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|000005d0| 75 73 20 4f 78 69 64 65 | 20 66 6f 72 20 46 72 61 |us Oxide| for Fra|
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|00000680| 4a 20 4f 72 74 68 6f 70 | 20 54 72 61 75 6d 61 7d |J Orthop| Trauma}|
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|000006c0| 31 39 39 31 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1991 Yea|r Book o|
|000006d0| 66 20 45 6d 65 72 67 65 | 6e 63 79 20 4d 65 64 69 |f Emerge|ncy Medi|
|000006e0| 63 69 6e 65 7d 0d 0a 24 | 43 68 61 70 74 65 72 7b |cine}..$|Chapter{|
|000006f0| 34 2d 34 38 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |4-48}..$|YBEditor|
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|00000720| 20 52 6f 62 65 72 74 73 | 2c 20 61 6e 64 20 53 70 | Roberts|, and Sp|
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|00000740| 0a 24 43 6f 6d 6d 65 6e | 74 61 74 6f 72 7b 52 2e |.$Commen|tator{R.|
|00000750| 57 2e 20 53 63 68 61 66 | 65 72 6d 65 79 65 72 2c |W. Schaf|ermeyer,|
|00000760| 20 4d 2e 44 2e 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 | M.D.}..|..Copyri|
|00000770| 67 68 74 20 28 43 29 20 | 59 65 61 72 20 42 6f 6f |ght (C) |Year Boo|
|00000780| 6b 20 4d 65 64 69 63 61 | 6c 20 50 75 62 6c 69 73 |k Medica|l Publis|
|00000790| 68 65 72 73 2c 20 49 6e | 63 2e 20 31 39 39 31 0d |hers, In|c. 1991.|
|000007a0| 0a 0d 0a 31 39 39 31 20 | 59 65 61 72 20 42 6f 6f |...1991 |Year Boo|
|000007b0| 6b 20 6f 66 20 45 6d 65 | 72 67 65 6e 63 79 20 4d |k of Eme|rgency M|
|000007c0| 65 64 69 63 69 6e 65 0d | 0a 0d 0a 43 68 61 70 74 |edicine.|...Chapt|
|000007d0| 65 72 20 34 20 2d 2d 20 | 53 70 65 63 69 61 6c 20 |er 4 -- |Special |
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|000007f0| 6e 66 61 6e 74 20 61 6e | 64 20 43 68 69 6c 64 68 |nfant an|d Childh|
|00000800| 6f 6f 64 20 45 6d 65 72 | 67 65 6e 63 69 65 73 0d |ood Emer|gencies.|
|00000810| 0a 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |...-----|--------|
|00000820| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000830| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000840| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000850| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000860| 2d 0d 0a 53 65 6c 66 2d | 41 64 6d 69 6e 69 73 74 |-..Self-|Administ|
|00000870| 65 72 65 64 20 4e 69 74 | 72 6f 75 73 20 4f 78 69 |ered Nit|rous Oxi|
|00000880| 64 65 20 66 6f 72 20 46 | 72 61 63 74 75 72 65 20 |de for F|racture |
|00000890| 52 65 64 75 63 74 69 6f | 6e 20 69 6e 20 43 68 69 |Reductio|n in Chi|
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|000008b0| 72 67 65 6e 63 79 20 52 | 6f 6f 6d 20 53 65 74 74 |rgency R|oom Sett|
|000008c0| 69 6e 67 0d 0a 0d 0a 57 | 61 74 74 65 6e 6d 61 6b |ing....W|attenmak|
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|000008e0| 20 4d 63 47 72 61 76 65 | 79 20 41 0d 0a 28 43 68 | McGrave|y A..(Ch|
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|00000910| 20 54 72 61 75 6d 61 20 | 34 3a 33 35 2d 33 38 2c | Trauma |4:35-38,|
|00000920| 20 31 39 39 30 0d 0a 2d | 2d 2d 2d 2d 2d 2d 2d 2d | 1990..-|--------|
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|00000950| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000960| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000970| 2d 2d 2d 2d 2d 0d 0a 0d | 0a 41 62 73 74 72 61 63 |-----...|.Abstrac|
|00000980| 74 0d 0a 0d 0a 20 20 20 | 20 20 54 72 61 64 69 74 |t....   |  Tradit|
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|00000a90| 67 65 6e 63 79 20 72 6f | 6f 6d 20 77 61 73 20 65 |gency ro|om was e|
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|00000ad0| 20 20 54 68 65 20 4e 69 | 74 72 6f 6e 6f 78 20 53 |  The Ni|tronox S|
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|00000af0| 77 61 73 20 75 73 65 64 | 20 62 79 20 74 68 65 0d |was used| by the.|
|00000b00| 0a 70 61 74 69 65 6e 74 | 20 61 73 20 74 68 65 20 |.patient| as the |
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|00000b70| 2e 20 20 54 68 65 20 70 | 61 74 69 65 6e 74 73 20 |.  The p|atients |
|00000b80| 77 65 72 65 20 61 74 20 | 6c 65 61 73 74 20 34 20 |were at |least 4 |
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|00000da0| 20 6e 69 74 72 6f 75 73 | 20 6f 63 69 64 65 20 75 | nitrous| ocide u|
|00000db0| 73 65 20 6f 63 63 75 72 | 72 65 64 2e 0d 0a 20 20 |se occur|red...  |
|00000dc0| 20 20 20 53 65 6c 66 2d | 61 64 6d 69 6e 69 73 74 |   Self-|administ|
