May 2017

If there is any delay in obtaining IV access, give benzodiazepines by a non-IV route to control seizure activity faster.

The window for tPA got wider with this study; ECASS III expanded the time of administration to 4.5 hours.

Febrile children 2-12 months of age with RSV or influenza may still have UTI as a source of the fever.  However, this study suggests that we may be able to base urine testing on the patient's risk of UTI, with urine testing only in kids with > 1% risk.

Triage nursing protocols that allowed early use of ondansetron and oral fluids significantly reduced the number of children who needed IV fluid without prolonging length of stay.

Think about cervical artery dissection in patients over 60 even if they lack some of the usual features, such as neck pain, mechanical trigger, or migraine.

A mobile stroke treatment unit in Cleveland, equipped with onboard CT scanner and telemedicine, reduced the time to tPA treatment drastically.

Ultrasound is the right first imaging test to rule out appendicitis, but it's very important to set family expectations low and inform them that the study is often not diagnostic and that more imaging may be needed.