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.
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.