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|00002950| 6f 6f 64 20 45 6d 65 72 | 67 65 6e 63 69 65 73 0d |ood Emer|gencies.|
|00002960| 0a 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |...-----|--------|
|00002970| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002980| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002990| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000029a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000029b0| 2d 0d 0a 54 61 70 65 20 | 4d 65 61 73 75 72 65 20 |-..Tape |Measure |
|000029c0| 74 6f 20 41 69 64 20 50 | 72 65 73 63 72 69 70 74 |to Aid P|rescript|
|000029d0| 69 6f 6e 20 69 6e 20 50 | 61 65 64 69 61 74 72 69 |ion in P|aediatri|
|000029e0| 63 20 52 65 73 75 73 63 | 69 74 61 74 69 6f 6e 0d |c Resusc|itation.|
|000029f0| 0a 0d 0a 48 75 67 68 65 | 73 20 47 3b 20 53 70 6f |...Hughe|s G; Spo|
|00002a00| 75 64 65 61 73 20 48 3b | 20 4b 6f 76 61 72 20 49 |udeas H;| Kovar I|
|00002a10| 5a 3b 20 4d 69 6c 6c 69 | 6e 67 74 6f 6e 20 48 54 |Z; Milli|ngton HT|
|00002a20| 0d 0a 28 43 68 61 72 69 | 6e 67 20 43 72 6f 73 73 |..(Chari|ng Cross|
|00002a30| 20 48 6f 73 70 2c 20 4c | 6f 6e 64 6f 6e 29 0d 0a | Hosp, L|ondon)..|
|00002a40| 41 72 63 68 20 45 6d 65 | 72 67 20 4d 65 64 20 37 |Arch Eme|rg Med 7|
|00002a50| 3a 32 31 2d 32 37 2c 20 | 31 39 39 30 0d 0a 2d 2d |:21-27, |1990..--|
|00002a60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002a70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002a80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002a90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002aa0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|00002ab0| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|....    |
|00002ac0| 20 54 68 65 20 55 6e 69 | 74 65 64 20 4b 69 6e 67 | The Uni|ted King|
|00002ad0| 64 6f 6d 20 68 61 73 20 | 6f 6e 6c 79 20 61 20 66 |dom has |only a f|
|00002ae0| 65 77 20 64 65 64 69 63 | 61 74 65 64 20 63 68 69 |ew dedic|ated chi|
|00002af0| 6c 64 72 65 6e 27 73 20 | 68 6f 73 70 69 74 61 6c |ldren's |hospital|
|00002b00| 73 20 61 6e 64 20 65 76 | 65 6e 0d 0a 66 65 77 65 |s and ev|en..fewe|
|00002b10| 72 20 73 70 65 63 69 61 | 6c 69 7a 65 64 20 70 65 |r specia|lized pe|
|00002b20| 64 69 61 74 72 69 63 20 | 45 44 73 2e 20 20 43 6f |diatric |EDs.  Co|
|00002b30| 6e 73 65 71 75 65 6e 74 | 6c 79 2c 20 65 6d 65 72 |nsequent|ly, emer|
|00002b40| 67 65 6e 63 69 65 73 20 | 61 6d 6f 6e 67 20 63 68 |gencies |among ch|
|00002b50| 69 6c 64 72 65 6e 20 61 | 72 65 0d 0a 74 72 65 61 |ildren a|re..trea|
|00002b60| 74 65 64 20 6d 6f 73 74 | 20 6f 66 74 65 6e 20 69 |ted most| often i|
|00002b70| 6e 20 61 64 75 6c 74 20 | 45 44 20 73 65 74 74 69 |n adult |ED setti|
|00002b80| 6e 67 73 20 62 79 20 73 | 74 61 66 66 20 6e 6f 74 |ngs by s|taff not|
|00002b90| 20 74 72 61 69 6e 65 64 | 20 69 6e 20 74 68 65 20 | trained| in the |
|00002ba0| 65 6d 65 72 67 65 6e 63 | 79 0d 0a 74 72 65 61 74 |emergenc|y..treat|
|00002bb0| 6d 65 6e 74 20 6f 66 20 | 63 68 69 6c 64 72 65 6e |ment of |children|
|00002bc0| 2e 20 20 50 72 65 73 63 | 72 69 70 74 69 6f 6e 20 |.  Presc|ription |
|00002bd0| 6f 66 20 64 72 75 67 73 | 20 61 6e 64 20 66 6c 75 |of drugs| and flu|
|00002be0| 69 64 73 20 66 6f 72 20 | 72 65 68 79 64 72 61 74 |ids for |rehydrat|
|00002bf0| 69 6f 6e 20 69 6e 0d 0a | 63 68 69 6c 64 72 65 6e |ion in..|children|
|00002c00| 20 69 73 20 62 61 73 65 | 64 20 6c 61 72 67 65 6c | is base|d largel|
|00002c10| 79 20 6f 6e 20 62 6f 64 | 79 20 77 65 69 67 68 74 |y on bod|y weight|
|00002c20| 20 61 6e 64 20 73 75 72 | 66 61 63 65 20 61 72 65 | and sur|face are|
|00002c30| 61 20 70 61 72 61 6d 65 | 74 65 72 73 2e 0d 0a 48 |a parame|ters...H|
|00002c40| 6f 77 65 76 65 72 2c 20 | 74 72 75 65 20 77 65 69 |owever, |true wei|
|00002c50| 67 68 74 73 20 61 72 65 | 20 75 73 75 61 6c 6c 79 |ghts are| usually|
|00002c60| 20 75 6e 6f 62 74 61 69 | 6e 61 62 6c 65 20 69 6e | unobtai|nable in|
|00002c70| 20 65 6d 65 72 67 65 6e | 63 69 65 73 2c 20 61 6e | emergen|cies, an|
|00002c80| 64 20 64 72 75 67 20 61 | 6e 64 0d 0a 66 6c 75 69 |d drug a|nd..flui|
|00002c90| 64 20 74 68 65 72 61 70 | 79 20 64 6f 73 65 73 20 |d therap|y doses |
|00002ca0| 61 72 65 20 65 73 74 69 | 6d 61 74 65 64 2e 20 20 |are esti|mated.  |
|00002cb0| 54 6f 20 72 65 64 75 63 | 65 20 74 68 65 20 70 6f |To reduc|e the po|
|00002cc0| 74 65 6e 74 69 61 6c 20 | 66 6f 72 20 65 72 72 6f |tential |for erro|
|00002cd0| 72 20 69 6e 0d 0a 64 65 | 74 65 72 6d 69 6e 69 6e |r in..de|terminin|
