Don't Forget the Bubbles

AUGUST 30, 2023

Pediatrics July 2020; 146 (1_MeetingAbstract): 206–209. 2020-014597 Friedman JN, Davis T, Somaskanthan A, Ma A. Am J Emerg Med. 2018;36(5):769-773. doi: 10.1016/j.ajem.2017.10.009 2017.10.009 Arora R, Vega C, Farooqi A, et al. 10.1542/peds.146.1MA3.206 146.1MA3.206 Bada C, Carreazo NY, Chalco JP, Huicho L. JAMA Pediatr. Pediatrics.

Emergency Department 131

Emergency Department Pediatrics Infectious Diseases Research 131

Pediatric EM Morsels

AUGUST 11, 2023

2020 Oct 24;12(10):e11141. Coli Proteus species Non-Abscess infection: Staphylococcus aures = the most common Pseudomonas aeruginosa and others still may be seen Perichondritis of the Ear: Presentation Redness , Pain , and Swelling of the pinna Typically spares the lobule ! Can Fam Physician. 2022 Sep;68(9):661-663. doi: 10.46747/cfp.6809661.

Burns 130

Burns Pediatrics EMS Outcomes 130

PulmCCM

DECEMBER 11, 2023

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. I hope you continue to find it valuable. Wishing you all a safe and happy holiday season!

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

Don't Forget the Bubbles

DECEMBER 16, 2024

Whooping Cough: A Cyclical but Preventable Disease Whooping cough, caused by the bacterium Bordetella pertussis , is another infectious disease experiencing a resurgence despite the availability of vaccines. These outbreaks increase the risk of imported cases in other regions, including the UK.

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

EB Medicine

JANUARY 17, 2023

Intro The number of ED visits and hospitalizations Studies show up to 57% of anaphylactic reactions are not recognized, and epinephrine is not administered in up to 80% of cases.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Infectious Diseases Emergency Department 52

PulmCCM

NOVEMBER 6, 2023

The therapy was approved for emergency use in 2020 by FDA after an observational study of 10 patients showed likely benefit (yes, 10, which should remind us of our collective desperation). patients infected with the Wuhan/Delta variants in 2020-2021).

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Pediatric EM Morsels

AUGUST 9, 2024

2019, there were 1,875 and this trend has continued to increase (2,157 case in 2020; 2,855 cases in 2021). doi: 10.1136/bcr-2020-240532. Rates of congenital syphilis are increasing. Foles, 2024 ] In the US, from 2013-2018, cases increased from 362 to 1,306. pallidum invades the bloodstream directly causing spirochetemia in the fetus.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

Advanced Medical Reviews

APRIL 17, 2019

He is scheduled to spend his last day on April 5 testifying against Congress on the budget proposal for fiscal year 2020. Protect the nation from the health effects of emerging and pandemic infectious diseases and chemical, biological, radiological and nuclear (CBRN) threats. Leverage the capabilities of the private sector.

Infectious Diseases 66

Infectious Diseases Radiology Radiology Administration 66

Taming the SRU

AUGUST 30, 2023

Spinal Infection: According to the Infectious Disease Society of America’s (IDSA) 2015 guidelines for native vertebral osteomyelitis, CRP and ESR in the setting of protracted back pain have sensitivities ranging from 94 to 100% for ruling out infection and malignancy in these patients. 2020 Nov 20;99(47):e23315. J Med Virol.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

ACEP Now

FEBRUARY 11, 2024

There was concern for possible cutaneous leishmaniasis (CL), therefore he was admitted to the hospital for infectious-disease and surgical consultations, as well as to complete a punch biopsy the following day. Centers for Disease Control and Prevention. Last reviewed February 18, 2020. Click to enlarge.) Microorganisms.

Infectious Diseases 52

Infectious Diseases CDC Military Emergency Department 52

The Skeptics' Guide to EM

MARCH 18, 2023

Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. Guest Skeptic: Dr. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children’s National Hospital in Washington, DC. JAMA Pediatr. JAMA Pediatr. Would he benefit from that too?” JAMA Pediatr.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

The Skeptics' Guide to EM

NOVEMBER 28, 2020

Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital. Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital. Should they do it?

Infectious Diseases 52

Infectious Diseases Operations Outcomes Wellness 52

RebelEM

FEBRUARY 29, 2024

Neurocrit Care 2020 , 32 (1), 272-285. Chest 2020 , 158 (6), 2292-2303. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 coli Need for broad-spectrum antibiotics after randomization was not different between groups. DOI: 10.1007/s12028-019-00773-w From NLM. Banzato, E.;

CDC 119

CDC Radiology Radiology Head Injuries 119

Don't Forget the Bubbles

MARCH 18, 2024

Clinical Infectious Diseases [Internet]. Disease severity of Shiga toxin-producingE. Cited June 2020]; 4 (11): 1261-1287. Cited June 2020]; Available from: [link] Hughes D. GG&C Paediatric Guidelines- Kidney Diseases. Cited June 2020]; Available from: [link] Balestracci A et al. Toxins (Basel).

