Kawasaki disease in children
Baumer JH, Love SJ, Gupta A, Haines LC, Maconochie I, Dua JS
Baumer JH, Love SJ, Gupta A, Haines LC, Maconochie I, Dua JS
OBJECTIVES: The objective of this review was to evaluate the effectiveness of salicylate in treating and preventing cardiac consequences of Kawasaki disease in children.
OBJECTIVES: The objective of this review was to evaluate the effectiveness of salicylate in treating and preventing cardiac consequences of Kawasaki disease in children.
Cochrane Systematic Review: Non-corticosteroid treatment for nephrotic syndrome in children
Pravitsitthikul N, Willis NS, Hodson EM, Craig JC
Pravitsitthikul N, Willis NS, Hodson EM, Craig JC
OBJECTIVES: To evaluate the benefits and harms of non-corticosteroid immunosuppressive medications in relapsing SSNS in children.
OBJECTIVES: To evaluate the benefits and harms of non-corticosteroid immunosuppressive medications in relapsing SSNS in children.
Cochrane Systematic Review: Treatment for lupus nephritis
Henderson L, Masson P, Craig JC, Flanc RS, Roberts MA, Strippoli GF, Webster AC
Henderson L, Masson P, Craig JC, Flanc RS, Roberts MA, Strippoli GF, Webster AC
OBJECTIVES: To assess the benefits and harms of different immunosuppressive treatments in biopsy-proven proliferative lupus nephritis.
OBJECTIVES: To assess the benefits and harms of different immunosuppressive treatments in biopsy-proven proliferative lupus nephritis.
Cochrane Systematic Review: Cisapride treatment for gastroesophageal reflux in children
Maclennan S, Augood C, Cash-Gibson L, Logan S, Gilbert RE. Cisapride treatment for gastroesophageal reflux in children. Cochrane Database Syst Rev. 2010 Apr...
Maclennan S, Augood C, Cash-Gibson L, Logan S, Gilbert RE. Cisapride treatme...
OBJECTIVES: To determine the effectiveness of cisapride versus placebo or non-surgical treatments for symptoms of GOR.
OBJECTIVES: To determine the effectiveness of cisapride versus placebo or non-surgical treatments for symptoms of GOR.
Cochrane Systematic Review: Honey as a topical treatment for wounds
Jull AB, Walker N, Deshpande S
Jull AB, Walker N, Deshpande S
OBJECTIVES: The objective was to determine whether honey increases the rate of healing in acute wounds (e.g. burns, lacerations) and chronic wounds (e.g. skin ulcers, infected surgical wounds).
OBJECTIVES: The objective was to determine whether honey increases the rate of healing in acute wounds (e.g. burns, lacerations) and chronic wounds (e.g. skin ulcers, infected surgical wounds).
Cochrane Systematic Review: Topical treatment for facial burns
Hoogewerf CJ, Van Baar ME, Hop MJ, Nieuwenhuis MK, Oen IM, Middelkoop E
Hoogewerf CJ, Van Baar ME, Hop MJ, Nieuwenhuis MK, Oen IM, Middelkoop E
OBJECTIVES: To assess the effects of topical interventions on wound healing in people with facial burns of any depth.
OBJECTIVES: To assess the effects of topical interventions on wound healing in people with facial burns of any depth.
Cochrane Systematic Review: Pharmacological treatment other than corticosteroids, intravenous immunoglobulin and plasma exchange for Guillain-Barr syndrome
Hughes RA, Pritchard J, Hadden RD
Hughes RA, Pritchard J, Hadden RD
OBJECTIVES: To review systematically the evidence from randomised controlled trials (RCTs) for pharmacological agents other than plasma exchange, intravenous immunoglobulin and corticosteroids.
OBJECTIVES: To review systematically the evidence from randomised controlled trials (RCTs) for pharmacological agents other than plasma exchange, intravenous immunoglobulin and corticosteroids.
Systematic Review: Is There A Role for Pre-, Pro- and Synbiotics in the Treatment of Functional Constipation in Children?
Koppen IJ, Benninga MA, Tabbers MM
Koppen IJ, Benninga MA, Tabbers MM
The objective of this systematic review was to investigate the efficacy and safety of pre-, pro- and synbiotics in the treatment of pediatric functional constipation.
The objective of this systematic review was to investigate the efficacy and safety of pre-, pro- and synbiotics in the treatment of pediatric functional constipation.
Review: Irritable Bowel Syndrome in Children: Pathogenesis, Diagnosis and Evidence-Based Treatment
Sandhu BK, Paul SP
Sandhu BK, Paul SP
This review covers the description, etiology, diagnosis and management of irritable bowel syndrome in children.
This review covers the description, etiology, diagnosis and management of irritable bowel syndrome in children.
Systematic Review: Currently recommended treatments of childhood constipation are not evidence based: a systematic literature review on the effect of laxative treatment and dietary measures
Pijpers MA, Tabbers MM, Benninga MA, Berger MY
Pijpers MA, Tabbers MM, Benninga MA, Berger MY
The objective of this systematic review was to investigate and summarise the quantity and quality of the current evidence for the effect of laxatives and dietary measures on functional childhood constipation.
The objective of this systematic review was to investigate and summarise the quantity and quality of the current evidence for the effect of laxatives and dietary measures on functional childhood constipation.
Systematic Review: Rest and treatment/rehabilitation following sport-related concussion: a systematic review
Schneider KJ, Leddy JJ, Guskiewicz KM, Seifert T, McCrea M, Silverberg ND, Feddermann-Demont N, Iverson GL, Hayden A, Makdissi M
Schneider KJ, Leddy JJ, Guskiewicz KM, Seifert T, McCrea M, Silverberg ND, Fe...
The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC).
The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC).
Systematic Review: Age- and severity-adjusted treatment of proximal humerus fractures in children and adolescents-A systematical review and meta-analysis
Hohloch L, Eberbach H, Wagner FC, Strohm PC, Reising K, Sdkamp NP, Zwingmann J
Hohloch L, Eberbach H, Wagner FC, Strohm PC, Reising K, Sdkamp NP, Zwingmann J
The aim of this systematic review was to gather the best evidence of different treatment methods and their associated functional outcome, complication rates, rates of limb length discrepancies and radiological outcome for proximal humerus fractures in children and adolescents.
The aim of this systematic review was to gather the best evidence of different treatment methods and their associated functional outcome, complication rates, rates of limb length discrepancies and radiological outcome for proximal humerus fractures in children and adolescents.
Systematic Review: Plate Fixation Versus Nonoperative Treatment for Displaced Midshaft Clavicular Fractures: A Meta-Analysis of Randomized Controlled Trials
Woltz S, Krijnen P, Schipper IB
Woltz S, Krijnen P, Schipper IB
The aim was to analyze whether patients with a displaced midshaft clavicular fracture are best managed with plate fization or nonoperative treatment with respect to nonunion, secondary operations, and functional outcome, by evaluating all available randomized controlled trials on this subject.
The aim was to analyze whether patients with a displaced midshaft clavicular fracture are best managed with plate fization or nonoperative treatment with respect to nonunion, secondary operations, and functional outcome, by evaluating all available randomized controlled trials on this subject.
Systematic Review: Outcomes of Nonoperative Treatment of Salter-Harris II Distal Radius Fractures: A Systematic Review
Larsen MC, Bohm KC, Rizkala AR, Ward CM
Larsen MC, Bohm KC, Rizkala AR, Ward CM
This systematic review was conducted of studies examining the radiographic and clinical outcomes of nonoperatively managed SH II distal radius fractures.
This systematic review was conducted of studies examining the radiographic and clinical outcomes of nonoperatively managed SH II distal radius fractures.
Review: Pediatric and Adolescent Forearm Fractures: Current Controversies and Treatment Recommendations
Pace JL
Pace JL
Pediatric and adolescent forearm fractures continue to present treatment challenges. Despite high-level evidence to the contrary, traditional guidelines for nonsurgical treatment have been challenged in favor of surgical intervention, but it is unclear if this results in improved outcomes. Recent evidence suggests that certain open fractures in children may be successfully treated nonsurgically. Good results have been achieved with closed reduction and appropriate casting and clinical follow-up. Further research investigating functional outcomes into adulthood is needed
Pediatric and adolescent forearm fractures continue to present treatment challenges. Despite high-level evidence to the contrary, traditional guidelines for nonsurgical treatment have been challenged in favor of surgical intervention, but it is unclear if this results in improved outcomes. Recent evidence suggests that certain open fractures in children may be successfully treated nonsurgically. Good results have been achieved with closed reduction and appropriate casting and clinical follow-up. Further research investigating functional outcomes into adulthood is needed
Systematic Review: The treatment of displaced supracondylar humerus fractures: evidence-based guideline
Mulpuri K, Wilkins K
Mulpuri K, Wilkins K
The purpose of this paper is to summarize and highlight the major findings from the systematic review that developed a clinical practice guideline from the American Academy of Orthopaedic Surgeons regarding treatment for type III supracondylar fractures.
The purpose of this paper is to summarize and highlight the major findings from the systematic review that developed a clinical practice guideline from the American Academy of Orthopaedic Surgeons regarding treatment for type III supracondylar fractures.
Systematic Review: Comparative Effectiveness of Imaging Modalities for the Diagnosis and Treatment of Intussusception: A Critically Appraised Topic
Carroll AG, Kavanagh RG, Ni Leidhin C, Cullinan NM, Lavelle LP, Malone DE
Carroll AG, Kavanagh RG, Ni Leidhin C, Cullinan NM, Lavelle LP, Malone DE
The purpose of this study was to critically appraise and compare the diagnostic performance of imaging modalities that are used for the diagnosis of intussusception and methods used in the treatment of ileocolic intussusception.