|00002ce0| 67 20 64 72 75 67 20 61 | 6e 64 20 66 6c 75 69 64 |g drug a|nd fluid|
|00002cf0| 20 72 65 70 6c 61 63 65 | 6d 65 6e 74 20 64 6f 73 | replace|ment dos|
|00002d00| 65 73 20 66 6f 72 20 63 | 68 69 6c 64 72 65 6e 2c |es for c|hildren,|
|00002d10| 20 61 20 73 69 6d 70 6c | 65 20 61 6e 64 20 72 61 | a simpl|e and ra|
|00002d20| 70 69 64 0d 0a 74 61 70 | 65 20 6d 65 61 73 75 72 |pid..tap|e measur|
|00002d30| 65 20 6d 65 74 68 6f 64 | 20 74 68 61 74 20 65 6e |e method| that en|
|00002d40| 61 62 6c 65 73 20 61 6e | 20 61 63 63 75 72 61 74 |ables an| accurat|
|00002d50| 65 20 65 73 74 69 6d 61 | 74 65 20 6f 66 20 62 6f |e estima|te of bo|
|00002d60| 64 79 20 77 65 69 67 68 | 74 20 69 6e 0d 0a 63 68 |dy weigh|t in..ch|
|00002d70| 69 6c 64 72 65 6e 20 77 | 61 73 20 64 65 76 65 6c |ildren w|as devel|
|00002d80| 6f 70 65 64 2e 0d 0a 20 | 20 20 20 20 49 6e 20 61 |oped... |    In a|
|00002d90| 20 74 65 73 74 20 6f 66 | 20 72 65 6c 69 61 62 69 | test of| reliabi|
|00002da0| 6c 69 74 79 2c 20 70 65 | 64 69 61 74 72 69 63 20 |lity, pe|diatric |
|00002db0| 6e 75 72 73 65 73 20 6d | 65 61 73 75 72 65 64 20 |nurses m|easured |
|00002dc0| 36 31 20 63 68 69 6c 64 | 72 65 6e 20 61 67 65 64 |61 child|ren aged|
|00002dd0| 20 36 0d 0a 77 65 65 6b | 73 2d 31 30 20 79 65 61 | 6..week|s-10 yea|
|00002de0| 72 73 20 64 75 72 69 6e | 67 20 72 6f 75 74 69 6e |rs durin|g routin|
|00002df0| 65 20 76 69 73 69 74 73 | 20 74 6f 20 61 20 70 65 |e visits| to a pe|
|00002e00| 64 69 61 74 72 69 63 20 | 6f 75 74 70 61 74 69 65 |diatric |outpatie|
|00002e10| 6e 74 20 63 6c 69 6e 69 | 63 2c 0d 0a 65 78 70 65 |nt clini|c,..expe|
|00002e20| 72 69 65 6e 63 65 64 20 | 45 44 20 6e 75 72 73 69 |rienced |ED nursi|
|00002e30| 6e 67 20 73 74 61 66 66 | 20 6d 65 61 73 75 72 65 |ng staff| measure|
|00002e40| 64 20 37 38 20 63 68 69 | 6c 64 72 65 6e 20 61 67 |d 78 chi|ldren ag|
|00002e50| 65 64 20 39 20 64 61 79 | 73 2d 31 30 20 79 65 61 |ed 9 day|s-10 yea|
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|00002e70| 75 67 68 74 20 74 6f 20 | 61 6e 20 45 44 2c 20 61 |ught to |an ED, a|
|00002e80| 6e 64 20 6a 75 6e 69 6f | 72 20 65 6d 65 72 67 65 |nd junio|r emerge|
|00002e90| 6e 63 79 20 6d 65 64 69 | 63 69 6e 65 20 70 68 79 |ncy medi|cine phy|
|00002ea0| 73 69 63 69 61 6e 73 20 | 6d 65 61 73 75 72 65 64 |sicians |measured|
|00002eb0| 20 32 34 0d 0a 63 68 69 | 6c 64 72 65 6e 20 61 67 | 24..chi|ldren ag|
|00002ec0| 65 64 20 31 20 6d 6f 6e | 74 68 2d 39 20 79 65 61 |ed 1 mon|th-9 yea|
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|00002f10| 6c 64 72 65 6e 20 73 65 | 65 6e 20 69 6e 20 74 68 |ldren se|en in th|
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|00002f30| 61 74 69 65 6e 74 20 63 | 6c 69 6e 69 63 20 61 6c |atient c|linic al|
|00002f40| 73 6f 20 77 65 72 65 20 | 61 73 73 65 73 73 65 64 |so were |assessed|
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|00002f60| 64 69 61 74 72 69 63 69 | 61 6e 2e 0d 0a 20 20 20 |diatrici|an...   |
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|00002fc0| 65 64 20 77 69 74 68 20 | 74 68 65 20 74 72 75 65 |ed with |the true|
|00002fd0| 20 62 6f 64 79 20 77 65 | 69 67 68 74 73 20 66 6f | body we|ights fo|
|00002fe0| 72 20 61 6c 6c 20 31 33 | 39 20 63 68 69 6c 64 72 |r all 13|9 childr|
|00002ff0| 65 6e 2e 20 20 54 68 69 | 73 20 73 74 75 64 79 0d |en.  Thi|s study.|
|00003000| 0a 63 6f 6e 66 69 72 6d | 65 64 20 74 68 61 74 20 |.confirm|ed that |
|00003010| 74 68 65 20 74 61 70 65 | 20 69 73 20 61 20 72 65 |the tape| is a re|
|00003020| 6c 69 61 62 6c 65 20 74 | 6f 6f 6c 20 66 6f 72 20 |liable t|ool for |
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|00003040| 77 65 69 67 68 74 20 69 | 6e 0d 0a 63 68 69 6c 64 |weight i|n..child|
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|00003060| 78 70 65 72 69 65 6e 63 | 65 64 20 68 61 6e 64 73 |xperienc|ed hands|
|00003070| 2e 20 20 54 68 65 20 75 | 73 65 20 6f 66 20 74 68 |.  The u|se of th|
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|000030b0| 66 20 65 72 72 6f 72 20 | 69 6e 20 63 61 6c 63 75 |f error |in calcu|
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|000030d0| 66 6c 75 69 64 20 72 65 | 71 75 69 72 65 6d 65 6e |fluid re|quiremen|
|000030e0| 74 73 0d 0a 66 6f 72 20 | 73 65 76 65 72 65 6c 79 |ts..for |severely|
|000030f0| 20 69 6c 6c 20 6f 72 20 | 69 6e 6a 75 72 65 64 20 | ill or |injured |
|00003100| 63 68 69 6c 64 72 65 6e | 20 62 72 6f 75 67 68 74 |children| brought|