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

EM Literature of Note

SEPTEMBER 13, 2024

The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons. Most regions used a strategy in which nirsevimab was provided to new births during RSV season, as well as other young infants born prior to the onset of the season.

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

EMDocs

NOVEMBER 4, 2023

doi:10.1186/1757-1626-1-165 Hackett B, Sletten Z, Bridwell R E (July 03, 2020) Testicular Abscess and Ischemia Secondary to Epididymo-orchitis. Clinical Infectious Disease. Published 2008 Sep 19. Cureus 12(7): e8991. doi:10.7759/cureus.8991 8991 ​​Schlossberg D. Cambridge Univ Pr. 2008) ISBN:0521871123.

EMS 96

EMS Ultrasounds Emergency Department Infectious Diseases 96

ACEP Now

AUGUST 11, 2024

Published November 2020. National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. References WHO Department of Food Safety and Zoonoses. Ciguatera poisoning. World Health Organization. Accessed July 15, 2024. Food poisoning from seafood. Updated March 30, 2022.

Poisoning 52

Poisoning Infectious Diseases EKG/ECG Emergency Department 52

Critical Care Now

MAY 12, 2022

Interests include trauma, toxicology, and infectious diseases. 2020; 11: 1 – 5. 2020; 11: 1 – 5. Reading Time: 5 minutes Ruben Santiago Emergency Medicine Pharmacist and medication hustler at a level I trauma center in Miami, FL. J Prim Care Community Health. Hand C, Harvey I. Br J Gen Pract. 2004; 54(508): 862 – 7.

Infectious Diseases 52

Infectious Diseases Stroke Emergency Department Administration 52

Pediatric Education

OCTOBER 8, 2023

The diagnosis of a healthy female was made who would be traveling to an area endemic for several infectious diseases. The pediatrician consulted the Centers for Disease Control website for vaccine recommendations for the Congo which indicated the need for malaria prophylaxis as well as Yellow Fever and Typhoid vaccine.

Infectious Diseases 40

Infectious Diseases Pediatrics Military Wellness 40

PulmCCM

JULY 10, 2023

Carbapenem-resistant Acinetobacter infections increased by almost 80% between 2019 and 2020, and Xacduro showed nominal superiority over colistin in subsets of randomized trials. Read in Read in Clinical Infectious Diseases baumannii ). Sulbactam is a beta-lactam and durlobactam a beta-lactamase inhibitor.

Stroke 52

Stroke Sepsis Infectious Diseases Outcomes 52

Northwestern EM Blog

JUNE 16, 2024

Myocardial Infarction Medication Sinus node dysfunction Infectious Disease Hypothermia Metabolic Abnormalities (hypothyroidism, hyperkalemia, ect.) CARDIAC OUTPUT = STROKE VOLUME X HEART RATE Treatment Algorithm for Symptomatic Bradycardia [2-4]: What are common causes of symptomatic bradycardia [2]? Circulation , 45 (3), 703–722.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Infectious Diseases Stroke Poisoning 52

ALiEM

MAY 13, 2024

Ann Emerg Med 2020 [5] 2,656 Systematic review of adult and pediatric studies 94.6% (89.4-97.4%) 2020 Jul;76(1):67-77. Epub 2020 Feb 17. Study N Methods POCUS Sensitivity (95% CI) POCUS Specificity (95% CI) Conclusions Gottleib et al., 97.4%) 85.4% (78.9-90.2%) 90.2%) POCUS has good diagnostic accuracy. Ann Emerg Med.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Don't Forget the Bubbles

FEBRUARY 28, 2024

2020; 64(12):e01426-20. European Journal of clinical microbiology and infectious diseases. Population Pharmacokinetics of Intravenous and Oral Aciclovir and Oral Valaciclovir in Pediatric Population To Optimize Dosing Regimens. Antimicrobial Agents and Chemotherapy. 1995; 14(4): 318–329. Vogel C, Wetzel L, Wutzler P, Gruhn B.

Pediatrics 59

Pediatrics Infectious Diseases Outcomes Research 59

Don't Forget the Bubbles

JANUARY 22, 2024

Emergency Medicine Journal 2020; 37: 851-85 Malhotra A, Maughan D, Ansell J, et al. Magnusen E, Maduemem K, Shafiq A , et al. TAP it’: trainee led initiative to reduce unnecessary blood testing in a paediatric emergency department.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

ALiEM

AUGUST 14, 2023

October 9, 2020. Treatment is appropriate antibiotics and improved foley hygiene, foley exchange as well as improved bowel regimen to increase stool transit time. References Meekins Pauline, Ramsay Amy, Ramsay Michael. Purple Urine Bag Syndrome. West J Emerg Med. 2012 Dec;13(6):499-500. Scleszka Laura, Swan Tricia. online] EMRA.

