Higher ETCO2 and Better Outcomes in Pediatric Arrest
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Targeted ETCO2 ≥20 mm Hg during pediatric resuscitation was associated with higher rate of survival in patients with in-hospital cardiac arrest.
Pediatric EMS VS Ranges to Predict Life-Saving Intervention
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Kids frequently present with abnormal vital signs but seldom require prehospital life-saving interventions (LSI). Based on the occurrence of LSI, age-group vital sign ranges were adjusted to better identify critically ill kids. Abnormal respiratory status (RR, SpO2) was strongly associated with prehospital LSI.
STOP RCT – Duration of Antibiotics for Pediatric Febrile UTI
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The Short-Course Oral Antibiotic Therapy of Acute Pyelonephritis (STOP trial) demonstrated that a 5-day course of amoxicillin-clavulanate was noninferior to the standard 10-day course with regard to recurrence of infection.
Source
STOP Trial Group. Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial. Pediatrics. 2024 Jan 1;153(1):e2023062598. doi: 10.1542/peds.2023-062598.
Do Preemies Have Higher Rate of Serious Bacterial Infection?
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There was no difference in rates of bacteremia or meningitis between term and preterm infants with fever. Preterm infants had lower rates of urinary tract infection (UTI) compared to term infants.
Source
Rate of Urinary Tract Infections, Bacteremia, and Meningitis in Preterm and Term Infants. Pediatrics. 2024 Mar 13. doi: 10.1542/peds.2023-062755. Epub ahead of print.
Phoenix Criteria – New Pediatric Sepsis Score
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The Phoenix Sepsis Score, which is a novel clinical criterion for pediatric sepsis and septic shock developed using measures of organ dysfunction, outperforms existing IPSCC criteria for the diagnosis of pediatric sepsis and septic shock.
Source
Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024 Feb 27;331(8):675-686. doi: 10.1001/jama.2024.0196.
Do Extremes of Weight in Children Mean High-Risk Intubation?
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Underweight (less than 5th percentile) and obese (over 95th percentile) children are more likely to suffer hypoxemia and adverse events during tracheal intubation.
Source
Adverse Tracheal Intubation Events in Critically Ill Underweight and Obese Children: Retrospective Study of the National Emergency Airway for Children Registry (2013-2020). Pediatr Crit Care Med. 2024 Feb 1;25(2):147-158. Doi: 10.1097/PCC.0000000000003387.
How to Choose Wisely in PEM
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The 5 Choosing Wisely recommendations for pediatric emergency medicine (PEM) focus on decreasing diagnostic testing related to respiratory conditions, medical clearance for psychiatric conditions, seizures, constipation, and viral respiratory tract infections.
Treatment Options for Cough and URI in Children
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Clinicians have an important role in advising families on the appropriate evidence-based treatments for upper respiratory tract infections (URTIs) in children.
Source
Treatments for cough and common cold in children. BMJ. 2024 Jan 25;384:e075306. doi: 10.1136/bmj-2023-075306.
Pay to Play – Telehealth and Inappropriate Antibiotics
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Using online telemedicine platforms, the authors found that it was appallingly easy to rapidly obtain inappropriate antibiotic prescriptions for symptoms of viral URIs by paying a nominal fee. This highlights the need for increased education and regulations around inappropriate prescribing of antibiotics to safeguard the public and uphold good medical practices.
Source
Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance. Clin Infect Dis. 2024 Feb 17;78(2):308-311. doi: 10.1093/cid/ciad472.
Comparing Intubation of Critically Ill Children between APRNs and Physicians
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Review of tracheal intubations (TIs) performed in pediatric ICUs found advanced practice registered nurses (APRNs) had a lower first attempt success compared to doctors and respiratory therapists.