Current PALS (and ACLS) algorithms recommend repeat epinephrine doses q3-5 minutes.  This study suggested that this is too frequent.  If doses were spaced 8-10 minutes, pediatric patients had significantly better survival.

Point of care ultrasound may be very useful during CPR, but it should not get in the way of chest compressions.  If you're going to use it, get in there quick and get out of the way or choose a view that allows continuous chest compressions (i.e. subxiphoid).

PALS recommends giving a fluid bolus to children in shock over 5-10minutes.  This study showed that giving it more slowly, over 15-20 minutes likely decreased the need for mechanical ventilation.

This large multi-center prospective study of pediatric sedation found adverse events occurred in 12%, most mild desaturation or vomiting.  Severe adverse events occurred in 1%.  Ketamine given alone was the safest drug.  Propofol alone, ketamine + fentanyl, or ketamine + propofol were associated with greater risk for severe adverse events.

A high plasma to PRBC transfusion ratio (>/= 1:2) was not beneficial in pediatric massive trauma transfusion. But this study was different than adult studies of damage control resuscitation in that these children did not receive platelets

There was no mortality advantage to early goal-directed therapy (EGDT) over protocol-based care (using lactate clearance), or usual sepsis care.

Numerous observational studies have suggested that prehospital intubation (PHI) (in this case of trauma patients) was associated with greater mortality than when it was done in the ED, and this systematic review indicated the same thing.

A non-invasive approach to monitoring sepsis patients by using lactate clearance rather than central venous O2 saturation was just as effective once central venous pressure and mean arterial pressure were optimized.

Implicit racial bias is likely influencing us in the ED, but whether that translates into impacting clinical decision making remains to be seen.

Patients intubated in the Emergency Department with usual care (no apneic oxygenation) vs apneic oxygenation (≥15L/min via nasal cannula) did not have significant differences in lowest mean oxygen saturation.