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|000031e0| 74 68 65 20 74 61 70 65 | 20 73 79 73 74 65 6d 20 |the tape| system |
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|000035c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 50 65 64 69 61 |--------|-..Pedia|
|000035d0| 74 72 69 63 20 50 72 6f | 63 65 64 75 72 65 73 3a |tric Pro|cedures:|
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|00003600| 61 75 63 68 6e 65 72 20 | 48 3b 20 56 69 6e 63 69 |auchner |H; Vinci|
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|00003670| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003680| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00004f30| 20 61 6e 64 20 53 70 69 | 76 65 79 7d 0d 0a 24 54 | and Spi|vey}..$T|
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|00005050| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005060| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 43 6f 6d 70 61 72 |--------|..Compar|
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|00005140| 52 0d 0a 28 43 68 69 6c | 64 72 65 6e 27 73 20 48 |R..(Chil|dren's H|
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|00005160| 2c 20 57 61 73 68 69 6e | 67 74 6f 6e 2c 20 44 43 |, Washin|gton, DC|
|00005170| 3b 20 46 61 69 72 66 61 | 78 20 48 6f 73 70 2c 20 |; Fairfa|x Hosp, |
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|000051a0| 20 31 39 3a 36 33 2d 36 | 37 2c 20 31 39 39 30 0d | 19:63-6|7, 1990.|
|000051b0| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|000051c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00005200| 0a 0d 0a 41 62 73 74 72 | 61 63 74 0d 0a 0d 0a 20 |...Abstr|act.... |
|00005210| 20 20 20 20 4c 69 64 6f | 63 61 69 6e 65 20 69 6e |    Lido|caine in|
|00005220| 66 69 6c 74 72 61 74 69 | 6f 6e 20 66 6f 72 20 6c |filtrati|on for l|
|00005230| 61 63 65 72 61 74 69 6f | 6e 20 72 65 70 61 69 72 |aceratio|n repair|
|00005240| 20 69 73 20 73 61 66 65 | 2c 20 62 75 74 20 69 74 | is safe|, but it|
|00005250| 73 20 75 73 65 20 69 6e | 0d 0a 63 68 69 6c 64 72 |s use in|..childr|
|00005260| 65 6e 20 69 73 20 6f 66 | 74 65 6e 20 70 61 69 6e |en is of|ten pain|
|00005270| 66 75 6c 20 61 6e 64 20 | 66 72 69 67 68 74 65 6e |ful and |frighten|
|00005280| 69 6e 67 2e 20 20 41 20 | 74 6f 70 69 63 61 6c 6c |ing.  A |topicall|
|00005290| 79 20 61 70 70 6c 69 65 | 64 20 73 6f 6c 75 74 69 |y applie|d soluti|
|000052a0| 6f 6e 20 6f 66 0d 0a 30 | 2e 35 25 20 74 65 74 72 |on of..0|.5% tetr|
|000052b0| 61 63 61 69 6e 65 2c 20 | 31 3a 32 2c 30 30 30 20 |acaine, |1:2,000 |
|000052c0| 61 64 72 65 6e 61 6c 69 | 6e 65 20 28 65 70 69 6e |adrenali|ne (epin|
|000052d0| 65 70 68 72 69 6e 65 29 | 2c 20 61 6e 64 20 31 31 |ephrine)|, and 11|
|000052e0| 2e 38 25 20 63 6f 63 61 | 69 6e 65 20 28 54 41 43 |.8% coca|ine (TAC|
|000052f0| 29 0d 0a 61 70 70 65 61 | 72 73 20 74 6f 20 70 72 |)..appea|rs to pr|
|00005300| 6f 76 69 64 65 20 65 66 | 66 65 63 74 69 76 65 20 |ovide ef|fective |
|00005310| 61 6e 65 73 74 68 65 73 | 69 61 20 66 6f 72 20 6c |anesthes|ia for l|
|00005320| 61 63 65 72 61 74 69 6f | 6e 20 72 65 70 61 69 72 |aceratio|n repair|
|00005330| 20 69 6e 20 63 68 69 6c | 64 72 65 6e 20 61 6e 64 | in chil|dren and|
|00005340| 0d 0a 61 64 75 6c 74 73 | 2e 20 20 48 6f 77 65 76 |..adults|.  Howev|
|00005350| 65 72 2c 20 74 68 65 20 | 65 66 66 69 63 61 63 79 |er, the |efficacy|
|00005360| 20 61 6e 64 20 73 61 66 | 65 74 79 20 6f 66 20 54 | and saf|ety of T|
|00005370| 41 43 20 69 73 20 73 74 | 69 6c 6c 20 62 65 69 6e |AC is st|ill bein|
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|00005390| 68 69 73 20 70 72 6f 73 | 70 65 63 74 69 76 65 2c |his pros|pective,|
|000053a0| 20 72 61 6e 64 6f 6d 69 | 7a 65 64 2c 20 75 6e 62 | randomi|zed, unb|
|000053b0| 6c 69 6e 64 65 64 20 73 | 74 75 64 79 20 77 61 73 |linded s|tudy was|
|000053c0| 20 64 6f 6e 65 20 74 6f | 20 63 6f 6d 70 61 72 65 | done to| compare|
|000053d0| 20 54 41 43 20 20 77 69 | 74 68 0d 0a 6c 69 64 6f | TAC  wi|th..lido|
|000053e0| 63 61 69 6e 65 20 66 6f | 72 20 6c 6f 63 61 6c 20 |caine fo|r local |
|000053f0| 61 6e 65 73 74 68 65 73 | 69 61 20 6f 66 20 73 75 |anesthes|ia of su|
|00005400| 70 65 72 66 69 63 69 61 | 6c 20 6c 61 63 65 72 61 |perficia|l lacera|
|00005410| 74 69 6f 6e 73 20 69 6e | 20 63 68 69 6c 64 72 65 |tions in| childre|
|00005420| 6e 2e 0d 0a 20 20 20 20 | 20 54 68 65 20 73 74 75 |n...    | The stu|
|00005430| 64 79 20 70 6f 70 75 6c | 61 74 69 6f 6e 20 63 6f |dy popul|ation co|