The purpose of this study was to critically appraise and compare the diagnostic performance of imaging modalities that are used for the diagnosis of intussusception and methods used in the treatment of ileocolic intussusception.
Review: Lyme disease: clinical diagnosis and treatment
Hatchette TF, Davis I, Johnston BL
Hatchette TF, Davis I, Johnston BL
Objective: To review the clinical diagnosis and treatment of Lyme disease for front-line clinicians.
Objective: To review the clinical diagnosis and treatment of Lyme disease for front-line clinicians.
Review: Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department
Dorsett M, Liang SY
Dorsett M, Liang SY
Objective: This review discusses the clinical signs and symptoms that should lead emergency physicians to consider CNS infection, paying particular attention to the sensitivity and specificity of different clinical findings at the bedside. Subsequently, the diagnostic workup and management of patients for whom there is high clinical suspicion for CNS infection is discussed.
Objective: This review discusses the clinical signs and symptoms that should lead emergency physicians to consider CNS infection, paying particular attention to the sensitivity and specificity of different clinical findings at the bedside. Subsequently, the diagnostic workup and management of patients for whom there is high clinical suspicion for CNS infection is discussed.
Review: Treatment of herpes simplex virus infections in pediatric patients: current status and future needs
James SH, Whitley RJ
James SH, Whitley RJ
Objective: To present an overview of the major clinical manifestations of HSV infections in the pediatric population.
Objective: To present an overview of the major clinical manifestations of HSV infections in the pediatric population.
Systematic Review: Suicide in the pediatric population: screening, risk assessment and treatment
Cwik MF, O'Keefe VM, Haroz EE
Cwik MF, O'Keefe VM, Haroz EE
Objective: to synthesise the literature on paediatric suicide screening, risk assessment and treatment to inform clinical practice and suicide prevention efforts.
Objective: to synthesise the literature on paediatric suicide screening, risk assessment and treatment to inform clinical practice and suicide prevention efforts.
Systematic Review: When Poorly Conducted Systematic Reviews and Meta-analyses can Mislead: a critical appraisal and update of systematic reviews and meta-analyses examining the effects of probiotics in the treatment of functional constipation in children
Harris RG,Neale EP,Ferreira I
Harris RG,Neale EP,Ferreira I
The aim of this study was to critically review and update the evidence in this field by mapping all the steps involved against those reported in previous reviews, in an attempt to understand the nature of their conflicting results.
The aim of this study was to critically review and update the evidence in this field by mapping all the steps involved against those reported in previous reviews, in an attempt to understand the nature of their conflicting results.
Systematic Review: The Role of Fiber in the Treatment of Functional Gastrointestinal Disorders in Children
Cara Hannah Axelrod,Miguel Saps
Cara Hannah Axelrod,Miguel Saps
We reviewed the available evidence on the role of fiber in the treatment of Functional Constipation (FC) and Irritable Bowel Syndrome (IBS) in children.
We reviewed the available evidence on the role of fiber in the treatment of Functional Constipation (FC) and Irritable Bowel Syndrome (IBS) in children.
Fluid treatment for children with diabetic ketoacidosis: How do the results of the pediatric emergency care applied research network Fluid Therapies Under Investigation in Diabetic Ketoacidosis (FLUID) Trial change our perspective?
Glaser N, Kuppermann N.
Glaser N, Kuppermann N.
The optimal fluid treatment protocol for children with diabetic ketoacidosis (DKA) has long been a subject of controversy. Until recently, there was no high-quality evidence from randomized clinical trials to support an optimal guideline, and recommendations were mainly based on theoretical considerations. As a consequence, fluid treatment protocols for children with DKA vary between institutions (and countries). In June 2018, the results from the Fluid Therapies Under Investigation in DKA Trial conducted in the Pediatric Emergency Care Applied Research Network were published. This large, factorial-designed randomized controlled trial assessed neurological outcomes of 1387 children with DKA who were treated with one of four fluid protocols that varied in infusion rate and sodium content. In this commentary, we review and discuss the results of this new study and the implications for clinical care of DKA in children.
The optimal fluid treatment protocol for children with diabetic ketoacidosis (DKA) has long been a subject of controversy. Until recently, there was no high-quality evidence from randomized clinical trials to support an optimal guideline, and recommendations were mainly based on theoretical considerations. As a consequence, fluid treatment protocols for children with DKA vary between institutions (and countries). In June 2018, the results from the Fluid Therapies Under Investigation in DKA Trial conducted in the Pediatric Emergency Care Applied Research Network were published. This large, factorial-designed randomized controlled trial assessed neurological outcomes of 1387 children with DKA who were treated with one of four fluid protocols that varied in infusion rate and sodium content. In this commentary, we review and discuss the results of this new study and the implications for clinical care of DKA in children.
Key Study: Extremity fracture pain after emergency department reduction and casting: predictors of pain after discharge
Thompson, RW, Krauss, B, Kim, YJ, Monuteaux, MC, Zerriny, S, & Lee, LK
Thompson, RW, Krauss, B, Kim, YJ, Monuteaux, MC, Zerriny, S, & Lee, LK
Objectives: To determine the prevalence of pediatric extremity fracture pain after emergency department (ED) discharge, compare pain severity between fractures requiring simple casting versus sedated reduction and casting, and explore predictors of postdischarge pain.
Objectives: To determine the prevalence of pediatric extremity fracture pain after emergency department (ED) discharge, compare pain severity between fractures requiring simple casting versus sedated reduction and casting, and explore predictors of postdischarge pain.
Key Study: Polyethylene Glycol Maintenance Treatment for Childhood Functional Constipation: A Randomized,Placebo-controlled Trial
Modin L,Walsted AM,Dalby K,Jakobsen MS
Modin L,Walsted AM,Dalby K,Jakobsen MS
The aim of this study was to investigate the long-term efficacy of polyethylene glycol (PEG) during maintenance treatment of childhood functional constipation (FC) in a randomized, double-blinded, placebo-controlled trial.
The aim of this study was to investigate the long-term efficacy of polyethylene glycol (PEG) during maintenance treatment of childhood functional constipation (FC) in a randomized, double-blinded, placebo-controlled trial.
Key study: Optimising pain management in children with acute otitis media through a primary care-based multifaceted educational intervention: study protocol for a cluster randomised controlled trial
van Uum RT, Venekamp RP, Sjoukes A, van de Pol AC, de Wit GA, Schilder AGM, Damoiseaux RAMJ,
van Uum RT, Venekamp RP, Sjoukes A, van de Pol AC, de Wit GA, Schilder AGM, D...
Objective: We have developed a primary care-based multifaceted educational intervention to optimise pain management in children with AOM, and we trial its clinical and cost effectiveness.
Objective: We have developed a primary care-based multifaceted educational intervention to optimise pain management in children with AOM, and we trial its clinical and cost effectiveness.
Key Study: Reducing Time to Pain Medication Administration for Pediatric Patients with Long Bone Fractures in the Emergency Department
Schuman, S S, Regen, R B, Stuart, L H, Harrell, C, Jones, T L, Stewart, B M, Berg, A M, Longjohn, M and Kink, R J
Schuman, S S, Regen, R B, Stuart, L H, Harrell, C, Jones, T L, Stewart, B M, ...
The purpose of this quality improvement project was to develop a protocol with the goal to administer pain medication to children presenting with suspected long bone fractures 47 minutes of emergency department arrival.
The purpose of this quality improvement project was to develop a protocol with the goal to administer pain medication to children presenting with suspected long bone fractures 47 minutes of emergency department arrival.
Key Study: Expedited Delivery of Pain Medication for Long-Bone Fractures Using an Intranasal Fentanyl Clinical Pathway
Schacherer, N M, Erikson Ramirez, D, Frazier, S B and Perkins, A M
Schacherer, N M, Erikson Ramirez, D, Frazier, S B and Perkins, A M
This study aims to determine whether a pathway designed to facilitate the use of intranasal (IN) fentanyl for long-bone fractures will expedite the delivery of pain medication, decrease the total length of emergency department (ED) stay, and provide faster analgesia compared with intravenous (IV) morphine.
This study aims to determine whether a pathway designed to facilitate the use of intranasal (IN) fentanyl for long-bone fractures will expedite the delivery of pain medication, decrease the total length of emergency department (ED) stay, and provide faster analgesia compared with intravenous (IV) morphine.
Key Study: A RCT of a Combination of Analgesics for Pain Management in Children With a Suspected Fracture
Alam Khan, T, Jamil Khattak, Y, Awais, M, Alam Khan, A, Husen, Y, Nadeem, N and Rehman, A
Alam Khan, T, Jamil Khattak, Y, Awais, M, Alam Khan, A, Husen, Y, Nadeem, N a...
To assess the utility of trauma series radiographs in the management of alert pediatric patients with traumatic injury and to ascertain whether it is necessary to acquire the entire trauma series in these children.
To assess the utility of trauma series radiographs in the management of alert pediatric patients with traumatic injury and to ascertain whether it is necessary to acquire the entire trauma series in these children.
Key Study: A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma
Clark, E, Plint, AC, Correll, R, et al
Clark, E, Plint, AC, Correll, R, et al
To determine which of 3 analgesics, acetaminophen, ibuprofen, or codeine, given as a single dose, provides the most efficacious analgesia for children presenting to the emergency department with pain from acute musculoskeletal injuries.
To determine which of 3 analgesics, acetaminophen, ibuprofen, or codeine, given as a single dose, provides the most efficacious analgesia for children presenting to the emergency department with pain from acute musculoskeletal injuries.
