2022 and Pediatrics - Emergency Care Today

The Broselow-Luten System

Pediatric EM Morsels

OCTOBER 27, 2023

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.

Pediatrics

Pediatrics Resuscitation Documentation/Coding Wellness

Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

JULY 19, 2024

Since tonsillectomy is one of the most common pediatric surgeries in the US (~500,000 per year) and the rate of post-tonsillectomy hemorrhage is about 1-5% , it is a good idea that we all are familiar with how to manage this issue! Detecting coagulopathy in pediatric patients with post-tonsillectomy hemorrhage. Epub 2022 Aug 6.

Airway Management

Airway Management Pediatrics Wellness Operations

Neurogenic Shock in Children

Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Unfortunately, there are numerous other pitfalls that can be encountered during the management of pediatric trauma patients.

Shock

Shock Pediatrics Hyperthermia / Hypothermia Dislocations

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

MORE WEBINARS

SGEM #425: Are You Ready for This? Pediatric Readiness of Emergency Departments

The Skeptics' Guide to EM

JANUARY 6, 2024

National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC. Reference: Remick KE, et al. JAMA Netw Open. Reference: Remick KE, et al.

Emergency Department

Emergency Department Pediatrics Anaphylaxis Leadership

Rebaked: Inborn Errors of Metabolism presenting in the ED

Pediatric EM Morsels

MARCH 29, 2024

Pediatrics. Pediatr Rev (2022) 43 (7): 371–383. link] The post Rebaked: Inborn Errors of Metabolism presenting in the ED appeared first on Pediatric EM Morsels. Incidence of inborn errors of metabolism in British Columbia, 1969–1996. 2000; 105:e 10. Inborn Errors of Metabolism: Becoming Ready for Rare. Samantha A.

Dehydration

Dehydration Pediatrics Sepsis EMS

SAEM Clinical Images Series: Pediatric Genitourinary Bleeding

ALiEM

NOVEMBER 17, 2023

Urethral prolapse is a rare condition occurring in prepubertal female pediatric patients. Initial treatment is medical management with topical estrogen cream in conjunction with Sitz baths and outpatient follow-up with pediatric urology or gynecology. Accessed January 5, 2022. Accessed January 5, 2022. Uptodate.com.

Pediatrics

Pediatrics Emergency Department Academics OB/GYN

Food Protein Induced Enterocolitis Syndrome (FPIES)

Pediatric EM Morsels

JUNE 2, 2023

Today we are talking about a rare disease called FPIES (food protein induced enterocolitis syndrome) and how you might encounter these patients in the Pediatric Emergency Department. Food protein-induced enterocolitis syndrome in a tertiary pediatric center: safety of guideline-conforming food challenges.

Dehydration

Dehydration Shock Pediatrics Emergency Department

Lung Abscess in Children

Pediatric EM Morsels

MARCH 1, 2024

Wojsyk-Banaszak, 2018 ) Mainstay of initial therapeutic management is: ( Wojsyk-Banaszak, 2018 ; Fernando, 2022 ) Prolonged course of IV antibiotics Chest physiotherapy Patients managed with medical strategies (compared to surgical) had lower complication rates and shorter hospitalizations. Pediatr Pulmonol. 2022 Jul;92(7-8):1850-1855.

Ultrasounds

Ultrasounds Pediatrics Operations Hospitals

Safely reducing abdominal/pelvic computed tomography imaging in pediatric trauma: a quality improvement initiative

EM Ottawa

JUNE 5, 2023

2022 Aug;24(5):535-543. Editorial: Reducing overuse of CT imaging in pediatric trauma: a model example of the Model for Improvement. Question and Methods: The aim of this QI project was to reduce unnecessary CT abdomen on pediatric trauma activations who were identified as being low risk of IAI. Methodology: 4.5/5

Pediatrics

For obese kids, the USPSTF recommends diet and exercise; the American Academy of Pediatrics recommends surgery and ozempic

Sensible Medicine

DECEMBER 18, 2023

The American Academic of Pediatrics (AAP) proudly told parents to avoid peanuts in kids at high risk of allergy. Sensible Medicine The AAP (American Academy of Pediatrics) is broken, failed organization The American Academy of Pediatrics (AAP) is a failed organization. JMM Sensible Medicine is a reader-supported publication.

Pediatrics

Pediatrics Documentation/Coding Burns Academics

Cuffed Endotracheal Tubes for Children: ReBaked Morsel

Pediatric EM Morsels

NOVEMBER 17, 2023

A single cadaveric study from the 1950s showed that the pediatric subglottic space approximated a circular funnel with the narrowest portion at the cricoid level This study included only 15 children aged 4 months–14 years But why was this a problem? Front Pediatr. 2022 May 11;10:864766. 2022 Apr;29(4):406-414.

Pediatrics

Pediatrics Emergency Department Outcomes Sepsis

PEM POCUS Series: Pediatric Lung Ultrasound

ALiEM

AUGUST 9, 2023

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric lung ultrasound. Take the ALiEMU PEM POCUS: Pediatric Lung Ultrasound Quiz Module Goals List indications for performing a pediatric lung point-of-care ultrasound (POCUS). He was admitted to the pediatric intensive care unit. Pediatrics.

