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SGEM#471: Are ESI Levels Accurate for Triage of Pediatric Patients?

The Skeptics' Guide to EM

Emergency Severity Index Version 4 and Triage of Pediatric Emergency Department Patients. She has noticed that recently, there has been an increasing number of pediatric cases presenting to your facility. Clinical Question: How accurate is ESI version 4 in predicting acuity and resource needs among pediatric ED patients?

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When Do Pediatric Ventriculoperitoneal Shunts Fail?

ACEP Now

To begin, a 2012 prospective pediatric study found a failure rate of 16.9 A 2016 multicenter prospective study evaluated 1,036 pediatric patients for shunt failure who received CSF shunts over a four-year period. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study.

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Pediatric Cervical Spine Injury Risk Stratification: Rebaked Morsel

Pediatric EM Morsels

Predisposing conditions ( Down Syndrome , Klippel-Fleil, achondroplasia, etc.) — OR 1.5 – 15 Torticollis — OR 1.8 – 64 The sensitivity of C-Spine plain films in pediatric patients is good (85-95% in multiple studies), but keep in mind that nothing is 100%. Pediatr Emerg Care. High Risk (12.8% When in doubt, MRI. 2018;34(10):677-686.

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The Broselow-Luten System

Pediatric EM Morsels

Bob Luten, a PEM physician in Jacksonville, FL , designed the Broselow-Luten color-coded length-based system to help estimate a child’s weight, and thereby offload the cognitive burden of medication dosing and choice of equipment sizes in pediatric resuscitations. DeBoer 2020] Now seen as industry standard in pediatric emergency care.

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Elbow Dislocations

RebelEM

2016 Jan 6;17:6-11. 2016 Jul;24(7):413-23. Medial epicondyle fractures in the pediatric population. Multiple Concomitant Injuries in One Upper Extremity: A Case Report. Am J Case Rep. doi: 10.12659/ajcr.894984. PMID: 26732673 Akhondi H, Varacallo M. Anterior Interosseous Syndrome. 2023 Aug 4. In: StatPearls [Internet].

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Acute Transverse Myelitis in Children

Pediatric EM Morsels

(Tavasoli 2018, Wolf 2012) More common in adults; children comprise 20% of total cases (Pidcock 2007, Wang 2019) Bimodal age distribution (Absoud 2016) Children < 5 years Children > 10 years Symptoms evolve over 2-4 days and peak at 5-6 days (Absoud 2016) ATM may occur alone OR as part of another disorders (e.g.

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Fluoroquinolone Use In Children

Pediatric EM Morsels

Jackson 2016) Ciprofloxacin was the first fluoroquinolone approved by the FDA in the 1980’s as a broad-spectrum antibiotic. Jackson 2016) It can also be used in UTIs , but is typically reserved for special cases where the infectious bacteria is found to be multidrug resistant or in complicated UTIs. Arthropathy was seen in 13.7%