Too much fluid in pediatric asthma is a bad thing, leading to worse clinical outcomes and increased interstitial lung water. For each 1% fluid overload, patients spent 7 additional hours in the hospital.

This large, retrospective study found the prevalence of PE in hospitalized patients discharged with a diagnosis of syncope was 0.15% to 2.1%; 0.35% to 2.63% at 90-day follow up.  This was much lower than the PESIT trial, at 17.3%.

Young children with community acquired pneumonia seemed to do fine with a beta-lactam antibiotic only and didn't appear to benefit from adding a macrolide.

In children without other comorbidities, with moderate to severe community acquired pneumonia requiring hospitalization, the yield of blood culture was very low.  Most isolated organisms were Streptococcus pneumoniae, 82% of which were penicillin sensitive.

Substantial agreement on clinical exam findings in children with suspicion of pneumonia was only present for wheezing and retractions.  All other clinical exam findings had poor to moderate agreement between clinician examiners.

No clinical criteria were powerful diagnostic discriminators of the presence or absence of pneumonia in children, though some were fair.  When in doubt, a CXR is probably warranted, with the exceptions of obvious bronchiolitis or asthma.  Low SpO2 (</= 95 to 96%) or increased work of breathing were the best predictors of radiographic pneumonia in children; auscultatory findings and tachypnea were poor.  You don't need a CXR if no cough, no fever, no tachypnea, and normal SpO2.

Oral steroids were of no benefit for non-asthmatic patients with bronchitis.

I couldn't state it better than the author's conclusion: "In adult patients, the presence of whooping or posttussive vomiting should rule in a possible diagnosis of pertussis, whereas the lack of a paroxysmal cough or the presence of fever should rule it out. In children, posttussive vomiting is much less helpful as a clinical diagnostic test."

Non-invasive ventilation (NIV) in patients with acute exacerbation of COPD decreased the need for intubation and reduced in-hospital mortality.

Starting a lung-protective mechanical ventilation strategy in the ED appeared to make a big difference in important clinical outcomes in this study.