June 2022

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Children with functional abdominal pain and irritable bowel syndrome taking an open-label placebo reported significantly less pain and took fewer rescue pain medications.

Source
Effect of Open-label Placebo on Children and Adolescents With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Clinical Trial. JAMA Pediatr. 2022 Apr 1;176(4):349-356. doi: 10.1001/jamapediatrics.2021.5750. Erratum in: doi: 10.1001/jamapediatrics.2022.0359.

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This review article highlighted some of the pivotal pediatric emergency medicine literature in 2021. It is a great update on commonly seen pathology in the pediatric population.

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Intubating neonates with high-flow nasal oxygen therapy improves chances of successful intubation on the first attempt without physiological instability.

Source
Nasal High-Flow Therapy during Neonatal Endotracheal Intubation. N Engl J Med. 2022 Apr 28;386(17):1627-1637. doi: 10.1056/NEJMoa2116735.

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There was no benefit to using high-flow nasal cannula at 60L/min vs regular NC at 15L/min for pre- and apneic oxygenation during emergency department intubations.

Source
Pre- and apnoeic high-flow oxygenation for rapid sequence intubation in the emergency department (the Pre-AeRATE trial): A multicentre randomised controlled trial. Ann Acad Med Singap. 2022 Mar;51(3):149-160. doi: 10.47102/annals-acadmedsg.2021407.

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This is an update on the presentation, diagnosis, and management of spontaneous intracranial hypotension.

Source
Spontaneous Intracranial Hypotension. N Engl J Med. 2021 Dec 2;385(23):2173-2178. doi: 10.1056/NEJMra2101561

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The pSOFA score was not a good screening tool for predicting in-hospital mortality when used in a pediatric emergency department (PED) setting.

Source
Validation of the Pediatric Sequential Organ Failure Assessment Score and Evaluation of Third International Consensus Definitions for Sepsis and Septic Shock Definitions in the Pediatric Emergency Department. JAMA Pediatr. 2022 May 16. doi: 10.1001/jamapediatrics.2022.1301. Online ahead of print.

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Paxlovid offers an oral option for treating COVID-19 infection. Here is what you need to know before prescribing.

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Using the CASH-75 score can help predict the absence of atypical pathogens (L. pneumophila or M. pneumoniae) as the causative agents of community acquired pneumonia (CAP) in hospitalized patients.

Source
Accuracy of a score predicting the presence of an atypical pathogen in hospitalized patients with moderately severe community-acquired pneumonia. BMC Infect Dis. 2022 May 3;22(1):424. doi: 10.1186/s12879-022-07423-1.

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A single dose of dexamethasone was as effective as two in treatment of mild to moderate pediatric asthma exacerbations in the emergency department.

Source
Single-Dose Dexamethasone Is Not Inferior to 2 Doses in Mild to Moderate Pediatric Asthma Exacerbations in the Emergency Department. Pediatr Emerg Care. 2022 May 3. doi: 10.1097/PEC.0000000000002727. Online ahead of print.

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We need to understand our recent history. The syphilis study is a story we must tell, internalize, and learn from so we won't make the same mistakes again.

Source
Fiftieth Anniversary of Uncovering the Tuskegee Syphilis Study: The Story and Timeless Lessons. Am J Respir Crit Care Med. 2022 May 15;205(10):1145-1158. doi: 10.1164/rccm.202201-0136SO.