Miscellaneous
Three activities constitute research misconduct:
falsification (manipulating materials, equipment, or procedures or changing or omitting data
to misrepresent findings)
fabrication (making up results)
plagiarism (appropriating another’s words, ideas, or results without giving credit)
Faces, Legs, Arms, Cry, Consolability (FLACC) scale has been validated for use in
preschool or younger children.

The Wong-Baker FACES rating scale, though widely reproduced and used for pediatric
patients, is not validated for use in children younger than 4–5 years of age.

Numeric rating scales (verbal 1-10) and colorimetric visual analog scales require a level
of abstract reasoning far outside the developmental ability of a preschooler.
Research Ethics
Pain Scales
Assent
The ability to provide assent is based on age, maturity, and psychological state. The age at
which children can provide assent typically begins around 7 years of age.

For studies that are considered to involve no more than minimal risk, the IRB may find it
sufficient to obtain consent from only one parent; thus, consent from both parents is not
required.

If the study involves inclusion of subjects in life-threatening conditions. In these cases, a
waiver of consent may be granted.
A trial of the use of a depilatory agent for hair tourniquets not on mucosal surfaces is
warranted. Eg. Nair, Magic Shave and Veet and are available over-the-counter.

Hair tourniquets should be considered when performing a physical examination on a child
whose chief complaint is crying.

Children younger than 6 months are at highest risk for hair tourniquets.
Hair Torniquet
911 Calls
The 911 calls give the phone number of the caller.  Enhanced 911 calls give the phone
number and the location from where the call was made.  

A basic life support unit is staffed only by an emergency medical technician-basic (EMT-B)
and is capable of patient assessment, spinal immobilization, noninvasive ventilatory
assistance, and defibrillation with automated external defibrillators.

An advanced life support unit must be staffed with at least one EMT-paramedic (EMT-P)
and is capable of providing a higher level of care, including recognition and treatment of
arrhythmias, advanced airway management (including endotracheal intubation and, in some
areas, emergent surgical airways and sedatives/paralytics with intubation), and
administration of intravenous fluids and life-saving medications.  
< 2 years -  rear-facing car safety seat (CSS)

> 2 - 8 years age - should use a forward-facing CSS with a harness.

8-12 years or > 4 ft, 9 in (144.8 cm) in height belt-positioning booster seat until the vehicle
lap-and-shoulder seat belt fits properly.

When children are old enough and large enough to use the vehicle seat belt alone, they
should always use lap-and-shoulder seat belts for optimal protection.

< 13 years - restrained in the rear seats of vehicles.
Car Seat
Autonomy: individual patient with appropriate capacity can make medical decisions freely
and without interference, and that these decisions must be respected whether they are in the
patient's best interest or not.

Nonmaleficence: physicians “do no harm” either by acts of commission or omission.

Beneficence:  physicians to “do the right thing” to benefit and act in the best interest of their
patients both by providing appropriate treatment and by protecting them from harm.

Justice:  physicians to treat patients with similar conditions similarly, after accounting for
patient or parent values and preferences.
Biomedical Ethics
The latch of the fence’s gate is recommended to be placed at a minimum height of 4.5 ft

The fence should be on all 4 sides and at least 4 ft tall.

Pool gates open out from the pool, and self-close and self-latch at a height children can't
reach.

Although a rigid pool cover may provide some protection if used correctly, it is not part of the
recommendations.

Inflatable toys should be stored not only out of the water but also out of sight to avoid
tempting young children to enter the pool unsupervised.   
Swimming Pool Guidance