|00005440| 6d 70 72 69 73 65 64 20 | 34 36 37 20 63 68 69 6c |mprised |467 chil|
|00005450| 64 72 65 6e 2c 20 61 67 | 65 64 20 37 20 6d 6f 6e |dren, ag|ed 7 mon|
|00005460| 74 68 73 2d 31 38 20 79 | 65 61 72 73 20 28 6d 65 |ths-18 y|ears (me|
|00005470| 61 6e 0d 0a 36 2e 33 20 | 79 65 61 72 73 29 2c 20 |an..6.3 |years), |
|00005480| 6f 66 20 77 68 6f 6d 20 | 32 36 32 20 72 65 63 65 |of whom |262 rece|
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|000054a0| 20 61 6e 64 20 32 30 35 | 20 72 65 63 65 69 76 65 | and 205| receive|
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|000054c0| 69 6c 74 72 61 74 69 6f | 6e 2e 20 20 4f 66 20 32 |iltratio|n.  Of 2|
|000054d0| 36 32 20 54 41 43 2d 74 | 72 65 61 74 65 64 20 63 |62 TAC-t|reated c|
|000054e0| 68 69 6c 64 72 65 6e 2c | 20 32 31 38 20 68 61 64 |hildren,| 218 had|
|000054f0| 20 66 61 63 69 61 6c 20 | 6f 72 20 73 63 61 6c 70 | facial |or scalp|
|00005500| 20 77 6f 75 6e 64 73 2c | 0d 0a 61 6e 64 20 34 34 | wounds,|..and 44|
|00005510| 20 68 61 64 20 65 78 74 | 72 65 6d 69 74 79 20 6f | had ext|remity o|
|00005520| 72 20 74 72 75 6e 6b 20 | 77 6f 75 6e 64 73 2e 20 |r trunk |wounds. |
|00005530| 20 4f 66 20 32 30 35 20 | 6c 69 64 6f 63 61 69 6e | Of 205 |lidocain|
|00005540| 65 2d 74 72 65 61 74 65 | 64 20 63 68 69 6c 64 72 |e-treate|d childr|
|00005550| 65 6e 2c 20 31 35 38 0d | 0a 68 61 64 20 66 61 63 |en, 158.|.had fac|
|00005560| 69 61 6c 20 6f 72 20 73 | 63 61 6c 70 20 77 6f 75 |ial or s|calp wou|
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|000055b0| 65 6c 6c 20 6d 61 74 63 | 68 65 64 20 66 6f 72 20 |ell matc|hed for |
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|000055e0| 20 63 68 69 6c 64 72 65 | 6e 20 77 69 74 68 0d 0a | childre|n with..|
|000055f0| 65 78 74 72 65 6d 69 74 | 79 20 6f 72 20 74 72 75 |extremit|y or tru|
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|00005630| 73 65 20 77 69 74 68 20 | 66 61 63 69 61 6c 0d 0a |se with |facial..|
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|00005650| 69 6f 6e 73 2e 0d 0a 20 | 20 20 20 20 41 64 65 71 |ions... |    Adeq|
|00005660| 75 61 74 65 20 61 6e 65 | 73 74 68 65 73 69 61 20 |uate ane|sthesia |
|00005670| 6f 66 20 66 61 63 69 61 | 6c 20 61 6e 64 20 73 63 |of facia|l and sc|
|00005680| 61 6c 70 20 77 6f 75 6e | 64 73 20 77 61 73 20 61 |alp woun|ds was a|
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|00005700| 74 72 65 6d 69 74 79 20 | 77 6f 75 6e 64 73 20 77 |tremity |wounds w|
|00005710| 61 73 20 61 63 68 69 65 | 76 65 64 20 66 6f 72 20 |as achie|ved for |
|00005720| 6f 6e 6c 79 20 34 33 25 | 20 6f 66 20 74 68 65 20 |only 43%| of the |
|00005730| 54 41 43 2d 74 72 65 61 | 74 65 64 0d 0a 77 6f 75 |TAC-trea|ted..wou|
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|00005790| 73 20 77 65 72 65 20 73 | 65 65 6e 20 69 6e 20 61 |s were s|een in a|
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|000057c0| 6f 75 6e 64 20 69 6e 66 | 65 63 74 69 6f 6e 20 77 |ound inf|ection w|
|000057d0| 61 73 20 32 2e 32 25 0d | 0a 66 6f 72 20 62 6f 74 |as 2.2%.|.for bot|
|000057e0| 68 20 54 41 43 20 61 6e | 64 20 6c 69 64 6f 63 61 |h TAC an|d lidoca|
|000057f0| 69 6e 65 2e 20 20 57 6f | 75 6e 64 20 64 65 68 69 |ine.  Wo|und dehi|
|00005800| 73 63 65 6e 63 65 20 6f | 66 20 66 61 63 69 61 6c |scence o|f facial|
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|00005820| 0d 0a 6f 63 63 75 72 72 | 65 64 20 69 6e 20 37 20 |..occurr|ed in 7 |
|00005830| 54 41 43 2d 74 72 65 61 | 74 65 64 20 70 61 74 69 |TAC-trea|ted pati|
|00005840| 65 6e 74 73 20 61 6e 64 | 20 32 20 6c 69 64 6f 63 |ents and| 2 lidoc|
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|00005860| 69 65 6e 74 73 2e 20 20 | 57 6f 75 6e 64 0d 0a 64 |ients.  |Wound..d|
|00005870| 65 68 69 73 63 65 6e 63 | 65 20 61 6c 73 6f 20 6f |ehiscenc|e also o|
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|000058a0| 69 64 6f 63 61 69 6e 65 | 2d 74 72 65 61 74 65 64 |idocaine|-treated|
|000058b0| 20 65 78 74 72 65 6d 69 | 74 79 0d 0a 77 6f 75 6e | extremi|ty..woun|
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|000058d0| 6e 63 65 73 20 77 65 72 | 65 20 73 74 61 74 69 73 |nces wer|e statis|
|000058e0| 74 69 63 61 6c 6c 79 20 | 6e 6f 74 20 73 69 67 6e |tically |not sign|
|000058f0| 69 66 69 63 61 6e 74 2e | 20 20 57 6f 75 6e 64 20 |ificant.|  Wound |
|00005900| 65 72 79 74 68 65 6d 61 | 0d 0a 77 61 73 20 73 65 |erythema|..was se|
|00005910| 65 6e 20 73 6c 69 67 68 | 74 6c 79 20 6d 6f 72 65 |en sligh|tly more|
