Oral Versus Intravenous Rehydration of Moderately Dehydrated Children: A Randomized, Controlled Trial

Spandorfer, Philip R.; Alessandrini, Evaline A.; Joffe, Mark; Localio, Russell; Shaw, Kathy N.

doi:10.1542/peds.2004-0245

Cited by 124 publications

(109 citation statements)

References 8 publications

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“…It has been proved that applying a local anaesthetic before a needle procedure decreases children's pain and distress and increases the success rate of the procedure (13,(18)(19)(20). Therefore, success at the first attempt is crucial in limiting…”

Section: Discussionmentioning

confidence: 99%

First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

et al. 2017

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Accepted ArticleThis article is protected by copyright. All rights reserved. Aim: More than 50% of children report apian during venipuncture or intravenous cannulation and using local anaesthetics before needle procedures can lead to different success rates. This study examined how many needle procedures were successful at the first attempt when children received either a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream. Methods:We conducted this multicentre randomised controlled trial at three tertiary-level children's hospitals in Italy in 2015. Children aged 3-10 years were enrolled in an emergency department, paediatric day hospital and paediatric ward and randomly allocated to receive a warm lidocaine and tetracaine patch or EMLA cream. The primary outcome was the success rate at the first attempt. Results:The analysis included 172 children who received a warm lidocaine and tetracaine patch and 167 who received an EMLA cream. The needle procedure was successful at the first attempt in 158 children (92.4%) who received the warm patch and in 142 children (85.0%) who received the cream (p=0.03). The pain scores were similar in both groups. Conclusion:This study showed that the first-time needle procedure success was 7.4% higher in children receiving a warm lidocaine and tetracaine patch than EMLA cream. Accepted ArticleThis article is protected by copyright. All rights reserved.Keywords: eutectic mixture of lidocaine and tetracaine cream; local anaesthetic; needle procedure; procedural success rate; warm lidocaine and tetracaine patch Key notes:• Applying local anesthetics may influence success rates in children undergoing painful needle procedures.• We compared how many needles were inserted at the first attempt when children received a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream.• The three Italian hospitals who took part reported that the success rate was higher in children treated with the warm patch (92.4%) than the cream (85.0%). AbbreviationsARR, absolute risk reduction; CI, confidence intervals; EMLA, eutectic mixture of lidocaine and tetracaine; IQR, interquartile ranges; NNT, number need to treat; RR, relative risks

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Section: Discussionmentioning

confidence: 99%

First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

et al. 2017

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“…Além disso, foi observada a inexistência, em ambos os serviços, de sala específica para reidratação oral. Nos estudos que demonstram a eficácia da TRO no manejo da desidratação moderada, sua administração foi realizada em um setor separado da própria emergência, sob supervisão contínua 4,5 . Insegurança em relação à eficiência da terapia, nas condições reais de uma emergência, sem o seguimento de seus princípios básicos, pode estar contribuindo para sua baixa utilização.…”

Section: Discussionunclassified

“…A pressão da demanda, contudo, não deveria ser um obstáculo para a realização da TRO, visto que o tempo de permanência no setor observado foi menor para as crianças que usaram essa terapia. Embora implique maior tempo para reidratação, o início da terapia e a realimentação são mais precoces com a TRO 5,6 .…”

Section: Discussionunclassified

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Oral rehydration therapy in emergency departments

Costa¹,

Silva²

2011

J Pediatr (Rio J)

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Objective: To describe the management of acute diarrhea in emergency departments with emphasis on the type of hydration and exploring factors associated with prescription of oral rehydration therapy vs. intravenous rehydration therapy for children with dehydration that is not severe. Methods:This was a descriptive study conducted from January to May of 2008 observing case management of children with non-severe dehydration due to acute diarrhea at two emergency units (A and B) in Recife, Brazil. Emergency unit B is affiliated to a teaching hospital. The primary variables were: 1) type of hydration prescribed, 2) associations with the characteristics of the children and emergency department (A or B).Results: A total of 166 children took part in the study. The rates of prescription of oral rehydration therapy were similar at both services (32.2 vs. 31.6% for A and B, respectively, p = 0.93) and were lower for cases with moderate dehydration (17.6%) compared with mild dehydration (35.6%) (p = 0.07). Neither service had a dedicated oral rehydration room.Conclusions: Most children were given intravenous rehydration therapy, especially those with moderate dehydration, without differences according type of service: whether a teaching institution or healthcare provider only.J Pediatr (Rio J). 2011;87(2):175-179: Emergency medical services, fluid therapy, gastroenteritis, child. ResumoObjetivo: Descrever o manejo da diarreia aguda na emergência, explorando fatores associados à prescrição da terapia de reidratação oral (TRO) versus terapia de reidratação venosa (TRV) para crianças com desidratação não grave.Métodos: Estudo descritivo conduzido de janeiro a maio de 2008 em duas unidades de emergência em Recife (PE), A e B, sendo a emergência B vinculada a um hospital-escola, com observação do manejo de crianças com desidratação não grave por diarreia aguda. As principais variáveis foram: 1) tipo de hidratação prescrito; 2) associação com características das crianças e local.Resultados: Cento e sessenta e seis crianças participaram do estudo. A indicação de TRO foi semelhante nos dois serviços (32,2 versus 31,6% em A e B, respectivamente, p = 0,93) e menor para os casos com desidratação moderada (17,6%) em relação à forma leve (35,6%), p = 0,07. Não havia sala de reidratação oral nos serviços. Conclusões:A maioria das crianças não fez uso de TRO, principalmente aquelas com desidratação moderada, não havendo diferença em relação ao tipo de serviço, assistencial ou de ensino.J Pediatr (Rio J). 2011;87(2):175-179: Serviços médicos de emergência, terapia de reidratação oral, gastroenterite, criança.

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“…1 Nearly all of these deaths are from dehydration, which is cheaply preventable through the use of oral rehydration salts (ORS) or other forms of oral rehydration therapy (ORT). [2][3][4][5][6] ORS has been lauded as one of the most important medical advances of the 20th century and since 1980, when ORS became widely available, there has been more than a twothirds reduction in diarrheal mortality for children 5 years of age. 7,8 As a result, ORS is recommended for all cases of child diarrhea regardless of illness severity.…”

Section: Introductionmentioning

confidence: 99%

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

Sood

Wagner²

2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13-17) than public providers and 12% points more likely to provide other treatments (95% CI 10-15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored.

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Oral Versus Intravenous Rehydration of Moderately Dehydrated Children: A Randomized, Controlled Trial

Cited by 124 publications

References 8 publications

First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

Oral rehydration therapy in emergency departments

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

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