Water Beads – An Expanding Hazard
Spoon Feed
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.
Source
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
New PECARN C-Spine Rule
Spoon Feed
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.
Source
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.
Should We Preemptively Start Oxygen for Pediatric Sedations?
Spoon Feed
A large retrospective registry analysis finds no difference in rates of additional respiratory interventions with preemptive administration of supplemental oxygen during pediatric sedation.
Source
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.
Optimal Time to Antibiotics in Pediatric Sepsis?
Spoon Feed
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.
Hematuria after Trauma…Urine Trouble?
Spoon Feed
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.
Can We Rule Out Pediatric Appendicitis If Appendix Not Seen on Ultrasound?
Spoon Feed
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
Does Duration of Fever Impact Febrile Infant Biomarkers?
Spoon Feed
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.
Does Leukopenia or Neutropenia Predict Bacterial Infection in Febrile Infants?
Spoon Feed
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.
POCUS for Pediatric Chest Tube – Is Fifth ICS Too Low?
Spoon Feed
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.
What You Need to Know About Pediatric Concussion
Spoon Feed
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.