|00005920| 20 6f 66 74 65 6e 20 69 | 6e 20 54 41 43 2d 74 72 | often i|n TAC-tr|
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|00005940| 68 61 6e 20 69 6e 20 6c | 69 64 6f 63 61 69 6e 65 |han in l|idocaine|
|00005950| 2d 74 72 65 61 74 65 64 | 0d 0a 70 61 74 69 65 6e |-treated|..patien|
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|00005970| 65 72 65 6e 63 65 20 77 | 61 73 20 61 6c 73 6f 20 |erence w|as also |
|00005980| 6e 6f 74 20 73 69 67 6e | 69 66 69 63 61 6e 74 2e |not sign|ificant.|
|00005990| 0d 0a 20 20 20 20 20 54 | 68 65 20 73 6f 6c 75 74 |..     T|he solut|
|000059a0| 69 6f 6e 20 6f 66 20 54 | 41 43 20 77 61 73 20 77 |ion of T|AC was w|
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|000059c0| 70 61 74 69 65 6e 74 73 | 20 61 6e 64 20 70 61 72 |patients| and par|
|000059d0| 65 6e 74 73 2c 0d 0a 70 | 61 72 74 69 63 75 6c 61 |ents,..p|articula|
|000059e0| 72 6c 79 20 77 68 65 6e | 20 75 73 65 64 20 6f 6e |rly when| used on|
|000059f0| 20 66 61 63 69 61 6c 20 | 61 6e 64 20 73 63 61 6c | facial |and scal|
|00005a00| 70 20 6c 61 63 65 72 61 | 74 69 6f 6e 73 2e 20 20 |p lacera|tions.  |
|00005a10| 50 61 72 65 6e 74 73 20 | 6f 66 20 63 68 69 6c 64 |Parents |of child|
|00005a20| 72 65 6e 0d 0a 77 69 74 | 68 20 54 41 43 2d 74 72 |ren..wit|h TAC-tr|
|00005a30| 65 61 74 65 64 20 65 78 | 74 72 65 6d 69 74 79 20 |eated ex|tremity |
|00005a40| 6f 72 20 74 72 75 6e 6b | 20 77 6f 75 6e 64 73 20 |or trunk| wounds |
|00005a50| 77 65 72 65 20 73 69 67 | 6e 69 66 69 63 61 6e 74 |were sig|nificant|
|00005a60| 6c 79 20 6c 65 73 73 20 | 73 61 74 69 73 66 69 65 |ly less |satisfie|
|00005a70| 64 0d 0a 77 69 74 68 20 | 74 68 65 20 61 6e 65 73 |d..with |the anes|
|00005a80| 74 68 65 73 69 61 2e 20 | 20 54 68 65 20 75 73 65 |thesia. | The use|
|00005a90| 20 6f 66 20 54 41 43 20 | 69 73 20 61 20 6d 6f 72 | of TAC |is a mor|
|00005aa0| 65 20 68 75 6d 61 6e 65 | 20 61 6c 74 65 72 6e 61 |e humane| alterna|
|00005ab0| 74 69 76 65 20 74 6f 20 | 6c 69 64 6f 63 61 69 6e |tive to |lidocain|
|00005ac0| 65 0d 0a 69 6e 66 69 6c | 74 72 61 74 69 6f 6e 20 |e..infil|tration |
|00005ad0| 66 6f 72 20 61 6e 65 73 | 74 68 65 74 69 7a 69 6e |for anes|thetizin|
|00005ae0| 67 20 73 75 70 65 72 66 | 69 63 69 61 6c 20 66 61 |g superf|icial fa|
|00005af0| 63 69 61 6c 20 61 6e 64 | 20 73 63 61 6c 70 20 6c |cial and| scalp l|
|00005b00| 61 63 65 72 61 74 69 6f | 6e 73 20 69 6e 0d 0a 63 |aceratio|ns in..c|
|00005b10| 68 69 6c 64 72 65 6e 2e | 20 20 49 74 20 69 73 20 |hildren.|  It is |
|00005b20| 6c 65 73 73 20 75 73 65 | 66 75 6c 20 66 6f 72 20 |less use|ful for |
|00005b30| 61 6e 65 73 74 68 65 74 | 69 7a 69 6e 67 20 65 78 |anesthet|izing ex|
|00005b40| 74 72 65 6d 69 74 79 20 | 77 6f 75 6e 64 73 2e 0d |tremity |wounds..|
|00005b50| 0a 0d 0a 50 6f 73 74 2d | 43 6f 6d 6d 65 6e 74 0d |...Post-|Comment.|
|00005b60| 0a 0d 0a 20 20 20 20 20 | 54 6f 70 69 63 61 6c 20 |...     |Topical |
|00005b70| 54 41 43 20 68 61 73 20 | 62 65 65 6e 20 61 72 6f |TAC has |been aro|
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|00005ba0| 74 65 64 20 66 6f 72 20 | 75 73 65 20 6f 6e 0d 0a |ted for |use on..|
|00005bb0| 73 6d 61 6c 6c 2c 20 73 | 75 70 65 72 66 69 63 69 |small, s|uperfici|
|00005bc0| 61 6c 20 6c 61 63 65 72 | 61 74 69 6f 6e 73 2e 0d |al lacer|ations..|
|00005bd0| 0a 20 20 20 20 20 49 66 | 20 6f 6e 65 20 63 68 6f |.     If| one cho|
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|00005bf0| 63 61 6c 20 61 6e 61 6c | 67 65 73 69 61 2c 20 74 |cal anal|gesia, t|
|00005c00| 68 65 72 65 20 61 72 65 | 20 32 20 6f 74 68 65 72 |here are| 2 other|
|00005c10| 20 74 72 69 63 6b 73 20 | 74 68 61 74 20 49 0d 0a | tricks |that I..|
|00005c20| 68 61 76 65 20 75 73 65 | 64 20 6f 76 65 72 20 74 |have use|d over t|
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|00005c40| 73 20 74 6f 20 61 64 6a | 75 73 74 20 74 68 65 20 |s to adj|ust the |
|00005c50| 70 48 20 6f 66 20 6c 69 | 64 6f 63 61 69 6e 65 20 |pH of li|docaine |
|00005c60| 62 79 20 70 6c 61 63 69 | 6e 67 20 31 0d 0a 6d 4c |by placi|ng 1..mL|
|00005c70| 20 6f 66 20 73 6f 64 69 | 75 6d 20 62 69 63 61 72 | of sodi|um bicar|
|00005c80| 62 6f 6e 61 74 65 20 77 | 69 74 68 20 31 30 20 6d |bonate w|ith 10 m|
|00005c90| 4c 20 6f 66 20 6c 69 64 | 6f 63 61 69 6e 65 2e 20 |L of lid|ocaine. |
|00005ca0| 20 46 6f 72 20 70 61 74 | 69 65 6e 74 73 20 77 69 | For pat|ients wi|
|00005cb0| 74 68 20 61 62 72 61 73 | 69 6f 6e 73 0d 0a 74 68 |th abras|ions..th|
