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Pediatric volvulus is associated with a high morbidity and mortality rate but remains a challenging diagnosis. This review highlights pearls and pitfalls of diagnosis and management.

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High risk and low incidence diseases: Pediatric digestive volvulus. Am J Emerg Med. 2024 Aug;82:153-160. doi: 10.1016/j.ajem.2024.06.012. Epub 2024 Jun 14. PMID: 38908340.

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Advanced imaging, including ultrasound, MRI, and CT, is an important tool for diagnosing children in the emergency department. This policy statement provides guidance to help clinicians optimize the use of these diagnostic tools.

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Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Policy Statement. Ann Emerg Med. 2024 Aug;84(2):e13-e23. doi: 10.1016/j.annemergmed.2024.03.023. PMID: 39032991.

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This was a single center retrospective study at a tertiary pediatric ED of patients with suspected pediatric appendicitis. The authors found that combining a low pediatric Appendicitis Risk Calculator (pARC) result with a nondiagnostic ultrasound results in a high negative predictive value for appendicitis.

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Identification of children with a nondiagnostic ultrasound at a low appendicitis risk using a pediatric Appendicitis Risk Calculator. Acad Emerg Med. Published online July 21, 2024.

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Maintaining a high suspicion for botulism is crucial in making a prompt diagnosis and in reducing morbidity and mortality. This review highlights pearls and pitfalls of diagnosis and management.

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High risk and low prevalence diseases: Botulism. Am J Emerg Med. 2024 Aug;82:174-182. doi: 10.1016/j.ajem.2024.06.018. Epub 2024 Jun 20. PMID: 38925095.

Please don't skip this 😬...

Tell us what you think about a potential new JF summary that incorporates AI, and see if you can tell which post was written by AI vs written by me. We will share these findings with the whole audience, but we need a bunch more responses to make sure these data are meaningful.

Many thanks,
Clay

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In a cohort of afebrile infants with pustular or vesicular rashes, none were diagnosed with serious bacterial infection attributable to a skin source, though some were ultimately diagnosed with herpes simplex virus (HSV).

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Management of Pustules and Vesicles in Afebrile Infants ≤60 Days Evaluated by Dermatology. Pediatrics. 2024 Jul 1;154(1):e2023064364. doi: 10.1542/peds.2023-064364. PMID: 38910522.

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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.