Sensitivity for UA with any leukocyte esterase, nitrite, or >5 WBCs/hpf was 94% for UTI growing >50,000 colony forming units (CFU).
In opioid naïve patients 13-21 years of age, persistent opioid use was found in 4.8% of the post-surgical group vs 0.1% of those in the non-surgical group. Procedures associated with the highest risk of persistent opioid use were cholecystectomy and colectomy. Independent risk factors included older age, female sex, diagnoses of substance use disorder and chronic pain.
Don't be falsely reassured if rhinovirus on a PCR viral panel is positive. The incidence of UTI was unchanged if </= 90 days, and the incidence of invasive bacterial infection (IBI) was no different </= 28 days. However, it may prove useful for risk stratifying infants for IBI in the 29 to 90-day age group.
Maintaining a diastolic blood pressure (DBP) of >/=25mm Hg in infants and >/= 30mm Hg in children over age 1 during CPR was associated with improved survival to discharge and improved neurologically intact survival. This is possible only if a child arrests and has invasive BP monitoring in place but is a good reminder that high quality CPR in all patients drastically impacts survival.
Failure of private hospitals to care for the uninsured resulted in informal ED to ED referrals, which meant up to 20% increased volume in public EDs for certain diagnoses, particularly orthopedic issues. This led to duplicate testing, increased cost, complications, delays in care, and poor treatment of the most vulnerable patients.