Bulb vs Suction Gadget – Does Type of Nasal Suctioning Help Infants with Bronchiolitis?
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In a randomized control trial of discharged infants with bronchiolitis, enhanced home nasal suctioning with a mechanical device did not lead to reduced unscheduled health care revisits as compared to standard bulb suctioning.
Nasal Suctioning Therapy Among Infants With Bronchiolitis Discharged Home From the Emergency Department: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(10):e2337810. Published 2023 Oct 2.
How to Manage Precipitous Delivery and Complications
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Although infrequent, precipitous vaginal deliveries in the ED occur and are associated with higher rates of maternal and fetal complications. Here's how you can be prepared to manage these deliveries and common complications.
900% Greater Odds of Going Home – Nasal Fentanyl for Pediatric Sickle Cell Crisis
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In this large, multi-center retrospective study of academic pediatric emergency departments across the US and Canada, researchers found that children presenting with sickle cell disease vaso-occlusive events had nine times (900%) greater adjusted odds of discharge home if given intranasal fentanyl (INF).
Source
Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Am J Hematol. 2023 Apr;98(4):620-627. doi: 10.1002/ajh.26837. Epub 2023 Feb 6.
Transfusion Trigger – New AABB Guidelines for Adults and Children
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For hemodynamically stable adults and children, 7g/dL is the best transfusion trigger, with a few exceptions.
Source
Red Blood Cell Transfusion: 2023 AABB International Guidelines. JAMA. 2023 Oct 12. doi: 10.1001/jama.2023.12914. Online ahead of print.
How Accurate Is an US + Fast MRI Pediatric Appendicitis Protocol?
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After a non-diagnostic screening ultrasound for appendicitis, a rapid-MRI has high clinical accuracy in establishing the appropriate diagnosis (appendicitis or not) in a pediatric patient population.
Source
Properties of ultrasound-rapid MRI clinical diagnostic pathway in suspected pediatric appendicitis. Am J Emerg Med. 2023 Sep;71:217-224. doi: 10.1016/j.ajem.2023.06.026. Epub 2023 Jun 16.
New UTI Culture Cutoff in Children
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A new cutoff of 10,000 colony-forming units per milliliter (CFU/mL) on urine culture to diagnose urinary tract infection (UTI) from catheterized specimens in infants and children <3 years improved sensitivity and specificity.
Source
Support for the Use of a New Cutoff to Define a Positive Urine Culture in Young Children. Pediatrics. 2023 Oct 1;152(4):e2023061931. doi: 10.1542/peds.2023-061931.
When to Crack the Pediatric Chest – New Guidelines
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Emergency department thoracotomy (EDT) is recommended in pulseless pediatric patients with signs of life* who have penetrating thoracic/abdominopelvic trauma; if pulseless with signs of life* and blunt trauma, a conditional recommendation is made.
Source
Emergency department thoracotomy in children: A Pediatric Trauma Society, Western Trauma Association, and Eastern Association for the Surgery of Trauma systematic review and practice management guideline. J Trauma Acute Care Surg. 2023 Sep 1;95(3):432-441. doi: 10.1097/TA.0000000000003879. Epub 2023 Mar 11.
Does a Gun Safety Video Make Kids Safer Around Actual Guns?
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Children who viewed a 1-minute firearm safety video exhibited safer behaviors around inert firearms staged in a playroom. With firearm-related deaths overtaking motor vehicles as the leading cause of US minor deaths, introducing children to firearm safety shows promise in addressing one dimension of this public health crisis.
Source
Effect of a Gun Safety Video on Children's Behavior Around Real Guns: A Randomized Clinical Trial. JAMA Pediatr. 2023 Sep 1;177(9):903-910. doi: 10.1001/jamapediatrics.2023.2397.
Pediatric Sinusitis – Plain Amoxicillin or Amoxicillin-Clavulanate?
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For pediatric patients with acute sinusitis, amoxicillin-clavulanate does not offer treatment benefit over amoxicillin alone and is more likely to be associated with gastrointestinal (GI) side effects and yeast infections than amoxicillin.
Source
Treatment Failure and Adverse Events After Amoxicillin-Clavulanate vs Amoxicillin for Pediatric Acute Sinusitis. JAMA. 2023 Sep 19;330(11):1064-1073. doi: 10.1001/jama.2023.15503.
New App for Pediatric Cardiac Arrest
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This RCT found residents using a pediatric cardiac arrest app better adhered to the pediatric cardiac arrest algorithm when compared to those using a PALS visual aid or no aid at all.
Source
Effectiveness of a Novel Tablet Application in Reducing Guideline Deviations During Pediatric Cardiac Arrest: A Randomized Clinical Trial. JAMA Netw Open. 2023 Aug 1;6(8):e2327272. doi: 10.1001/jamanetworkopen.2023.27272.