|00005cc0| 61 74 20 6e 65 65 64 20 | 63 6c 65 61 6e 69 6e 67 |at need |cleaning|
|00005cd0| 20 6f 72 20 72 65 6d 6f | 76 61 6c 20 6f 66 20 72 | or remo|val of r|
|00005ce0| 6f 61 64 20 74 61 72 73 | 2c 20 49 20 68 61 76 65 |oad tars|, I have|
|00005cf0| 20 75 73 65 64 20 74 68 | 65 20 32 25 20 6f 72 20 | used th|e 2% or |
|00005d00| 34 25 20 6c 69 64 6f 63 | 61 69 6e 65 0d 0a 28 58 |4% lidoc|aine..(X|
|00005d10| 79 6c 6f 63 61 69 6e 65 | 29 20 6a 65 6c 6c 79 2e |ylocaine|) jelly.|
|00005d20| 20 20 42 65 63 61 75 73 | 65 20 65 61 63 68 20 6f |  Becaus|e each o|
|00005d30| 66 20 74 68 65 73 65 20 | 68 61 73 20 61 20 68 69 |f these |has a hi|
|00005d40| 67 68 65 72 20 61 6d 6f | 75 6e 74 20 6f 66 20 6c |gher amo|unt of l|
|00005d50| 69 64 6f 63 61 69 6e 65 | 20 70 65 72 0d 0a 6d 69 |idocaine| per..mi|
|00005d60| 6c 6c 69 6c 69 74 65 72 | 20 74 68 61 6e 20 54 41 |lliliter| than TA|
|00005d70| 43 2c 20 6f 6e 65 20 6e | 65 65 64 73 20 74 6f 20 |C, one n|eeds to |
|00005d80| 70 61 79 20 70 61 72 74 | 69 63 75 6c 61 72 20 61 |pay part|icular a|
|00005d90| 74 74 65 6e 74 69 6f 6e | 20 74 6f 20 74 68 65 20 |ttention| to the |
|00005da0| 74 6f 74 61 6c 20 76 6f | 6c 75 6d 65 0d 0a 75 73 |total vo|lume..us|
|00005db0| 65 64 2e 20 20 44 6f 20 | 6e 6f 74 20 65 78 63 65 |ed.  Do |not exce|
|00005dc0| 65 64 20 61 20 64 6f 73 | 65 20 6f 66 20 33 20 6d |ed a dos|e of 3 m|
|00005dd0| 67 20 6f 66 20 6c 69 64 | 6f 63 61 69 6e 65 2f 6b |g of lid|ocaine/k|
|00005de0| 67 2e 0d 0a 20 20 20 20 | 20 43 6f 6e 73 63 69 6f |g...    | Conscio|
|00005df0| 75 73 20 73 65 64 61 74 | 69 6f 6e 20 69 73 20 61 |us sedat|ion is a|
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|00005e30| 6e 2e 2d 2d 52 2e 57 2e | 20 53 63 68 61 66 65 72 |n.--R.W.| Schafer|
|00005e40| 6d 65 79 65 72 2c 20 4d | 2e 44 2e 0d 0a 24 55 6e |meyer, M|.D...$Un|
|00005e50| 69 71 75 65 5f 49 44 7b | 59 52 42 30 31 33 30 36 |ique_ID{|YRB01306|
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|00005e80| 6e 65 2c 20 50 72 6f 6d | 65 74 68 61 7a 69 6e 65 |ne, Prom|ethazine|
|00005e90| 2c 20 61 6e 64 20 43 68 | 6c 6f 72 70 72 6f 6d 61 |, and Ch|lorproma|
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|00005eb0| 0a 6f 66 20 55 73 65 20 | 61 6e 64 20 43 6f 6d 70 |.of Use |and Comp|
|00005ec0| 6c 69 63 61 74 69 6f 6e | 73 20 69 6e 20 34 38 37 |lication|s in 487|
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|00005ee0| 65 6e 63 79 20 44 65 70 | 61 72 74 6d 65 6e 74 20 |ency Dep|artment |
|00005ef0| 50 61 74 69 65 6e 74 73 | 7d 0d 0a 24 41 75 74 68 |Patients|}..$Auth|
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|00005f10| 45 0d 0a 43 61 6e 74 6f | 72 2c 20 52 4d 0d 0a 4d |E..Canto|r, RM..M|
|00005f20| 61 64 64 65 6e 2c 20 43 | 4d 7d 0d 0a 24 41 66 66 |adden, C|M}..$Aff|
|00005f30| 69 6c 69 61 74 69 6f 6e | 7b 53 74 61 74 65 20 55 |iliation|{State U|
|00005f40| 6e 69 76 20 6f 66 20 4e | 65 77 20 59 6f 72 6b 2c |niv of N|ew York,|
|00005f50| 20 53 79 72 61 63 75 73 | 65 7d 0d 0a 24 4a 6f 75 | Syracus|e}..$Jou|
|00005f60| 72 6e 61 6c 7b 41 6e 6e | 20 45 6d 65 72 67 20 4d |rnal{Ann| Emerg M|
|00005f70| 65 64 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 31 38 7d |ed}..$Vo|lume{18}|
|00005f80| 0d 0a 24 50 61 67 65 7b | 35 32 38 2d 35 33 33 7d |..$Page{|528-533}|
|00005f90| 0d 0a 24 44 61 74 65 7b | 31 39 38 39 7d 0d 0a 24 |..$Date{|1989}..$|
|00005fa0| 59 42 56 6f 6c 7b 31 39 | 39 31 20 59 65 61 72 20 |YBVol{19|91 Year |
|00005fb0| 42 6f 6f 6b 20 6f 66 20 | 45 6d 65 72 67 65 6e 63 |Book of |Emergenc|
|00005fc0| 79 20 4d 65 64 69 63 69 | 6e 65 7d 0d 0a 24 43 68 |y Medici|ne}..$Ch|
|00005fd0| 61 70 74 65 72 7b 34 2d | 35 34 7d 0d 0a 24 59 42 |apter{4-|54}..$YB|
|00005fe0| 45 64 69 74 6f 72 7b 44 | 72 73 2e 20 57 61 67 6e |Editor{D|rs. Wagn|
|00005ff0| 65 72 2c 20 42 75 72 64 | 69 63 6b 2c 20 44 61 76 |er, Burd|ick, Dav|
|00006000| 69 64 73 6f 6e 2c 20 52 | 6f 62 65 72 74 73 2c 20 |idson, R|oberts, |
|00006010| 61 6e 64 20 53 70 69 76 | 65 79 7d 0d 0a 24 54 61 |and Spiv|ey}..$Ta|
|00006020| 62 6c 65 7b 7d 0d 0a 24 | 43 6f 6d 6d 65 6e 74 61 |ble{}..$|Commenta|
|00006030| 74 6f 72 7b 4b 2e 4e 2e | 20 53 68 61 77 2c 20 4d |tor{K.N.| Shaw, M|
|00006040| 2e 44 2e 7d 0d 0a 0d 0a | 43 6f 70 79 72 69 67 68 |.D.}....|Copyrigh|
|00006050| 74 20 28 43 29 20 59 65 | 61 72 20 42 6f 6f 6b 20 |t (C) Ye|ar Book |
|00006060| 4d 65 64 69 63 61 6c 20 | 50 75 62 6c 69 73 68 65 |Medical |Publishe|
|00006070| 72 73 2c 20 49 6e 63 2e | 20 31 39 39 31 0d 0a 0d |rs, Inc.| 1991...|