Key Study: A Randomized Clinical Trial of Jet-Injected Lidocaine to Reduce Venipuncture Pain for Young Children
Lunoe MM, Drendel AL, Levas MN, Weisman SJ, Dasgupta M, Hoffmann RG, Brousseau DC
Lunoe MM, Drendel AL, Levas MN, Weisman SJ, Dasgupta M, Hoffmann RG, Broussea...
Study Objective: The J-Tip (National Medical Products Inc, Irvine, CA) uses air instead of a needle to push lidocaine into the skin. To our knowledge, no studies have investigated its use for venipuncture in young children. We determine whether the J-Tip
Study Objective: The J-Tip (National Medical Products Inc, Irvine, CA) uses air instead of a needle to push lidocaine into the skin. To our knowledge, no studies have investigated its use for venipuncture in young children. We determine whether the J-Tip
Key Study: Music to reduce pain and distress in the pediatric emergency department: a randomized clinical trial
Hartling L, Newton AS, Liang Y, Jou H, Hewson K, Klassen TP, Curtis S
Hartling L, Newton AS, Liang Y, Jou H, Hewson K, Klassen TP, Curtis S
Objective: To compare music with standard care to manage pain and distress.
Objective: To compare music with standard care to manage pain and distress.
Key Study: Outpatient treatment of moderate croup with dexamethasone: intramuscular versus oral dosing
Rittichier, KK, Ledwith, CA,
Rittichier, KK, Ledwith, CA,
Objective: Steroid use for the treatment of croup has been supported by several studies, although few have addressed the use of oral dexamethasone for outpatient management. The efficacy of oral (PO) versus intramuscular (IM) dosing of dexamethasone in the outpatient treatment of moderate croup are compared in this study.
Objective: Steroid use for the treatment of croup has been supported by several studies, although few have addressed the use of oral dexamethasone for outpatient management. The efficacy of oral (PO) versus intramuscular (IM) dosing of dexamethasone in the outpatient treatment of moderate croup are compared in this study.
Key Study: Nebulized budesonide and oral dexamethasone for treatment of croup: a randomized controlled trial
Klassen, TP, Craig, WR, Moher, D, Osmond, MH, Pasterkamp, H, Sutcliffe, T, Watters, LK, Rowe, PC,
Klassen, TP, Craig, WR, Moher, D, Osmond, MH, Pasterkamp, H, Sutcliffe, T, Wa...
Objective: To determine the effectiveness of 3 glucocorticoid regimens in patients with croup.
Objective: To determine the effectiveness of 3 glucocorticoid regimens in patients with croup.
Key Study: Early goal-directed therapy in the treatment of severe sepsis and septic shock (2001)
Rivers EN, B.; Havstad, S.; Ressler, J.; Muzzin, A.; Knoblich, B.; Peterson, E.; Tomlanovich, M.
Rivers EN, B.; Havstad, S.; Ressler, J.; Muzzin, A.; Knoblich, B.; Peterson, ...
Background: Goal-directed therapy has been used for severe sepsis and septic shock in the intensive care unit. This approach involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with oxygen demand. The purpose of this study was to evaluate the efficacy of early goal-directed therapy before admission to the intensive care unit. Published: 2001.
Background: Goal-directed therapy has been used for severe sepsis and septic shock in the intensive care unit. This approach involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with oxygen demand. The purpose of this study was to evaluate the efficacy of early goal-directed therapy before admission to the intensive care unit. Published: 2001.
Key Study: Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease
Kramer HH, Sommer M, Rammos S, Krogmann O
Kramer HH, Sommer M, Rammos S, Krogmann O
This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).
This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).
Key study: Treatment of acute otitis media in children under 2 years of age
Hoberman A, Paradise JL, Rockette HE, Shaikh N, Wald ER, Kearney DH, Colborn DK, Kurs-Lasky M, Bhatnagar S, Haralam MA, Zoffel LM, Jenkins C, Pope MA, Balent...
Hoberman A, Paradise JL, Rockette HE, Shaikh N, Wald ER, Kearney DH, Colborn ...
Objective: We undertook this clinical trial to determine the extent to which antimicrobial treatment affects the course of both symptoms and signs of acute otitis media, irrespective of the apparent severity of the disease, among children 6 to 23 months of age in whom the diagnosis of acute otitis media is quite certain.
Objective: We undertook this clinical trial to determine the extent to which antimicrobial treatment affects the course of both symptoms and signs of acute otitis media, irrespective of the apparent severity of the disease, among children 6 to 23 months of age in whom the diagnosis of acute otitis media is quite certain.
Key study: A placebo-controlled trial of antimicrobial treatment for acute otitis media
Thtinen PA, Laine MK, Huovinen P, Jalava J, Ruuskanen O, Ruohola A
Thtinen PA, Laine MK, Huovinen P, Jalava J, Ruuskanen O, Ruohola A
Objective: We conducted a randomized, double-blind, placebo-controlled study of the efficacy of antimicrobial therapy in the age group with the highest incidence of acute otitis media. Our aim was to assess the efficacy of antimicrobial treatment for acute otitis media when strict diagnostic criteria are used and the antimicrobial coverage and dosage of the active treatment are adequate.
Objective: We conducted a randomized, double-blind, placebo-controlled study of the efficacy of antimicrobial therapy in the age group with the highest incidence of acute otitis media. Our aim was to assess the efficacy of antimicrobial treatment for acute otitis media when strict diagnostic criteria are used and the antimicrobial coverage and dosage of the active treatment are adequate.
Key Study: Injury treatment among children with autism or pervasive developmental disorder
McDermott S, Zhou L, Mann J
McDermott S, Zhou L, Mann J
This study examined the difference in the frequency and type of injury for children with autism and pervasive developmental disorder compared with typically developing peers.
This study examined the difference in the frequency and type of injury for children with autism and pervasive developmental disorder compared with typically developing peers.
Key Study: Comparison of Polyethylene Glycol-Electrolyte Solution vs Polyethylene Glycol-3350 for the Treatment of Fecal Impaction in Pediatric Patients
Boles EE, Gaines CL, Tillman EM
Boles EE, Gaines CL, Tillman EM
The objective of this study was to evaluate the safety and efficacy of polyethylene glycol-electrolyte solution vs polyethylene glycol-3350 for the treatment of fecal impaction in pediatric patients.
The objective of this study was to evaluate the safety and efficacy of polyethylene glycol-electrolyte solution vs polyethylene glycol-3350 for the treatment of fecal impaction in pediatric patients.
Key Study: Polyethylene glycol 4000 for treatment of functional constipation in children
Dziechciarz P, Horvath A, Szajewska H
Dziechciarz P, Horvath A, Szajewska H
The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children.
The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children.
Key Study: Pediatric constipation in the emergency department: evaluation, treatment, and outcomes
Freedman SB, Thull-Freedman J, Rumantir M, Eltorki M, Schuh S
Freedman SB, Thull-Freedman J, Rumantir M, Eltorki M, Schuh S
The primary objective of this study was to determine whether enema administration is associated with 7-day emergency department (ED) revisits for persistent symptoms of pediatric constipation. Secondary objectives focused on assessing other predictors of ED revisits.
The primary objective of this study was to determine whether enema administration is associated with 7-day emergency department (ED) revisits for persistent symptoms of pediatric constipation. Secondary objectives focused on assessing other predictors of ED revisits.
Key Study: Safety and efficacy of milk and molasses enemas compared with sodium phosphate enemas for the treatment of constipation in a pediatric emergency department
Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J
Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J
The purpose of this study was to determine the safety and efficacy of routine milk and molasses enemas (MME) compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department (ED). A secondary objective included the identification of factors associated with enema selection in the pediatric ED.
The purpose of this study was to determine the safety and efficacy of routine milk and molasses enemas (MME) compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department (ED). A secondary objective included the identification of factors associated with enema selection in the pediatric ED.
Key Study: Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG
Bekkali NL, van den Berg MM, Dijkgraaf MG, van Wijk MP, Bongers ME, Liem O, Benninga MA
Bekkali NL, van den Berg MM, Dijkgraaf MG, van Wijk MP, Bongers ME, Liem O, B...
This study tested the hypothesis that enemas and polyethylene glycol (PEG) would be equally effective in treating rectal fecal impaction (RFI) but enemas would be less well tolerated and colonic transit time (CTT) would improve during disimpaction.
This study tested the hypothesis that enemas and polyethylene glycol (PEG) would be equally effective in treating rectal fecal impaction (RFI) but enemas would be less well tolerated and colonic transit time (CTT) would improve during disimpaction.
Key Study: PEG3350 in the treatment of childhood constipation: a multicenter, double-blinded, placebo-controlled trial
Nurko S, Youssef NN, Sabri M, Langseder A, McGowan J, Cleveland M, Di Lorenzo C
Nurko S, Youssef NN, Sabri M, Langseder A, McGowan J, Cleveland M, Di Lorenzo C
This study aimed to establish the efficacy and best starting dose of polyethylene glycol (PEG)3350 in the short-term treatment of children with functional constipation.
This study aimed to establish the efficacy and best starting dose of polyethylene glycol (PEG)3350 in the short-term treatment of children with functional constipation.
Key Study: Reducing resource utilization during non-operative treatment of pediatric proximal humerus fractures
Gladstein AZ, Schade AT, Howard AW, Camp MW
Gladstein AZ, Schade AT, Howard AW, Camp MW
The primary outcome of the study was the proportion of proximal humerus fractures, initially treated non-operatively, for which displacement or angulation on follow-up radiographs led to a change to operative treatment.
The primary outcome of the study was the proportion of proximal humerus fractures, initially treated non-operatively, for which displacement or angulation on follow-up radiographs led to a change to operative treatment.
Key Study: Functional outcomes following non-operative versus operative treatment of clavicle fractures in adolescents
Herzog MM, Whitesell RC, Mac LM, Jackson ML, Culotta BA, Axelrod JR, Busch MT, Willimon SC
Herzog MM, Whitesell RC, Mac LM, Jackson ML, Culotta BA, Axelrod JR, Busch MT...
