By Denise Goodman, Thomas Green, Sharon Unti, Elizabeth Powell
"This is a smart first version reference, delivering suggestions and step by step guideline for strategies in pediatrics and pediatric subspecialties. it's very important for college kids and housestaff whereas on name and will also be of gain to fundamental care companies and practitioners. three Stars."--Doody's evaluation carrier This crucial consultant to pediatric methods places all of the newest ideas correct within the palm of your hand. You wil locate authoritative insurance of greater than 70 pediatric strategies, together with peripheral IV insertion, sedation and discomfort administration, blood strain administration, gastric lavage, suturing of lacerations, tympanometry, corneal abrasion and eye patching, nearby nerve blocks, and extra!
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Additional info for Current Procedures: Pediatrics (Lange Medical Books)
Skin preparation solution (either 2% chlorhexidine-based preparation for patients older than 2 months or 10% povidone-iodine). Sterile drapes. Scalpel blade. 0 silk). Sterile gauze pads. RISKS ■ ■ ■ ■ ■ Bleeding (can usually be managed by applying pressure to the site). Infection (can be minimized with the use of good sterile technique during placement and regular catheter care). Embolization of the guidewire if the operator does not use proper technique. Vessel perforation. Embolization of a preexisting thrombus.
Bone fracture. Hematoma. Extravasation. Compartment syndrome. Severe vasoconstriction if vasoactive substances extravasate. PEARLS AND TIPS ■ ■ ■ ■ ■ Do not place hands under the site of insertion. Avoid administration of bone marrow–suppressing drugs. Avoid prolonged use. Replace with an intravenous line after the patient is stabilized. A properly placed unsupported needle will remain upright. Fluid should ﬂow freely through the needle, and the line should ﬂush without resistance. PATIENT PREPARATION ■ ■ ■ ■ Introduce yourself to the parents and the patient.
Must be able to manage the airway. 1. 0 mg/kg. Onset of action: 30–60 seconds. Duration of effect: 4–6 minutes. Major disadvantage is vagal stimulation, which can result in bradycardia and cardiac arrest, especially after second dose. Should always be preceded by atropine. Metabolized by plasma pseudocholinesterase. Contraindications include the following: • Traumatic and burn injuries (increased receptor density 24 hours to 6 months after injury; note: not contraindicated at time of injury).