|00006080| 0a 31 39 39 31 20 59 65 | 61 72 20 42 6f 6f 6b 20 |.1991 Ye|ar Book |
|00006090| 6f 66 20 45 6d 65 72 67 | 65 6e 63 79 20 4d 65 64 |of Emerg|ency Med|
|000060a0| 69 63 69 6e 65 0d 0a 0d | 0a 43 68 61 70 74 65 72 |icine...|.Chapter|
|000060b0| 20 34 20 2d 2d 20 53 70 | 65 63 69 61 6c 20 45 6d | 4 -- Sp|ecial Em|
|000060c0| 65 72 67 65 6e 63 69 65 | 73 0d 0a 0d 0a 49 6e 66 |ergencie|s....Inf|
|000060d0| 61 6e 74 20 61 6e 64 20 | 43 68 69 6c 64 68 6f 6f |ant and |Childhoo|
|000060e0| 64 20 45 6d 65 72 67 65 | 6e 63 69 65 73 0d 0a 0d |d Emerge|ncies...|
|000060f0| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00006100| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006110| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006120| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006130| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00006140| 0a 49 6e 74 72 61 6d 75 | 73 63 75 6c 61 72 20 4d |.Intramu|scular M|
|00006150| 65 70 65 72 69 64 69 6e | 65 2c 20 50 72 6f 6d 65 |eperidin|e, Prome|
|00006160| 74 68 61 7a 69 6e 65 2c | 20 61 6e 64 20 43 68 6c |thazine,| and Chl|
|00006170| 6f 72 70 72 6f 6d 61 7a | 69 6e 65 3a 20 20 41 6e |orpromaz|ine:  An|
|00006180| 61 6c 79 73 69 73 20 6f | 66 20 55 73 65 0d 0a 61 |alysis o|f Use..a|
|00006190| 6e 64 20 43 6f 6d 70 6c | 69 63 61 74 69 6f 6e 73 |nd Compl|ications|
|000061a0| 20 69 6e 20 34 38 37 20 | 50 65 64 69 61 74 72 69 | in 487 |Pediatri|
|000061b0| 63 20 45 6d 65 72 67 65 | 6e 63 79 20 44 65 70 61 |c Emerge|ncy Depa|
|000061c0| 72 74 6d 65 6e 74 20 50 | 61 74 69 65 6e 74 73 0d |rtment P|atients.|
|000061d0| 0a 0d 0a 54 65 72 6e 64 | 72 75 70 20 54 45 3b 20 |...Ternd|rup TE; |
|000061e0| 43 61 6e 74 6f 72 20 52 | 4d 3b 20 4d 61 64 64 65 |Cantor R|M; Madde|
|000061f0| 6e 20 43 4d 0d 0a 28 53 | 74 61 74 65 20 55 6e 69 |n CM..(S|tate Uni|
|00006200| 76 20 6f 66 20 4e 65 77 | 20 59 6f 72 6b 2c 20 53 |v of New| York, S|
|00006210| 79 72 61 63 75 73 65 29 | 0d 0a 41 6e 6e 20 45 6d |yracuse)|..Ann Em|
|00006220| 65 72 67 20 4d 65 64 20 | 31 38 3a 35 32 38 2d 35 |erg Med |18:528-5|
|00006230| 33 33 2c 20 31 39 38 39 | 0d 0a 2d 2d 2d 2d 2d 2d |33, 1989|..------|
|00006240| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006250| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006260| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006270| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006280| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|00006290| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 54 68 65 |ract....|     The|
|000062a0| 20 75 73 65 20 6f 66 20 | 44 50 54 2c 20 61 20 6d | use of |DPT, a m|
|000062b0| 69 78 74 75 72 65 20 6f | 66 20 6d 65 72 70 65 72 |ixture o|f merper|
|000062c0| 69 64 69 6e 65 20 28 44 | 65 6d 65 72 6f 6c 29 2c |idine (D|emerol),|
|000062d0| 20 70 72 6f 6d 65 74 68 | 61 7a 69 6e 65 0d 0a 28 | prometh|azine..(|
|000062e0| 50 68 65 6e 65 72 67 61 | 6e 29 2c 20 61 6e 64 20 |Phenerga|n), and |
|000062f0| 63 68 6c 6f 72 70 72 6f | 6d 61 7a 69 6e 65 20 28 |chlorpro|mazine (|
|00006300| 54 68 6f 72 61 7a 69 6e | 65 29 2c 20 68 61 73 20 |Thorazin|e), has |
|00006310| 62 65 65 6e 20 61 63 63 | 65 70 74 65 64 20 74 6f |been acc|epted to|
|00006320| 20 73 6f 6d 65 20 64 65 | 67 72 65 65 0d 0a 62 79 | some de|gree..by|
|00006330| 20 74 68 65 20 70 65 64 | 69 61 74 72 69 63 20 63 | the ped|iatric c|
|00006340| 6f 6d 6d 75 6e 69 74 79 | 2c 20 62 75 74 20 72 65 |ommunity|, but re|
|00006350| 63 6f 6d 6d 65 6e 64 61 | 74 69 6f 6e 73 20 66 6f |commenda|tions fo|
|00006360| 72 20 69 74 73 20 75 73 | 65 20 73 74 69 6c 6c 20 |r its us|e still |
|00006370| 64 69 66 66 65 72 2e 0d | 0a 50 61 74 74 65 72 6e |differ..|.Pattern|
|00006380| 73 20 6f 66 20 44 50 54 | 20 75 73 65 20 77 65 72 |s of DPT| use wer|
|00006390| 65 20 65 78 61 6d 69 6e | 65 64 20 69 6e 20 61 20 |e examin|ed in a |
|000063a0| 72 65 76 69 65 77 20 6f | 66 20 6e 65 61 72 6c 79 |review o|f nearly|
|000063b0| 20 35 30 30 20 70 65 64 | 69 61 74 72 69 63 20 70 | 500 ped|iatric p|
|000063c0| 61 74 69 65 6e 74 73 0d | 0a 73 65 65 6e 20 69 6e |atients.|.seen in|
|000063d0| 20 61 6e 20 45 44 20 69 | 6e 20 61 20 32 2d 79 65 | an ED i|n a 2-ye|
|000063e0| 61 72 20 70 65 72 69 6f | 64 2e 20 20 54 68 65 20 |ar perio|d.  The |
|000063f0| 6d 69 78 74 75 72 65 20 | 77 61 73 20 67 69 76 65 |mixture |was give|
+--------+-------------------------+-------------------------+--------+--------+