This study aimed to assess shoulder function in adolescents following shortened clavicle fracture and compare operative versus non-operative treatment.
This study aimed to assess shoulder function in adolescents following shortened clavicle fracture and compare operative versus non-operative treatment.
Key Study: Emerging U.S. National Trends in the Treatment of Pediatric Supracondylar Humeral Fractures
Holt JB, Glass NA, Bedard NA, Weinstein SL, Shah AS
Holt JB, Glass NA, Bedard NA, Weinstein SL, Shah AS
Understanding national treatment trends will provide important insight into variations in regional treatment standards and help identify areas for improvement in value in care delivery.
Understanding national treatment trends will provide important insight into variations in regional treatment standards and help identify areas for improvement in value in care delivery.
Key Study: Capitellar Fractures in Children and Adolescents: Classification and Early Results of Treatment
Murthy PG, Vuillermin C, Naqvi MN, Waters PM, Bae DS
Murthy PG, Vuillermin C, Naqvi MN, Waters PM, Bae DS
The purpose of this investigation was to characterize capitellar fracture patterns in children and adolescents and to assess early clinical and radiographic treatment outcomes.
The purpose of this investigation was to characterize capitellar fracture patterns in children and adolescents and to assess early clinical and radiographic treatment outcomes.
Key Study: Childhood Obesity Increases the Risk of Failure in the Treatment of Distal Forearm Fractures
Auer RT, Mazzone P, Robinson L, Nyland J, Chan G
Auer RT, Mazzone P, Robinson L, Nyland J, Chan G
A retrospective case-controlled study was conducted to determine whether obesity is an independent risk factor for the failure of closed reduction and casting.
A retrospective case-controlled study was conducted to determine whether obesity is an independent risk factor for the failure of closed reduction and casting.
Key Study: Functional Outcomes After Treatment of Scaphoid Fractures in Children and Adolescents
Bae DS, Gholson JJ, Zurakowski D, Waters PM
Bae DS, Gholson JJ, Zurakowski D, Waters PM
The purpose of this investigation was to characterize the functional outcomes of children and adolescents treated for scaphoid fractures.
The purpose of this investigation was to characterize the functional outcomes of children and adolescents treated for scaphoid fractures.
Key Study: Radiographic Evaluation During Treatment of Pediatric Forearm Fractures: Implications on Clinical Care and Cost
Luther G, Miller P, Waters PM, Bae DS
Luther G, Miller P, Waters PM, Bae DS
The purpose of this study was to analyze the clinical utility and cost of the week 4 radiograph following closed treatment of pediatric forearm fractures.
The purpose of this study was to analyze the clinical utility and cost of the week 4 radiograph following closed treatment of pediatric forearm fractures.
Key Study: Reducing Cost and Radiation Exposure During the Treatment of Pediatric Greenstick Fractures of the Forearm
Ting BL, Kalish LA, Waters PM, Bae DS
Ting BL, Kalish LA, Waters PM, Bae DS
The purpose of this investigtion was to evaluate the LOR rate requiring intervention - including either repeat closed reduction or surgical reduction and fixation- following closed reduction and cast immobilization of pediatric greenstick forearm fractures.
The purpose of this investigtion was to evaluate the LOR rate requiring intervention - including either repeat closed reduction or surgical reduction and fixation- following closed reduction and cast immobilization of pediatric greenstick forearm fractures.
Key Study: Synthetic versus plaster of Paris casts in the treatment of fractures of the forearm in children: a randomised trial of clinical outcomes and patient satisfaction
Inglis M, McClelland B, Sutherland LM, Cundy PJ
Inglis M, McClelland B, Sutherland LM, Cundy PJ
The aim of this study was to investigate which cast material is superior for the management of fractures of the forearm.
The aim of this study was to investigate which cast material is superior for the management of fractures of the forearm.
Key Study: Simple treatment for torus fractures of the distal radius
Davidson JS, Brown DJ, Barnes SN, Bruce CE
Davidson JS, Brown DJ, Barnes SN, Bruce CE
Based on the results of a postal questionnaire and a prospective randomised trial, this study descibes a simple treatement for a torus fracture of the distal radius, which saves both time and money.
Based on the results of a postal questionnaire and a prospective randomised trial, this study descibes a simple treatement for a torus fracture of the distal radius, which saves both time and money.
Key Study: Examining Emergency Department Treatment Processes in Severe Pediatric Traumatic Brain Injury
Ajdari A, Boyle LN, Kannan N, Rowhani-Rahbar A, Wang J, Mink R, Ries B, Wainwright M, Groner JI, Bell MJ, Giza C, Zatzick DF, Ellenbogen RG, Mitchell PH, Riv...
Ajdari A, Boyle LN, Kannan N, Rowhani-Rahbar A, Wang J, Mink R, Ries B, Wainw...
Our objectives were to examine the treatment process of acute pediatric TBI and the impact of non-value-added time (NVAT) on patient outcomes.
Our objectives were to examine the treatment process of acute pediatric TBI and the impact of non-value-added time (NVAT) on patient outcomes.
Key Study: Prevalence and Impact of Admission Acute Traumatic Coagulopathy on Treatment Intensity, Resource Use, and Mortality: An Evaluation of 956 Severely Injured Children and Adolescents
Liras IN, Caplan HW, Stensballe J, Wade CE, Cox CS, Cotton BA
Liras IN, Caplan HW, Stensballe J, Wade CE, Cox CS, Cotton BA
The purpose of this study was to assess the prevalence and impact of arrival coagulopathy, determined by viscoelastic hemostatic testing, in severely injured children.
The purpose of this study was to assess the prevalence and impact of arrival coagulopathy, determined by viscoelastic hemostatic testing, in severely injured children.
Key study: Efficacy of nebulized L-epinephrine for treatment of croup: a randomized, double-blind study
Eghbali A, Sabbagh A, Bagheri B, Taherahmadi H, Kahbazi M
Eghbali A, Sabbagh A, Bagheri B, Taherahmadi H, Kahbazi M
Objective: The objective of this study was to compare the effect of L-epinephrine plus dexamethasone vs. dexamethasone for treatment of croup in children.
Objective: The objective of this study was to compare the effect of L-epinephrine plus dexamethasone vs. dexamethasone for treatment of croup in children.
Key study: The comparison of oral and IM dexamethasone efficacy in croup treatment
Soleimani G, Daryadel A, Ansari Moghadam A, Sharif MR
Soleimani G, Daryadel A, Ansari Moghadam A, Sharif MR
Objective: In this study, the efficacies of intramuscular and oral dexamethasone administration are compared for treatment of croup.
Objective: In this study, the efficacies of intramuscular and oral dexamethasone administration are compared for treatment of croup.
Key study: A randomized comparison of dexamethasone 0.15 mg/kg versus 0.6 mg/kg for the treatment of moderate to severe croup
Chub-Uppakarn S, Sangsupawanich P
Chub-Uppakarn S, Sangsupawanich P
Objective: The aim of this study was to investigate the effectiveness of dexamethasone 0.15 mg/kg single dose compared with the recommended dose of 0.6 mg/kg for treatment of hospitalized children with moderate to severe croup.
Objective: The aim of this study was to investigate the effectiveness of dexamethasone 0.15 mg/kg single dose compared with the recommended dose of 0.6 mg/kg for treatment of hospitalized children with moderate to severe croup.
Key study: Adult bacterial meningitis: earlier treatment and improved outcome following guideline revision promoting prompt lumbar puncture
Glimker M, Johansson B, Grindborg , Bottai M, Lindquist L, Sjlin J
Glimker M, Johansson B, Grindborg , Bottai M, Lindquist L, Sjlin J
Objective: Despite guideline emphasis on early treatment, performing CT prior to LP implies a risk of delayed treatment and unfavorable outcome. Therefore, Swedish guidelines were revised in 2009, deleting impaired mental status as a contraindication for LP without prior CT scan. The aim of the present study was to evaluate the guideline revision.
Objective: Despite guideline emphasis on early treatment, performing CT prior to LP implies a risk of delayed treatment and unfavorable outcome. Therefore, Swedish guidelines were revised in 2009, deleting impaired mental status as a contraindication for LP without prior CT scan. The aim of the present study was to evaluate the guideline revision.
Key study: A comparison of ceftriaxone and cefuroxime for the treatment of bacterial meningitis in children
Schaad UB, Suter S, Gianella-Borradori A, Pfenninger J, Auckenthaler R, Bernath O, Cheseaux JJ, Wedgwood J
Schaad UB, Suter S, Gianella-Borradori A, Pfenninger J, Auckenthaler R, Berna...
Objective: To compare ceftriaxone with cefuroxime for the treatment of meningitis, we conducted a study in which 106 children with acute bacterial meningitis were randomly assigned to receive either ceftriaxone (100 mg per kilogram of body weight per day, administered intravenously once daily; n = 53) or cefuroxime (240 mg per kilogram per day, administered intravenously in four equal doses; n = 53).
Objective: To compare ceftriaxone with cefuroxime for the treatment of meningitis, we conducted a study in which 106 children with acute bacterial meningitis were randomly assigned to receive either ceftriaxone (100 mg per kilogram of body weight per day, administered intravenously once daily; n = 53) or cefuroxime (240 mg per kilogram per day, administered intravenously in four equal doses; n = 53).
Key study: Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children
Hoberman A, Paradise JL, Rockette HE, Kearney DH, Bhatnagar S, Shope TR, Martin JM, Kurs-Lasky M, Copelli SJ, Colborn DK, Block SL, Labella JJ, Lynch TG, Coh...
