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Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures

Pediatric EM Morsels

Buckle Fractures: Evolving literature Multiple prospective studies have been performed using single posterior slabs, splints, braces and soft bulky bandages (Davidson, 2001. Hospital versus home management of children with buckle fractures of the distal radius. West, 2005. Plint, 2006. J Pediatr Orthop. 2005;25:322–325.

Fractures 290
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Glasgow Coma Scale in Children

Pediatric EM Morsels

2001 Apr;68(4):311-4. Systematic review showed 85% of studies with substantial reliability with kappa statistic >0.6 Pediatr Neurol. 2006 May;34(5):379-87. doi: 10.1016/j.pediatrneurol.2005.10.012. 2005.10.012. PMID: 16647999. Chaturvedi P, Kishore M. Modified Glasgow Coma Scale to predict mortality in febrile unconscious children.

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Adjunctive Methylene Blue in Septic Shock?

RebelEM

It also reduced length of stay in ICU and hospital without adverse effects. Crit Care Med 2001. What They Did: Single-center, parallel, double blind, randomized controlled trial performed in a medical-surgical ICU (Mexico) Both groups received: Adjunctive vasopressin initiated at a dose of 0.03 95% CI 15.4 95% CI 15.4 Crit Care 2023.

Shock 145
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Clinical Conundrums: Should You Give the First Dose of Antibiotics IV Before Discharging Home on Oral Antibiotics?

RebelEM

2001; 111(5):367-74. The use of oral temafloxacin compared with a parenteral cephalosporin in hospitalized patients with pneumonia. Efficacy and safety of oral and early-switch therapy for community-acquired pneumonia: a randomized controlled trial. The American journal of medicine. PMID: 11583639 Vogel F, Lode H.

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Older cardiology trials were often hugely positive. Newer cardiology trials not so much

Stop and Think

Consider heart failure hospitalization. The problem is that in some trials, hospitalization for heart failure represents only a small fraction of total hospitalizations. Yes, hospitalizations for heart failure are 29% lower with the drug. Yes, hospitalizations for heart failure are 29% lower with the drug.

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The Private Equity Wave in Health Care

ACEP Now

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. Christopher’s Hospital for Children by private equity (PE) firm Paladin Healthcare Capital for 170 million dollars. 14 Dr. Stinson remembers what it was like to work for a PE-owned hospital early in her career. “I

Hospitals 113
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Fluoroquinolone Use In Children

Pediatric EM Morsels

(Etminan 2019) In Belgium between 2010 – 2013, of the 262 children treated with fluroquinolones while hospitalized, only 17% were used for labelled indications. From 2001 to 2009, in a pediatric hospital gram negative culture showed a drop in sensitivity to ciprofloxacin from 96% to 93%. J Pediatric Infect Dis Soc.