Blog
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Mar 29 2024
Phoenix Criteria – New Pediatric Sepsis Score
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The Phoenix Sepsis Score, which is a novel clinical criterion for pediatric sepsis and septic shock developed using measures of organ dysfunction, outperforms existing IPSCC criteria for the diagnosis of pediatric sepsis and septic shock.Source
Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024 Feb 27;331(8):675-686. doi: 10.1001/jama.2024.0196. -
Mar 28 2024
Do Extremes of Weight in Children Mean High-Risk Intubation?
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Underweight (less than 5th percentile) and obese (over 95th percentile) children are more likely to suffer hypoxemia and adverse events during tracheal intubation.Source
Adverse Tracheal Intubation Events in Critically Ill Underweight and Obese Children: Retrospective Study of the National Emergency Airway for Children Registry (2013-2020). Pediatr Crit Care Med. 2024 Feb 1;25(2):147-158. Doi: 10.1097/PCC.0000000000003387. -
Mar 27 2024
How to Choose Wisely in PEM
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The 5 Choosing Wisely recommendations for pediatric emergency medicine (PEM) focus on decreasing diagnostic testing related to respiratory conditions, medical clearance for psychiatric conditions, seizures, constipation, and viral respiratory tract infections. -
Mar 26 2024
Treatment Options for Cough and URI in Children
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Clinicians have an important role in advising families on the appropriate evidence-based treatments for upper respiratory tract infections (URTIs) in children.Source
Treatments for cough and common cold in children. BMJ. 2024 Jan 25;384:e075306. doi: 10.1136/bmj-2023-075306. -
Mar 25 2024
Pay to Play – Telehealth and Inappropriate Antibiotics
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Using online telemedicine platforms, the authors found that it was appallingly easy to rapidly obtain inappropriate antibiotic prescriptions for symptoms of viral URIs by paying a nominal fee. This highlights the need for increased education and regulations around inappropriate prescribing of antibiotics to safeguard the public and uphold good medical practices.Source
Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance. Clin Infect Dis. 2024 Feb 17;78(2):308-311. doi: 10.1093/cid/ciad472. -
Mar 22 2024
Conservative or Cowboy – Does Risk Tolerance Impact Admission Rate?
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In this retrospective study of ED physicians in one state, researchers found statistically significant differences in admission rates among clinicians but little consistency in admission tendencies across multiple conditions. Clinicians with greater tolerance to risk (as a general attitude) had associated lower rates of admission when compared to projections.Source
Clinician Risk Tolerance and Rates of Admission From the Emergency Department. JAMA Netw Open. 2024 Feb 5;7(2):e2356189. doi: 10.1001/jamanetworkopen.2023.56189. -
Mar 21 2024
Inequities in Hallway Bed Placement
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In the absence of a standardized approach, patients placed in hallway beds were more likely to be male, have Medicaid/self-pay payer status, and elope in this single health system study.Source
Inequities among patient placement in emergency department hallway treatment spaces. Am J Emerg Med. 2024 Feb;76:70-74. doi: 10.1016/j.ajem.2023.11.013. Epub 2023 Nov 11. -
Mar 20 2024
Emergency Medicine Should Embrace Our Technological Overlords
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This article is a call to action for emergency medicine clinicians to encourage us to embrace the opportunity to leverage digital technologies and shape their implementation within our healthcare system. -
Mar 19 2024
Adding Fludrocortisone to Hydrocortisone Reduces Mortality in Septic Shock
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This Bayesian network meta-analysis of RCTs indirectly compares hydrocortisone + fludrocortisone to hydrocortisone alone or placebo in septic shock and finds superiority with the combination regimen.Source
Effectiveness of Fludrocortisone Plus Hydrocortisone Versus Hydrocortisone Alone in Septic Shock: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Am J Respir Crit Care Med. Published online January 25, 2024. doi:10.1164/rccm.202310-1785OC -
Mar 18 2024
Everything You Need to Know About Managing High-Risk PE…Mostly
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One third of eligible patients with high-risk pulmonary embolism (PE) receive systemic thrombolysis (ST) despite demonstrated mortality benefit. This review provides a comprehensive overview of current evidence on assessment and management of high-risk PE, with emphasis on reperfusion therapies.Source
Rouleau SG, Casey SD, Kabrhel C, Vinson DR, Long B. Management of high-risk pulmonary embolism in the emergency department: A narrative review. Am J Emerg Med. Published online February 3, 2024. doi:10.1016/j.ajem.2024.01.039