Hoberman A, Paradise JL, Rockette HE, Kearney DH, Bhatnagar S, Shope TR, Mart...
Objective: Given methodologic limitations in available publications, we undertook the current trial involving children 6 to 23 months of age to determine whether limiting antimicrobial treatment to 5 days rather than using the standard 10-day regimen would afford equivalent outcomes and whether doing so also for subsequent episodes would lead to a reduction in the overall use of antimicrobial treatment, with a resulting reduction in the development of antimicrobial resistance.
Objective: Given methodologic limitations in available publications, we undertook the current trial involving children 6 to 23 months of age to determine whether limiting antimicrobial treatment to 5 days rather than using the standard 10-day regimen would afford equivalent outcomes and whether doing so also for subsequent episodes would lead to a reduction in the overall use of antimicrobial treatment, with a resulting reduction in the development of antimicrobial resistance.
Key Study: Effect of potassium infusion on serum levels in children during treatment of diabetic ketoacidosis
Musaitif R and Basnet S
Musaitif R and Basnet S
Objectives: to determine the effect of 40 mEq/L and 60 mEq/L infusions on potassium levels in children during treatment of DKA.
Objectives: to determine the effect of 40 mEq/L and 60 mEq/L infusions on potassium levels in children during treatment of DKA.
Key Study: Emergency room closed reduction versus in situ splinting in the treatment of paediatric supracondylar humerus fractures
Sylvia, SM, Maguire, KJ, Molho, DA, Levens, BJ, Stone, MEJ, Hanstein, R, Schulz, JF and Fornari, ED
Sylvia, SM, Maguire, KJ, Molho, DA, Levens, BJ, Stone, MEJ, Hanstein, R, Schu...
The purpose of this study was to investigate if outcomes or complications differ between two management methods.
The purpose of this study was to investigate if outcomes or complications differ between two management methods.
Key Study: A comparison of intervention and conservative treatment for angulated fractures of the distal forearm in children (AFIC): study protocol for a randomized controlled trial
Adrian, M, Wachtlin, D, Kronfeld, K, Sommerfeldt, D and Wessel, LM
Adrian, M, Wachtlin, D, Kronfeld, K, Sommerfeldt, D and Wessel, LM
The primary objective of this trial is to assess whether or not the long-term functional outcome in remodeling patients is inferior to patients receiving closed reduction and K-wire pinning.
The primary objective of this trial is to assess whether or not the long-term functional outcome in remodeling patients is inferior to patients receiving closed reduction and K-wire pinning.
Key Study: Multiple interventions improve analgesic treatment of supracondylar humerus fractures in a pediatric emergency department
Porter, RN, Chafe, RE, Newhook, LA and Murnaghan, KD
Porter, RN, Chafe, RE, Newhook, LA and Murnaghan, KD
To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.
To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.
Key Study: Comparison of two analgesia protocols for the treatment of pediatric orthopedic emergencies
Barcelos, A, Garcia, P C, Portela, J L, Piva, J P, Garcia, J P and Santana, J C
Barcelos, A, Garcia, P C, Portela, J L, Piva, J P, Garcia, J P and Santana, J C
To compare the efficacy of two analgesia protocols (ketamine versus morphine) associated with midazolam for the reduction of dislocations or closed fractures in children.
To compare the efficacy of two analgesia protocols (ketamine versus morphine) associated with midazolam for the reduction of dislocations or closed fractures in children.
Key Study: Lubiprostone for the treatment of functional constipation in children.
Hyman PE,Di Lorenzo C,Prestridge LL,Youssef NN,Ueno R.
Hyman PE,Di Lorenzo C,Prestridge LL,Youssef NN,Ueno R.
We evaluated the safety and effectiveness of lubiprostone in children and adolescents with functional constipation.
We evaluated the safety and effectiveness of lubiprostone in children and adolescents with functional constipation.
Key study: No association between metoclopramide treatment in ED and reduced risk of post-concussion headache
Bresee N, Aglipay M, Dubrovsky AS, et al.
Bresee N, Aglipay M, Dubrovsky AS, et al.
There is a lack of definitive pediatric literature on effective pharmacotherapy for persistent post-concussion headache symptoms. This study assessed whether acute metoclopramide treatment in the Emergency Department (ED) was associated with a reduction in persistent headache in children at 1- and 4-weeks post-concussion.
There is a lack of definitive pediatric literature on effective pharmacotherapy for persistent post-concussion headache symptoms. This study assessed whether acute metoclopramide treatment in the Emergency Department (ED) was associated with a reduction in persistent headache in children at 1- and 4-weeks post-concussion.
High flow nasal cannula and continuous positive airway pressure therapy in treatment of viral bronchiolitis: a randomized clinical trial.
Vahlkvist S, Jrgensen L, la Cour A, Markoew S, Petersen TH, Kofoed PE.
Vahlkvist S, Jrgensen L, la Cour A, Markoew S, Petersen TH, Kofoed PE.
Continuous positive airway pressure (CPAP) has been used in infants with bronchiolitis for decades. Recently, high flow nasal cannula (HFNC) therapy was introduced. We conducted a trial of 50 children with bronchiolitis who were randomized to treatment with CPAP or HFNC. Objectives were to compare the development in respiratory rate, pCO2, and Modified Woods Clinical Asthma Score (M-WCAS) in young children with bronchiolitis, treated with CPAP or HFNC. Secondarily, to compare Neonatal Infant Pain Score (NIPS), treatment duration, treatment failure, and hospitalization length.
Continuous positive airway pressure (CPAP) has been used in infants with bronchiolitis for decades. Recently, high flow nasal cannula (HFNC) therapy was introduced. We conducted a trial of 50 children with bronchiolitis who were randomized to treatment with CPAP or HFNC. Objectives were to compare the development in respiratory rate, pCO2, and Modified Woods Clinical Asthma Score (M-WCAS) in young children with bronchiolitis, treated with CPAP or HFNC. Secondarily, to compare Neonatal Infant Pain Score (NIPS), treatment duration, treatment failure, and hospitalization length.
High-Flow Nasal Cannula vs. Continuous Positive Airway Pressure Therapy for the Treatment of Children <2 Years With Mild to Moderate Respiratory Failure Due to Pneumonia.
Liu C, Cheng WY, Li JS, Tang T, Tan PL, Yang L.
Liu C, Cheng WY, Li JS, Tang T, Tan PL, Yang L.
The aim of this prospective randomized controlled study was to further compare the clinical benefits and adverse reactions of HFNC with CPAP in the treatment of mild to moderate respiratory failure due to pneumonia in children below 2 years old. HFNC is an effective and safe initial respiratory support treatment in children <2 years with mild to moderate respiratory failure due to pneumonia, and the incidence of intubation and death is very low; concurrently, the comfort and tolerance of HFNC are better. To some extent, HFNC is a well-tolerated alternative to CPAP.
The aim of this prospective randomized controlled study was to further compare the clinical benefits and adverse reactions of HFNC with CPAP in the treatment of mild to moderate respiratory failure due to pneumonia in children below 2 years old. HFNC is an effective and safe initial respiratory support treatment in children <2 years with mild to moderate respiratory failure due to pneumonia, and the incidence of intubation and death is very low; concurrently, the comfort and tolerance of HFNC are better. To some extent, HFNC is a well-tolerated alternative to CPAP.
Key Study: Brief Report: Knowledge and Confidence of Emergency Medical Service Personnel Involving Treatment of an Individual with Autism Spectrum Disorder.
Wachob D, Pesci LJ.
Wachob D, Pesci LJ.
In order to best respond to an emergency situation, professionals need to have an understanding about Autism Spectrum Disorder (ASD) and techniques that will ensure proper care. The purpose of this study was to determine the knowledge and confidence of EMS personnel on interacting and treating an individual with ASD. Emergency Medical Technicians (EMT), and Paramedics were surveyed on their knowledge of ASD; familiarity or experience with ASD, and level of comfort responding to emergencies involving an individual with ASD. The results found that autism-specific training and resources were associated with higher comfort levels, but not knowledge. It was also determined that newer and younger professionals had higher knowledge and comfort when compared to the more experienced and older professionals.
In order to best respond to an emergency situation, professionals need to have an understanding about Autism Spectrum Disorder (ASD) and techniques that will ensure proper care. The purpose of this study was to determine the knowledge and confidence of EMS personnel on interacting and treating an individual with ASD. Emergency Medical Technicians (EMT), and Paramedics were surveyed on their knowledge of ASD; familiarity or experience with ASD, and level of comfort responding to emergencies involving an individual with ASD. The results found that autism-specific training and resources were associated with higher comfort levels, but not knowledge. It was also determined that newer and younger professionals had higher knowledge and comfort when compared to the more experienced and older professionals.
Antipyretic treatment in young children with fever: acetaminophen, ibuprofen, or both alternating in a randomized, double-blind study
Sarrell EM, Wielunsky E, Cohen HA.
Sarrell EM, Wielunsky E, Cohen HA.
To compare the antipyretic benefit of acetaminophen or ibuprofen monotherapy with an alternating regimen of both drugs in young children aged 6 to 36 months.
To compare the antipyretic benefit of acetaminophen or ibuprofen monotherapy with an alternating regimen of both drugs in young children aged 6 to 36 months.
Levetiracetam as an alternative to phenytoin for second-line emergency treatment of children with convulsive status epilepticus: the EcLiPSE RCT
Appleton RE, Rainford NE, Gamble C, Messahel S, Humphreys A, Hickey H, et al.
Appleton RE, Rainford NE, Gamble C, Messahel S, Humphreys A, Hickey H, et al.
To determine whether phenytoin or levetiracetam (Keppra, UCB Pharma, Brussels, Belgium) is the more clinically effective intravenous second-line treatment of paediatric convulsive status epilepticus and to help better inform its management.
