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There are an increasing number of water bead related injuries in children, with the majority occurring in children less than five. While most cases can be treated and released from the ED, water bead injury can be serious and even deadly.

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Pediatric water bead-related visits to United States emergency departments. Am J Emerg Med. 2024 Jul 28:84:81-86. doi: 10.1016/j.ajem.2024.07.048. Online ahead of print. PMID: 39096713

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A new PECARN clinical decision rule for cervical spine imaging in children after blunt trauma identifies children at low risk for C-spine injury utilizing nine risk factors.

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PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024 Jul;8(7):482-490. doi: 10.1016/S2352-4642(24)00104-4. Epub 2024 Jun 4. PMID: 38843852; PMCID: PMC11261431.

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A large retrospective registry analysis finds no difference in rates of additional respiratory interventions with preemptive administration of supplemental oxygen during pediatric sedation.

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Preprocedural Oxygenation and Procedural Oxygenation During Pediatric Procedural Sedation: Patterns of Use and Association With Interventions. Ann Emerg Med. Published online June 12, 2024. doi:10.1016/j.annemergmed.2024.04.014.

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In a cohort of septic children, delays in antibiotic administration 330 minutes or longer from arrival to the emergency department led to an increase in mortality.

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Delays to Antibiotics in the Emergency Department and Risk of Mortality in Children With Sepsis. JAMA Netw Open. 2024 Jun 3;7(6):e2413955. doi: 10.1001/jamanetworkopen.2024.13955. PMID: 38837160; PMCID: PMC11154154.

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In a cohort of children with blunt trauma, the presence of hematuria does not predict clinically important intraabdominal injury.

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Presence of Microscopic Hematuria Does Not Predict Clinically Important Intra-Abdominal Injury in Children. Pediatr Emerg Care. 2024 Jun 7. doi: 10.1097/PEC.0000000000003210. Epub ahead of print. PMID: 38849150.

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In pediatric patients who have an Alvarado score 6 and below, the absence of free fluid or periappendiceal fat inflammation, when the appendix was not visualized on ultrasound, had a negative predictive value of 99.4% for appendicitis.

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Predictive values of indirect ultrasound signs for low risk of acute appendicitis in paediatric patients without visualisation of the appendix on ultrasound. Emerg Med J. 2024 May 10:emermed-2023-213466. doi: 10.1136/emermed-2023-213466. Online ahead of print. PMID: 38729752

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In a cohort of febrile infants, the performance of WBC, ANC, and CRP decreased in patients with less than 2 hours of fever; PCT remained similar.

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Performance of Febrile Infant Algorithms by Duration of Fever. Pediatrics. 2024 May 1;153(5):e2023064342. doi: 10.1542/peds.2023-064342. PMID: 38563061.

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In a cohort of febrile infants, leukopenia ≤2500 cells/µL was associated with invasive bacterial infections; neutropenia was not predictive.

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Leukopenia, neutropenia, and procalcitonin levels in young febrile infants with invasive bacterial infections. Acad Emerg Med. 2024 Apr 25. doi: 10.1111/acem.14921. Epub ahead of print. PMID: 38661246.

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Reliance on landmark guidance for chest tube placement may pose significant safety issues in pediatric patients.

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Ultrasound Investigation of the Fifth Intercostal Space Landmark for Chest Tube Thoracostomy Site Selection in Pediatric Patients. Pediatr Emerg Care. 2024 Apr 23. doi: 10.1097/PEC.0000000000003207. Epub ahead of print. PMID: 38713844.

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This new review summarizes the current evidence regarding diagnosis and management of mild TBI in children.

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Contemporary diagnosis and management of mild TBI (concussions): What you need to know. J Trauma Acute Care Surg. 2024 Jun 1;96(6):865-869. doi: 10.1097/TA.0000000000004297. Epub 2024 May 2. PMID: 38696496.