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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.

Source
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.

Source
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.

Source
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.

Source
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.

Source
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.

Source
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.

Source
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.

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In the setting of pediatric trauma, patients with a seatbelt sign are at greater risk of blunt cardiovascular injury if they have an injury severity score greater than 15, c-spine fracture, basilar skull fracture, or "other motorized" (i.e. ATV but not MVC) mechanism of injury.

Source
Risk Factors for Blunt Cerebrovascular Injury in a Cohort of Pediatric Patients With Cervical Seat Belt Sign. Pediatr Emerg Care. 2024;40(5):359-363.

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Data supporting pediatric cardiac arrest guidelines are limited. This study found increases in the longest pause in chest compressions (CC) during pediatric in-hospital cardiac arrest (pIHCA) were inversely associated with survival and ROSC.

Source
Association Between Chest Compression Pause Duration and Survival After Pediatric In-Hospital Cardiac Arrest. Circulation. 2024 May 7;149(19):1493-1500. doi: 10.1161/CIRCULATIONAHA.123.066882. Epub 2024 Apr 2. PMID: 38563137; PMCID: PMC11073898.

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In this RCT, successful intubation on the first attempt in critically ill neonates was much higher in patients when video laryngoscopy (VL) was used compared to direct laryngoscopy (DL).

Source
Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants. NEJM. 2024 May 5. Online ahead of print. DOI: 10.1056/NEJMoa2402785