Academics 52

Academics Wellness Infectious Diseases 52

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

Don't Forget the Bubbles

JANUARY 10, 2024

In 2020, the TRACT investigators shared their results with key stakeholders at a meeting with paediatric and blood transfusion groups from Africa. Choosing to perform a large RCT in the setting in which the guidelines will be taken up makes their research almost immediately translatable into practice. That’s exactly what they did.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

EMDocs

NOVEMBER 16, 2024

Infections For stable patients, obtain microbiologic samples prior to antibiotics (per the American Academy of Orthopedic surgery and The Infectious Diseases Society of America). 2020 Sep 30;5(9):558-567. 2020 Aug 6;9(8):2548. 7,8 Majority are managed operatively. Ramavath A, Lamb JN, Palan J, Pandit HG, Jain S.

EMS 98

EMS Dislocations Fractures Operations 98

EMDocs

AUGUST 26, 2023

2020 Nov 7;18(1):22. Sobel, Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America, Clinical Infectious Diseases , Volume 62, Issue 4, 15 February 2016, Pages e1–e50, [link] Iacopino AM, Wathen WF. Licensed under CC BY-SA 3.0 Clin Mol Allergy.

EMS 97

EMS Infectious Diseases Pediatrics Emergency Department 97

EMDocs

MAY 29, 2023

2020 Jan 1;153(1):14-29. Available from: [link] (11) Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, Hendershot EF, Holtom PD, Huddleston PM 3rd, Petermann GW, Osmon DR, Infectious Diseases Society of America. The Open Infectious Disease Journal. 2020 Apr;478(4):923. Pediatr Ann.

Infectious Diseases 58

Infectious Diseases Emergency Department EMS Hospitals 58

Pediatric EM Morsels

APRIL 5, 2024

(CDC 2024) Generally, most ticks require >24 hours of attachment for there to be a risk of transfer of the infectious agent. This is true of hard ticks , which carry the majority of bacteria and viruses which can infect humans (Rochlin 2020) This is not true when the infectious agent is carried by a soft tick.

CDC 164

CDC Infectious Diseases Pediatrics Shock 164

Pediatric Education

JUNE 25, 2023

The most recent (2020) Cochrane Collaboration review states, “[t]reatment of [chronic suppurative otitis media] with topical antibiotics (quinolones) probably results in an increase in resolution of ear discharge compared with boric acid at up to two weeks.” ”” Questions for Further Discussion 1.

Infectious Diseases 40

Infectious Diseases Pediatrics Seizures Outcomes 40

Pediatric EM Morsels

FEBRUARY 2, 2024

A “Syndromic” Approach for Diagnosing and Managing Travel-Related Infectious Diseases in Children. Infectious Disease Acquisition in Pediatric International Travelers: A 10-Year Review at a Canadian Tertiary Care Hospital. Glob Pediatr Health. 2021 May; 8:1-16. PMID: 34423077 Flores MS, Hickey PW, Fields JH, Ottolini MG.

Infectious Diseases 164

Infectious Diseases Pediatrics Sepsis Documentation/Coding 164

Don't Forget the Bubbles

SEPTEMBER 18, 2023

2020 May;10(5):e035343. 2020 Nov 18;m4238. 2020 Jun 4 [cited 2022 Dec 28];2020(6). The 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. Randel A, Infectious Disease Society of America. 2020 May;220:132-138.e2.

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

Sensible Medicine

JUNE 6, 2024

The first two weeks of March 2020 were jolting. Although he initially rejected it, by April 2020, he recommended community cloth masking to slow the coronavirus (an intervention for which we now have randomized data showing it doesn’t work). No trials of masking vs no masking, or n95 masking vs cloth masking.

Infectious Diseases 145

Infectious Diseases Research Outcomes 145

Pediatric EM Morsels

SEPTEMBER 6, 2024

So, let’s find out more about Kikuchi-Fujimoto Disease. Supportive care for Kikuchi Disease is the main treatment, but even before you know this diagnosis, do what you can to make your patient comfortable. Kikuchi-Fujimoto disease in children. 2020 Mar;56(3):389-393. Be Supportive! J Paediatr Child Health. PMID: 31576642.

Pediatrics 154

Pediatrics Ultrasounds EMS Infectious Diseases 154

Pediatric Education

DECEMBER 17, 2023

The admitting team was concerned about travel-based causes of meningitis and consulted an infectious disease specialist who felt that the patient should also be given acyclovir and doxycycline in addition to cover for potential herpes simplex and also various rickettsial diseases. Rickettsioses in Children – A Review.

Infectious Diseases 40

Infectious Diseases Pediatrics Sepsis Wellness 40