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.
What is the Yield of Abdominal X-ray in Suspected Intussusception?
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In this retrospective trial of pediatric patients with suspected intussusception, abdominal radiographs occasionally identify alternate clinical diagnoses.
Source
Yield of abdominal radiographs in children with suspected intussusception; rate of pneumoperitoneum and other abdominal pathology. Am J Emerg Med. Published online December 22, 2023.
Oseltamivir Won’t Keep You Out of the Hospital
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This systematic review and meta-analysis concluded, with moderate certainty evidence, that oseltamivir has little to no effect on hospitalization but does increase nausea and vomiting.
Source
Evaluation of Oseltamivir Used to Prevent Hospitalization in Outpatients With Influenza. JAMA Intern Med. 2024 Jan 1;184(1):18-27. doi: 10.1001/jamainternmed.2023.0699. Erratum in: JAMA Intern Med. 2023 Nov 20;: PMID: 37306992; PMCID: PMC10262060.
New Guidelines for Mild Pediatric TBI
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In this systematic review, authors identified clinical practice guideline (CPG) recommendations with moderate to high quality evidence that can be used by the ED practitioner to help in the care of pediatric patients with mild traumatic brain injury (mTBI).
Source
Clinical Practice Guideline Recommendations in Pediatric Mild Traumatic Brain Injury: A Systematic Review. Ann Emerg Med. 2023 Dec 22:S0196-0644(23)01381-1. doi: 10.1016/j.annemergmed.2023.11.012. Epub ahead of print.
Does SARS-CoV-2 Lead to Misstep-by-Steps in Febrile Infants?
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In febrile infants with SARS-CoV-2 infection, current risk stratification tools for identifying invasive bacterial infections (IBIs) demonstrate high negative predictive values at the cost of decreased sensitivity.
Source
Inflammatory Markers in Febrile Young Infants With and Without SARS-CoV-2 Infections. Pediatrics. 2024;153(2):e2023063857. doi:10.1542/peds.2023-063857
Does This Febrile Neonate Need a CXR?
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This prospective study identified a handful of clinical features associated with radiographic pneumonia in young febrile infants, including elevated procalcitonin and/or absolute neutrophil count, respiratory distress, and positive viral testing.
Source
Radiographic pneumonia in young febrile infants presenting to the emergency department: secondary analysis of a prospective cohort study. Emerg Med J. 2023;41(1):13-19. Published 2023 Dec 22. doi:10.1136/emermed-2023-213089.
Don’t Push! Excessive Neonatal Mask Pressure and Apnea-Bradycardia
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When providing respiratory support to preterm infants with a facemask, avoid excessive force on the face that is associated with apnea and bradycardia.
Source
Exerted force on the face mask in preterm infants at birth is associated with apnoea and bradycardia. Resuscitation. 2024;194:110086.
Pediatric Gastroenteritis – 22 Pathogen Stool PCR for All?
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This prospective multi-center stepped wedge trial found that routine molecular multiplex testing for all children who presented to pediatric EDs with acute gastroenteritis detected more clinically relevant pathogens (2.1% to 15%) and led to an adjusted 21% decrease in return visits.
Source
Clinical Impact of Multiplex Molecular Diagnostic Testing in Children With Acute Gastroenteritis Presenting to an Emergency Department: A Multicenter Prospective Study. Preprint. medRxiv. 2023;2023.07.27.23293208. Published 2023 Jul 31. doi:10.1101/2023.07.27.23293208
Should Testing for THC in Altered Children Be Routine?
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Given a substantial increase in the number of children who have accidental ingestion of THC-based products, these authors advocate for consideration of early urine drug screen testing on children who present with altered mental status or neurological symptoms.
Source
Urine Toxicology Test for Children With Altered Mental Status. Pediatrics. 2023. Nov 1;152(5):e2022060861Doi: 10.1542/peds.
Do Febrile Neonates with COVID-19 Need a Full Workup?
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This systematic review and meta-analysis of almost 4,000 febrile infants ≤ 90 days old diagnosed with COVID-19 indicated that these patients have a low prevalence of invasive bacterial infection (IBI), especially the subgroup >28 days old.