A Randomized Trial of a Single Dose of Oral Dexamethasone for Mild Croup

Bjornson, Candice; Klassen, Terry P.; Williamson, J; Brant, Rollin; Mitton, Craig; Plint, Amy C.; Bulloch, Blake; Evered, Lisa; Johnson, David W.

doi:10.1056/nejmoa033534

Cited by 170 publications

(98 citation statements)

References 24 publications

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“…The overall evidence suggests that the oral delivery of dexamethasone at a dose of 0.3 mg/kg for moderate croup up to 0.6 mg/kg for severe croup as a single dose is helpful in decreasing symptoms at 6, 12, and 24 hours after treatment, decreasing the need to use nebulized epinephrine, reducing the length of stay in the ED and resulting in fewer hospital admissions. 36,39,40 The onset of action of dexamethasone may be clinically apparent as soon as 30 minutes after its administration. 41 In a patient who is not vomiting, there is little evidence to suggest that parenteral administration is superior to oral administration.…”

Section: Croupmentioning

confidence: 99%

Update on the utility of corticosteroids in acute pediatric respiratory disorders

Beigelman¹,

Chipps²,

Bacharier³

2015

allergy asthma proc

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Section: Croupmentioning

confidence: 99%

Update on the utility of corticosteroids in acute pediatric respiratory disorders

Beigelman¹,

Chipps²,

Bacharier³

2015

allergy asthma proc

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“…Other rigorously designed studies support the use of parental recall via telephone follow-up with respect to reports on physician visits within the time frame used in this study. , 17,18 Families were asked about the following details related to the index fracture: clinical status, pain (never, occasionally, often, or always) and return to usual activities (always, most of the time, some of the time, not very often, or never); type (if any) of physician follow-up; parent management of splint usage and return to activities; and physician visits and diagnostic imaging taken after the ED visit, with respective changes in diagnosis/treatment. Families were also asked about their satisfaction with PCP follow-up and PCP-recommended time frames for splint usage and return to usual activities.…”

Section: Follow-upmentioning

confidence: 99%

Primary Care Physician Follow-up of Distal Radius Buckle Fractures

Koelink

Schuh²,

Howard³

et al. 2016

Pediatrics

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OBJECTIVES: Our main objective was to determine the proportion of children referred to a primary care provider (PCP) for follow-up of a distal radius buckle fracture who subsequently did not deviate from this reassessment strategy.METHODS: This prospective cohort study was conducted at a tertiary care pediatric emergency department (ED). Eligible children were aged 2 to 17 years with a distal radius buckle fracture treated with a removable splint and referred to the PCP for reassessment. We telephoned families 28 days after their ED visit. The primary outcome was the proportion who received PCP follow-up exclusively. We also measured the proportion who received PCP anticipatory guidance and those children who reported returning to usual activities "always" by 4 weeks. RESULTS:We enrolled 200 children, and 180 (90.0%) received telephone follow-up. Of these, 157 (87.2% [95% confidence interval: 82.3 to 92.1]) received PCP follow-up exclusively. Specifically, 11 (6.1%) families opted out of physician follow-up, 5 (2.8%) self-referred to an ED, and the PCP requested specialty consultation in 7 (3.9%) cases. Of the 164 with a PCP visit, 77 (47.0%) parents received anticipatory guidance on return to activities for their child, and 162 (98.8%) reported return to usual activities within 4 weeks. CONCLUSIONS:The vast majority of children with distal radius buckle fractures presented to the PCP for follow-up and did not receive additional orthopedic surgeon or ED consultations. Despite a suboptimal rate of PCP advice on return to activities, almost all parents reported full return to usual activities within 4 weeks.

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“…Bjornson a étudié l'efficacité de la dexaméthasone pour traiter le croup dans une étude randomisée contrôlée portant sur 720 enfants. 28 Une dose unique de 0,6 mgÁkg -1 de dexaméthasone a été donnée à l'urgence, et aucun événement néfaste n'a été rapporté lors du rendez-vous de suivi, 21 jours plus tard. Cette dose est considérablement plus élevée que la dose généralement administrée en période périopératoire.…”

Section: Innocuité Deunclassified

“…Bjornson studied the efficacy of dexamethasone to treat croup in a randomized controlled trial of 720 children. 28 A single 0.6 mgÁkg -1 dose of dexamethasone was given in the emergency department, and there were no reports of any adverse events on follow-up after 21 days. This dose is significantly greater than the dose typically used in the perioperative period.…”

mentioning

confidence: 96%