To determine whether phenytoin or levetiracetam (Keppra, UCB Pharma, Brussels, Belgium) is the more clinically effective intravenous second-line treatment of paediatric convulsive status epilepticus and to help better inform its management.
Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial
Lyttle MD, Rainford NEA, Gamble C, Messahel S, Humphreys A, Hickey H, et al.
Lyttle MD, Rainford NEA, Gamble C, Messahel S, Humphreys A, Hickey H, et al.
Phenytoin is the recommended second-line intravenous anticonvulsant for treatment of paediatric convulsive status epilepticus in the UK; however, some evidence suggests that levetiracetam could be an effective and safer alternative. This trial compared the efficacy and safety of phenytoin and levetiracetam for second-line management of paediatric convulsive status epilepticus.
Phenytoin is the recommended second-line intravenous anticonvulsant for treatment of paediatric convulsive status epilepticus in the UK; however, some evidence suggests that levetiracetam could be an effective and safer alternative. This trial compared the efficacy and safety of phenytoin and levetiracetam for second-line management of paediatric convulsive status epilepticus.
Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial
Dalziel SR, Borland ML, Furyk J, Bonisch M, Neutze J, Donath S, et al.
Dalziel SR, Borland ML, Furyk J, Bonisch M, Neutze J, Donath S, et al.
Phenytoin is the current standard of care for second-line treatment of paediatric convulsive status epilepticus after failure of first-line benzodiazepines, but is only effective in 60% of cases and is associated with considerable adverse effects. A newer anticonvulsant, levetiracetam, can be given more quickly, is potentially more efficacious, and has a more tolerable adverse effect profile. We aimed to determine whether phenytoin or levetiracetam is the superior second-line treatment for paediatric convulsive status epilepticus.
Phenytoin is the current standard of care for second-line treatment of paediatric convulsive status epilepticus after failure of first-line benzodiazepines, but is only effective in 60% of cases and is associated with considerable adverse effects. A newer anticonvulsant, levetiracetam, can be given more quickly, is potentially more efficacious, and has a more tolerable adverse effect profile. We aimed to determine whether phenytoin or levetiracetam is the superior second-line treatment for paediatric convulsive status epilepticus.
Management of generalised convulsive status epilepticus (SE): A prospective randomised controlled study of combined treatment with intravenous lorazepam with either phenytoin, sodium valproate or levetiracetam--Pilot study
Mundlamuri RC, Sinha S, Subbakrishna DK, Prathyusha PV, Nagappa M, Bindu PS, et al.
Mundlamuri RC, Sinha S, Subbakrishna DK, Prathyusha PV, Nagappa M, Bindu PS, ...
This study was conducted to compare the efficacy of phenytoin, valproate and levetiracetam in patients with GCSE.
This study was conducted to compare the efficacy of phenytoin, valproate and levetiracetam in patients with GCSE.
Intramuscular midazolam versus intravenous lorazepam for the prehospital treatment of status epilepticus in the pediatric population
Welch RD, Nicholas K, Durkalski-Mauldin VL, Lowenstein DH, Conwit R, Mahajan PV, et al.
Welch RD, Nicholas K, Durkalski-Mauldin VL, Lowenstein DH, Conwit R, Mahajan ...
To examine the effectiveness of intramuscular (IM) midazolam versus intravenous (IV) lorazepam for the treatment of pediatric patients with status epilepticus (SE) in the prehospital care setting.
To examine the effectiveness of intramuscular (IM) midazolam versus intravenous (IV) lorazepam for the treatment of pediatric patients with status epilepticus (SE) in the prehospital care setting.
RAMPART (Rapid Anticonvulsant Medication Prior to Arrival Trial): a double-blind randomized clinical trial of the efficacy of intramuscular midazolam versus intravenous lorazepam in the prehospital treatment of status epilepticus by paramedics
Silbergleit R, Lowenstein D, Durkalski V, Conwit R.
Silbergleit R, Lowenstein D, Durkalski V, Conwit R.
Early treatment of prolonged seizures with benzodiazepines given intravenously by paramedics in the prehospital setting has been shown to be associated with improved outcomes. However, an increasing number of Emergency Medical System (EMS) protocols use an intramuscular (IM) route because it is faster and consistently achievable. RAMPART (Rapid Anticonvulsant Medication Prior to Arrival Trial) is a double-blind randomized clinical trial to determine if the efficacy of IM midazolam is noninferior by a margin of 10% to that of intravenous (IV) lorazepam in patients treated by paramedics for status epilepticus (SE). Children and adults with >5 min of convulsions who are still seizing after paramedic arrival are administered study medication by IM autoinjector or IV infusion. The primary efficacy outcome is absence of seizures at emergency department (ED) arrival, without EMS rescue therapy. Safety outcomes include acute endotracheal intubation and recurrent seizures. Secondary outcomes include timing of treatment and initial seizure cessation. At the time of writing this communication, enrollment of all subjects is near completion and the study data will soon be analyzed.
Early treatment of prolonged seizures with benzodiazepines given intravenously by paramedics in the prehospital setting has been shown to be associated with improved outcomes. However, an increasing number of Emergency Medical System (EMS) protocols use an intramuscular (IM) route because it is faster and consistently achievable. RAMPART (Rapid Anticonvulsant Medication Prior to Arrival Trial) is a double-blind randomized clinical trial to determine if the efficacy of IM midazolam is noninferior by a margin of 10% to that of intravenous (IV) lorazepam in patients treated by paramedics for status epilepticus (SE). Children and adults with >5 min of convulsions who are still seizing after paramedic arrival are administered study medication by IM autoinjector or IV infusion. The primary efficacy outcome is absence of seizures at emergency department (ED) arrival, without EMS rescue therapy. Safety outcomes include acute endotracheal intubation and recurrent seizures. Secondary outcomes include timing of treatment and initial seizure cessation. At the time of writing this communication, enrollment of all subjects is near completion and the study data will soon be analyzed.
Lorazepam versus diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children: a randomized controlled trial
Sreenath TG, Gupta P, Sharma KK, Krishnamurthy S.
Sreenath TG, Gupta P, Sharma KK, Krishnamurthy S.
To determine whether intravenous lorazepam is as efficacious as diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children.
To determine whether intravenous lorazepam is as efficacious as diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children.
Comparison of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in Ugandan children: a randomized clinical trial
Mpimbaza A, Ndeezi G, Staedke S, Rosenthal PJ, Byarugaba J.
Mpimbaza A, Ndeezi G, Staedke S, Rosenthal PJ, Byarugaba J.
Our goal was to compare the efficacy and safety of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in Ugandan children.
Our goal was to compare the efficacy and safety of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in Ugandan children.
Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: a randomised controlled trial
McIntyre J, Robertson S, Norris E, Appleton R, Whitehouse WP, Phillips B, et al.
McIntyre J, Robertson S, Norris E, Appleton R, Whitehouse WP, Phillips B, et al.
Rectal diazepam and buccal midazolam are used for emergency treatment of acute febrile and afebrile (epileptic) seizures in children. We aimed to compare the safety and efficacy of these drugs.
Rectal diazepam and buccal midazolam are used for emergency treatment of acute febrile and afebrile (epileptic) seizures in children. We aimed to compare the safety and efficacy of these drugs.
Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial
Scott RC, Besag FM, Neville BG.
Scott RC, Besag FM, Neville BG.
Convulsive status epilepticus is the most common neurological medical emergency and has high morbidity and mortality. Early treatment before admission to hospital is best with an effective medication that can be administered safely. We aimed to find out whether there are differences in efficacy and adverse events between buccal administration of liquid midazolam and rectal administration of liquid diazepam in the acute treatment of seizures.
Convulsive status epilepticus is the most common neurological medical emergency and has high morbidity and mortality. Early treatment before admission to hospital is best with an effective medication that can be administered safely. We aimed to find out whether there are differences in efficacy and adverse events between buccal administration of liquid midazolam and rectal administration of liquid diazepam in the acute treatment of seizures.
A prospective, randomized study comparing intramuscular midazolam with intravenous diazepam for the treatment of seizures in children
Chamberlain JM, Altieri MA, Futterman C, Young GM, Ochsenschlager DW, Waisman Y.
Chamberlain JM, Altieri MA, Futterman C, Young GM, Ochsenschlager DW, Waisman Y.
To compare treatment of ongoing seizures using intramuscular (IM) midazolam versus intravenous (IV) diazepam.
To compare treatment of ongoing seizures using intramuscular (IM) midazolam versus intravenous (IV) diazepam.
Association of Time to Treatment With Short-term Outcomes for Pediatric Patients With Refractory Convulsive Status Epilepticus
Ganza-Lein M, Snchez Fernndez I, Jackson M, Abend NS, Arya R, Brenton JN, et al.
Ganza-Lein M, Snchez Fernndez I, Jackson M, Abend NS, Arya R, Brenton JN, et...
To evaluate whether untimely first-line benzodiazepine treatment is associated with unfavorable short-term outcomes.
To evaluate whether untimely first-line benzodiazepine treatment is associated with unfavorable short-term outcomes.
Treatment of community-onset, childhood convulsive status epilepticus: a prospective, population-based study
Chin RF, Neville BG, Peckham C, Wade A, Bedford H, Scott RC.
Chin RF, Neville BG, Peckham C, Wade A, Bedford H, Scott RC.
Episodes of childhood convulsive status epilepticus (CSE) commonly start in the community. Treatment of CSE aims to minimise the length of seizures, treat the causes, and reduce adverse outcomes; however, there is a paucity of data on the treatment of childhood CSE. We report the findings from a systematic, population-based study on the treatment of community-onset childhood CSE.
