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Bubble Wrap PLUS – June 2023

Don't Forget the Bubbles

Guidelines and best evidence Analgesia and sedation in critically ill pediatric patients: an update from the recent guidelines and point of view. 2023 May;182(5):2013-2026 QuantiFERON-TB Gold Plus Performance in Children: A Narrative Review. N Engl J Med. 2023 May 11;388(19):1755-1766. Mondardini MC, et al. Eur J Pediatr. 2023 May 30.

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Choosing Wisely – Viral Respiratory Panels in children with respiratory symptoms

Don't Forget the Bubbles

Effect of point-of-care testing for respiratory pathogens on antibiotic use in children. Reducing Unnecessary Respiratory Viral Testing to Promote High-Value Care. Establishing benchmarks for the hospitalized care of children with asthma, bronchiolitis, and pneumonia. 2013 Feb;18(1):5-10. Pediatrics.

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Diagnostics: Inflammatory Markers

Taming the SRU

Similarly, a 2013 meta-analysis of 6 studies with 1,006 patients published in the American Journal of Emergency Medicine showed neither CRP nor PCT are sufficient to rule-in or rule-out infective endocarditis, with PCT having a pooled sensitivity of 64% and specificity of 73% and CRP having a pooled sensitivity of 75% and specificity of 73% [40].

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Antibiotics in the paediatric emergency department

Don't Forget the Bubbles

However, results may take some time and, as such, rapid point-of-care tests are increasingly used. 2013 Sep 1;88(5):338–40. A throat culture is the gold standard for confirming a bacterial infection. Beware of false positives from colonisation of the throat with streptococcus. Med J Aust. 2021 Mar;214(5):220–7.

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Episode 24 - First Trimester Pregnancy Emergencies: Recognition and Management

EB Medicine

This corresponds nicely to a 2013 retrospective study demonstrating a bHCG threshold for the fetal pole to be just below 1400. Let me repeat that Gadolinium should always be avoided Nachi: Let’s also briefly touch on a controversial topic -- that of using qualitative urine point of care tests with blood instead of urine.