Therapy Article Case Scenarios
1. You are in the midst of your ward rotation during January. You feel crummy
and suspect your are experiencing a “pre-cold”. While rushing off the floor to
head over to continuity clinic, where you know you will see another half
dozen kids with URIs. you are wonder if any of those “herbal remedies” will
do anything about fighting your cold, or preventing you from catching
anything else those little buggars might expose you to today. You decide to
do a lit search…
Cohen HA, Varsano I, Kahan E, Sarrell EM, Uziel Y. Effectiveness of an Herbal Preparation
Containing Echinacea, Propolis, and Vitamin C in Preventing Respiratory Tract Infections in
Children. Arch Pediatr Adolesc Med, 2004; 158:217-221.
2. It is April in the ED. You are watching 4 of your patients with vomiting,
diarrhea and dehydration fail their PO trials. You are troubled because there
are no beds available on 11N. You suggest to your attending that you try a
dose of ondansetron to see if it helps with the vomiting in these children. She
thinks it’s worth a try, but wants you to back up your plan with some
literature.
Freedman SB, Adler M, Seshadri R, Powell EC. Oral Ondansetram for Gastroenteritis in a
Pediatric Emergency Department. N Engl J Med, 2006; 354:1698-1705.
3. You are working in the ER in November. You are evaluating a 4 month old
infant with respiratory distress, tachypnea and hypoxia. You suspect the
infant has bronchiolitis and would like to give a racemic epi neb. Your
attending wonders if you should try albuterol first, thinking that if it works,
you could send your patient home with some albuterol. The patient
ultimately ends up being admitted to the hospital, but you are wondering if
anyone has ever investigated albuterol vs. racemic epi for the treatment of
bronchiolitis. You decide to look into it on your next day off.
Mull CC, Scarfone RJ, Ferri LR, Carlin T, Salvaggio C, Bechtel KA, Hanes Trephan MA, Rissman
RL, Gracely EJ. A Randomized Trial of Nebulized Epinephrine vs Albuterol in the Emergency
Department Treatment of Bronchiolitis. Arch Pediatr Adol Med, 2004; 158:113-118.
©Maribeth Chitkara, MD, 2011