Episodes of childhood convulsive status epilepticus (CSE) commonly start in the community. Treatment of CSE aims to minimise the length of seizures, treat the causes, and reduce adverse outcomes; however, there is a paucity of data on the treatment of childhood CSE. We report the findings from a systematic, population-based study on the treatment of community-onset childhood CSE.
Lorazepam versus diazepam in the acute treatment of epileptic seizures and status epilepticus.
Appleton R, Sweeney A, Choonara I, Robson J, Molyneux E.
Appleton R, Sweeney A, Choonara I, Robson J, Molyneux E.
Lorazepam was compared with diazepam for the treatment of acute convulsions and status epilepticus in 102 children in a prospective, open, 'odd and even dates' trial. Convulsions were controlled in 76 per cent of patients treated with a single dose of lorazepam and 51 per cent of patients treated with a single dose of diazepam. Significantly fewer patients treated with lorazepam required additional anticonvulsants to terminate the seizure. Respiratory depression occurred in 3 per cent of lorazepam-treated patients and 15 per cent of diazepam-treated patients. No patient who received lorazepam required admission to the intensive care unit for either respiratory depression or persisting status epilepticus. Rectally administered lorazepam appeared to be particularly valuable (100 per cent efficacy) when venous access was not possible.
Lorazepam was compared with diazepam for the treatment of acute convulsions and status epilepticus in 102 children in a prospective, open, 'odd and even dates' trial. Convulsions were controlled in 76 per cent of patients treated with a single dose of lorazepam and 51 per cent of patients treated with a single dose of diazepam. Significantly fewer patients treated with lorazepam required additional anticonvulsants to terminate the seizure. Respiratory depression occurred in 3 per cent of lorazepam-treated patients and 15 per cent of diazepam-treated patients. No patient who received lorazepam required admission to the intensive care unit for either respiratory depression or persisting status epilepticus. Rectally administered lorazepam appeared to be particularly valuable (100 per cent efficacy) when venous access was not possible.
A Comparison of Intravenous Levetiracetam and Valproate for the Treatment of Refractory Status Epilepticus in Children
gder R, Gzel O, Ceylan G, Ylmaz , An H.
gder R, Gzel O, Ceylan G, Ylmaz , An H.
Because of the lack of studies comparing the efficacy and safety of levetiracetam and valproate before the induction of general anesthesia in the treatment of convulsive refractory status epilepticus in children, we aimed to compare the effectiveness of these antiepileptic drugs in patients with convulsive status epilepticus admitted to the Pediatric Intensive Care Unit between 2011 and 2014. Forty-six (59%) of the 78 patients received levetiracetam, and 32 (41%) received valproate for the treatment of refractory status epilepticus. The response rate was not significantly different between the 2 groups. Although no adverse event was noted in patients who received levetiracetam, 4 (12.5%) patients in the valproate group experienced liver dysfunction (P = .025). According to our results, levetiracetam and valproate may be used in the treatment of refractory status epilepticus before the induction of general anesthesia. Levetiracetam appears as effective as valproate, and also safer.
Because of the lack of studies comparing the efficacy and safety of levetiracetam and valproate before the induction of general anesthesia in the treatment of convulsive refractory status epilepticus in children, we aimed to compare the effectiveness of these antiepileptic drugs in patients with convulsive status epilepticus admitted to the Pediatric Intensive Care Unit between 2011 and 2014. Forty-six (59%) of the 78 patients received levetiracetam, and 32 (41%) received valproate for the treatment of refractory status epilepticus. The response rate was not significantly different between the 2 groups. Although no adverse event was noted in patients who received levetiracetam, 4 (12.5%) patients in the valproate group experienced liver dysfunction (P = .025). According to our results, levetiracetam and valproate may be used in the treatment of refractory status epilepticus before the induction of general anesthesia. Levetiracetam appears as effective as valproate, and also safer.
Effectiveness of intravenous levetiracetam as an adjunctive treatment in pediatric refractory status epilepticus
Kim JS, Lee JH, Ryu HW, Lim BC, Hwang H, Chae JH, et al.
Kim JS, Lee JH, Ryu HW, Lim BC, Hwang H, Chae JH, et al.
Intravenous levetiracetam (LEV) has been shown to be effective and safe in treating adults with refractory status epilepticus (SE). We sought to investigate the efficacy and safety of intravenous LEV for pediatric patients with refractory SE.
Intravenous levetiracetam (LEV) has been shown to be effective and safe in treating adults with refractory status epilepticus (SE). We sought to investigate the efficacy and safety of intravenous LEV for pediatric patients with refractory SE.
Diagnosis and Treatment of Status Epilepticus
Lee SK.
Lee SK.
Currently, the most acceptable duration of continuous seizure activity is 5 minutes. In 2015, the International League Against Epilepsy Task Force, which was convened to develop a definition and classification of SE, presented a new classification based on four axes: 1) semiology, 2) etiology, 3) electroencephalogram (EEG) correlates, and 4) age. The essential element of nonconvulsive SE (NCSE) is the presence of neurological abnormalities induced by a prolonged epileptic process. The definition of refractory SE involves either clinical or electrographic seizures that persist after adequate doses of an initial benzodiazepine and acceptable second-line antiseizure drugs. The use of EEG is critical in the diagnosis and treatment of NCSE.
Currently, the most acceptable duration of continuous seizure activity is 5 minutes. In 2015, the International League Against Epilepsy Task Force, which was convened to develop a definition and classification of SE, presented a new classification based on four axes: 1) semiology, 2) etiology, 3) electroencephalogram (EEG) correlates, and 4) age. The essential element of nonconvulsive SE (NCSE) is the presence of neurological abnormalities induced by a prolonged epileptic process. The definition of refractory SE involves either clinical or electrographic seizures that persist after adequate doses of an initial benzodiazepine and acceptable second-line antiseizure drugs. The use of EEG is critical in the diagnosis and treatment of NCSE.
A Theoretical Paradigm for Evaluating Risk-Benefit of Status Epilepticus Treatment
Amorim E, McGraw CM, Westover MB.
Amorim E, McGraw CM, Westover MB.
Aggressive treatment of status epilepticus with anesthetic drugs can provide rapid seizure control, but it might lead to serious medical complications and worse outcomes. Using a decision analysis approach, this concise review provides a framework for individualized decision making about aggressive and nonaggressive treatment in status epilepticus. The authors propose and review the most relevant parameters guiding the risk-benefit analysis of treatment aggressiveness in status epilepticus and present real-world-based case examples to illustrate how these tools could be used at the bedside and serve to guide future research in refractory status epilepticus treatment.
Aggressive treatment of status epilepticus with anesthetic drugs can provide rapid seizure control, but it might lead to serious medical complications and worse outcomes. Using a decision analysis approach, this concise review provides a framework for individualized decision making about aggressive and nonaggressive treatment in status epilepticus. The authors propose and review the most relevant parameters guiding the risk-benefit analysis of treatment aggressiveness in status epilepticus and present real-world-based case examples to illustrate how these tools could be used at the bedside and serve to guide future research in refractory status epilepticus treatment.
Treatment of Generalized Convulsive Status Epilepticus in Pediatric Patients
Alford EL, Wheless JW, Phelps SJ.
Alford EL, Wheless JW, Phelps SJ.
Generalized convulsive status epilepticus (GCSE) is one of the most common neurologic emergencies and can be associated with significant morbidity and mortality if not treated promptly and aggressively. Management of GCSE is staged and generally involves the use of life support measures, identification and management of underlying causes, and rapid initiation of anticonvulsants. The purpose of this article is to review and evaluate published reports regarding the treatment of impending, established, refractory, and super-refractory GCSE in pediatric patients.
Generalized convulsive status epilepticus (GCSE) is one of the most common neurologic emergencies and can be associated with significant morbidity and mortality if not treated promptly and aggressively. Management of GCSE is staged and generally involves the use of life support measures, identification and management of underlying causes, and rapid initiation of anticonvulsants. The purpose of this article is to review and evaluate published reports regarding the treatment of impending, established, refractory, and super-refractory GCSE in pediatric patients.
Generalized convulsive status epilepticus in adults and children: treatment guidelines and protocols
Shearer P, Riviello J.
Shearer P, Riviello J.
Generalized convulsive status epilepticus (GCSE) has a high morbidity and mortality, such that the rapid delivery of anticonvulsant therapy should be initiated within minutes of seizure onset to prevent permanent neuronal damage. GCSE is not a specific disease but is a manifestation of either a primary central nervous system (CNS) insult or a systemic disorder with secondary CNS effects. It is mandatory to look for an underlying cause. First-line therapies for seizures and status epilepticus include the use of a benzodiazepine, followed by an infusion of a phenytoin with a possible role for intravenous valproate or phenobarbital. If these first-line medications fail to terminate the GCSE, treatment includes the continuous infusion of midazolam, pentobarbital, or propofol.
Generalized convulsive status epilepticus (GCSE) has a high morbidity and mortality, such that the rapid delivery of anticonvulsant therapy should be initiated within minutes of seizure onset to prevent permanent neuronal damage. GCSE is not a specific disease but is a manifestation of either a primary central nervous system (CNS) insult or a systemic disorder with secondary CNS effects. It is mandatory to look for an underlying cause. First-line therapies for seizures and status epilepticus include the use of a benzodiazepine, followed by an infusion of a phenytoin with a possible role for intravenous valproate or phenobarbital. If these first-line medications fail to terminate the GCSE, treatment includes the continuous infusion of midazolam, pentobarbital, or propofol.
Resource - Acute Procedural Pain Toolkits
Canadian Association of Paediatric Health Centres Pain Community of Practice
Canadian Association of Paediatric Health Centres Pain Community of Practice
These Toolkits are a resource for clinicians who work with children that may experience acute procedural pain and support moving best practice recommendations into practice. Based on the best research evidence and clinical practice, these Toolkits
These Toolkits are a resource for clinicians who work with children that may experience acute procedural pain and support moving best practice recommendations into practice. Based on the best research evidence and clinical practice, these Toolkits
Emergency Medicine Cases Podcast: Pediatric abdominal pain & appendicitis
Dr. Anna Jarvis & Dr. Stephen Freedman
Dr. Anna Jarvis & Dr. Stephen Freedman
Episode 19 Part 1:In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis & Dr. Stephen Freedman discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. Published online: December 2011.
Episode 19 Part 1:In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis & Dr. Stephen Freedman discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. Published online: December 2011.
Emergency Medicine Cases Podcast: Pediatric Pain Management
Dr. Samina Ali & Dr. Anthony Crocco
Dr. Samina Ali & Dr. Anthony Crocco
Episode 67: Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
Episode 67: Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
Pain Ease(R): Topical anesthetic skin refrigerant (for children 4 years and older)
BC Children's Hospital
BC Children's Hospital
Purpose: Pain Ease spray is a vapocoolant (skin refrigerant) intended for topical application to skin and minor open wounds. It controls pain associated with injections (venipunctures, IV start) and minor surgical procedures (eg. irrigating laceration/
Purpose: Pain Ease spray is a vapocoolant (skin refrigerant) intended for topical application to skin and minor open wounds. It controls pain associated with injections (venipunctures, IV start) and minor surgical procedures (eg. irrigating laceration/
An Evidence-Based Approach to Minimizing Acute Procedural Pain in the Emergency Department and Beyond. Pediatr Emerg Care 2016;32(1):36-42.
Ali S, McGrath T, Drendel AL
Ali S, McGrath T, Drendel AL
Objective: This review article aims to provide a summary of several strategies, which are supported by definitive and systematically reviewed evidence, that can be implemented alone or in combination to reduce procedural pain and anxiety for children in t
Objective: This review article aims to provide a summary of several strategies, which are supported by definitive and systematically reviewed evidence, that can be implemented alone or in combination to reduce procedural pain and anxiety for children in t
Psychological Interventions
BC Children's Hospital
BC Children's Hospital
Even with sedation, the success of a procedure is equally reliant upon careful consideration of psychosocial aspects as it is reliant on physical aspects. A sense of mastery and control experienced by parents and children is crucial to their confidence
Even with sedation, the success of a procedure is equally reliant upon careful consideration of psychosocial aspects as it is reliant on physical aspects. A sense of mastery and control experienced by parents and children is crucial to their confidence
Sucrose as a procedural analgesic for infants up to 12 months of age
BC Children's Hospital
BC Children's Hospital
Purpose: Oral sucrose and other sweet tasting solutions have been used for management of pain in infants for centuries. Studies done since the early 1990's have demonstrated that the administration of sucrose and non-nutritive sucking are effective non
Purpose: Oral sucrose and other sweet tasting solutions have been used for management of pain in infants for centuries. Studies done since the early 1990's have demonstrated that the administration of sucrose and non-nutritive sucking are effective non
Clincal Practice Guideline: Practice Guideline for the Assessment and Treatment of Patients With Suicidal Behaviors
American Psychology Association
American Psychology Association
Non peds specific practise guidline for assessment treatment suicidal behavors
Non peds specific practise guidline for assessment treatment suicidal behavors
Clincal Practice Guideline: Practice Parameter for the Assessment and Treatment of Children and Adolescents With Suicidal Behavior. American Academy of Child and Adolescent Psychiatry
American Academy of Child and Adolescent Psychiatry
American Academy of Child and Adolescent Psychiatry
These guidelines review what is known about the epidemiology, causes, management, and prevention of suicide and attempted suicide in young people. Detailed guidelines are provided concerning the assessment and emergency management of the children and adolescents who present with suicidal behavior.
These guidelines review what is known about the epidemiology, causes, management, and prevention of suicide and attempted suicide in young people. Detailed guidelines are provided concerning the assessment and emergency management of the children and adolescents who present with suicidal behavior.
Hospital Emergency Treatment of Convulsive Status Epilepticus: Comparison of Pathways From Ten Pediatric Research Centers
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We aimed to evaluate and compare the status epilepticus treatment pathways used by pediatric status epilepticus research group (pSERG) hospitals in the United States and the American Epilepsy Society (AES) status epilepticus guideline.
We aimed to evaluate and compare the status epilepticus treatment pathways used by pediatric status epilepticus research group (pSERG) hospitals in the United States and the American Epilepsy Society (AES) status epilepticus guideline.
Status epilepticus treatment guidelines
Klviinen R
Klviinen R
Treatment of Refractory Convulsive Status Epilepticus: A Comprehensive Review by the American Epilepsy Society Treatments Committee
Vossler DG, Bainbridge JL, Boggs JG, Novotny EJ, Loddenkemper T, Faught E, et al.
Vossler DG, Bainbridge JL, Boggs JG, Novotny EJ, Loddenkemper T, Faught E, et...
Established tonic-clonic status epilepticus (SE) does not stop in one-third of patients when treated with an intravenous (IV) benzodiazepine bolus followed by a loading dose of a second antiseizure medication (ASM). These patients have refractory status epilepticus (RSE) and a high risk of morbidity and death. For patients with convulsive refractory status epilepticus (CRSE), we sought to determine the strength of evidence for 8 parenteral ASMs used as third-line treatment in stopping clinical CRSE.
Established tonic-clonic status epilepticus (SE) does not stop in one-third of patients when treated with an intravenous (IV) benzodiazepine bolus followed by a loading dose of a second antiseizure medication (ASM). These patients have refractory status epilepticus (RSE) and a high risk of morbidity and death. For patients with convulsive refractory status epilepticus (CRSE), we sought to determine the strength of evidence for 8 parenteral ASMs used as third-line treatment in stopping clinical CRSE.
Manitoba Adolescent Treatment Centre- Centre de traitement des adolescents du Manitoba
MATC provides a range of mental health services to children and adolescents who experience psychiatric and/or emotional disorders.
Le MATC offre une gamme de services de santé mentale aux enfants et aux adolescents qui souffrent de troubles psychiatriques ou émotionnels.
MATC provides a range of mental health services to children and adolescents who experience psychiatric and/or emotional disorders.
Le MATC offre une gamme de services de santé mentale aux enfants et aux adolescents qui souffrent de troubles psychiatriques ou émotionnels.
Agitation treatment for pediatric emergency patients
Hilt, R. J. and T. A. Woodward
Hilt, R. J. and T. A. Woodward
Intranasal Lorazepam for Treatment of Severe Agitation in a Pediatric Behavioral Health Patient in the Emergency Department
Bregstein, J. S., A. M. Wagh and D. S. Tsze
Bregstein, J. S., A. M. Wagh and D. S. Tsze
A non-randomized, Open study with aripiprazole and ziprasidone for the treatment of aggressive behavior in youth in a community clinic
Bastiaens, L.
Bastiaens, L.
A pilot, open-label safety study of quetiapine for treatment of moderate psychotic agitation in the emergency setting
Currier, G. W., A. J. Trenton, P. G. Walsh and E. van Wijngaarden
Currier, G. W., A. J. Trenton, P. G. Walsh and E. van Wijngaarden
Prehospital Ketamine is a Safe and Effective Treatment for Excited Delirium in a Community Hospital Based EMS System
Scaggs, T. R., D. M. Glass, M. G. Hutchcraft and W. B. Weir
Scaggs, T. R., D. M. Glass, M. G. Hutchcraft and W. B. Weir
The psychopharmacologic treatment of violent youth
Gilligan, J. and B. Lee
Gilligan, J. and B. Lee
Pharmacogenetics of acute treatment of depression and anxiety in children and adolescents
Kronenberg, S., A. Apter, M. Carmel, A. Frisch and A. Weizman
Kronenberg, S., A. Apter, M. Carmel, A. Frisch and A. Weizman
Lurasidone for the Treatment of Irritability Associated with Autistic Disorder
Loebel, A., M. Brams, R. S. Goldman, R. Silva, D. Hernandez, L. Deng, R. Mankoski and R. L. Findling
Loebel, A., M. Brams, R. S. Goldman, R. Silva, D. Hernandez, L. Deng, R. Mank...
Comparison of risperidone orodispersible tablet and intramuscular haloperidol in the treatment of acute psychotic agitation: a randomized open, prospective study
Lim, H. K., J. J. Kim, C. U. Pae, C. U. Lee, C. Lee and I. H. Paik
Lim, H. K., J. J. Kim, C. U. Pae, C. U. Lee, C. Lee and I. H. Paik
Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial
March, J. S.
March, J. S.
Comparison of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorder and attention deficit-hyperactivity disorder: A randomized clinical trial
Safavi, P., A. Hasanpour-Dehkordi and M. Amirahmadi
Safavi, P., A. Hasanpour-Dehkordi and M. Amirahmadi
Treatment of aggression with risperidone in children and adolescents with bipolar disorder: a case series
Saxena, K., K. Chang and H. Steiner
Saxena, K., K. Chang and H. Steiner
A randomized, double-blind study of paliperidone extended-release in treatment of acute schizophrenia in adolescents
Singh, J., A. Robb, U. Vijapurkar, I. Nuamah and D. Hough
Singh, J., A. Robb, U. Vijapurkar, I. Nuamah and D. Hough
Risperidone versus haloperidol, in combination with lorazepam, in the treatment of acute agitation and psychosis: a pilot, randomized, double-blind, placebo-controlled trial
Veser, F. H., B. D. Veser, J. T. McMullan, J. Zealberg and G. W. Currier
Veser, F. H., B. D. Veser, J. T. McMullan, J. Zealberg and G. W. Currier