Ultrasounds

Ultrasounds Pediatrics Emergency Department Operations

Contrast Media Shortage of 2022 – Lessons Learned

EMDocs

OCTOBER 30, 2023

” – Musings of an American ED resident in July 2022 when US healthcare was affected simultaneously by supply chain issues from GE Healthcare (contrast media) and Abbott Laboratories (Similac baby formula). A baby formula milk shortage for adults.” 11 Table 1.

Radiology

Radiology Radiology Emergency Department Hospitals

Return to Learn / Return to Sport after Concussion

Pediatric EM Morsels

AUGUST 23, 2024

Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. The post Return to Learn / Return to Sport after Concussion appeared first on Pediatric EM Morsels. Br J Sports Med. 2023 Jun;57(11):695-711. doi: 10.1136/bjsports-2023-106898. PMID: 37316210.

Seizures

Seizures Pediatrics Academics Emergency Department

Anti-NMDA Receptor Encephalitis in Children and Adolescents

Pediatric EM Morsels

JULY 26, 2024

Make sure to consult your friendly neighborhood pediatric neurologist and/or rheumatologist! 2022 Jul 6;9(5):e200013. The post Anti-NMDA Receptor Encephalitis in Children and Adolescents appeared first on Pediatric EM Morsels. The prevalence ranges from 12.5%-61% Neurol Neuroimmunol Neuroinflamm. doi: 10.1212/NXI.0000000000200013.

Psychiatric

Psychiatric Seizures Outcomes Pediatrics

Elbow Dislocations

RebelEM

NOVEMBER 6, 2024

2022 Aug 2. Medial epicondyle fractures in the pediatric population. Acute elbow dislocation: evaluation and management. J Am Acad Orthop Surg. 1998 Jan-Feb;6(1):15-23. doi: 10.5435/00124635-199801000-00002. PMID: 9692937 Decker N, Norse A. Anterior Elbow Dislocation. In: StatPearls [Internet]. Simple elbow dislocation. Shoulder Elbow.

Dislocations

Dislocations Fractures Soft Tissue Injuries Outcomes

SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis

The Skeptics' Guide to EM

FEBRUARY 22, 2025

Clinical Chemistry and Laboratory Medicine 2022; 60(5):786-792 Clin Chem Lab Med. 2022 Date: February 21, 2025 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona.

Sepsis

Sepsis Infectious Diseases Emergency Department Pediatrics

Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

JANUARY 5, 2025

2022 ;279(3):1601-1607. Int J Pediatr Otorhinolaryngol. Anesthetic management of the pediatric bleeding tonsil. He is the founder and host of the Emergency Medicine Cases podcast and website. References Grasl S, Mekhail P, Janik S, et al. Temporal fluctuations of post-tonsillectomy haemorrhage. Eur Arch Otorhinolaryngol.

Airway Management

Airway Management Operations Resuscitation Pediatrics

But Can You Just PO?

Taming the SRU

DECEMBER 17, 2024

This has been particularly validated in pediatric literature; however, this can be applicable to the adult patient population within the right circumstances i.e 2022 Sep 11;5(5):e827. A number of studies have compared the effects of ORT and IV rehydration therapy in infants and children with acute GI illness. Health Sci Rep.

Dehydration

Dehydration Fluid Resuscitation Resuscitation Administration

Acute Esophageal Variceal Bleeding in Children

Pediatric EM Morsels

JUNE 9, 2023

Acute Esophageal Variceal Bleeding: Basics Pediatric liver disease may be due to numerous causes. Banc-Husu, 2023 ] Cholestastis Inflammatory conditions Genetic and Metabolic diseases Pediatric cirrhotic liver disease has many complications. Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics.

Pediatrics

Pediatrics Head Injuries Airway Management Resuscitation

ToxCard: Second Generation Antipsychotic Overdose

EMDocs

NOVEMBER 19, 2024

Published 2022. Low-dose lipid emulsion for pediatric vasoplegic shock due to quetiapine and fluvoxamine overdose: a case report. Low-dose lipid emulsion for pediatric vasoplegic shock due to quetiapine and fluvoxamine overdose: a case report. J Emerg Crit Care Med Vol 6 (October 30, 2022) J Emerg Crit Care Med.

Poisoning

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures

Choosing Wisely – Investigations for seizures that have returned to baseline

Don't Forget the Bubbles

SEPTEMBER 13, 2023

An expert committee appraised the evidence behind recommendations to avoid imaging to inform the 2022 NICE guidance. Take home points References American Academy of Pediatrics, Subcommittee on Febrile Seizures. Pediatrics. J Trop Pediatr. Pediatr Rev. Pediatrics. Front Pediatr. Published 2022 Jan 13.

Seizures

Seizures Pediatrics Emergency Department Radiology

Pediatric Ortho Cases 007

Life in the Fast Lane

DECEMBER 10, 2023

Michael Gibbs MD Pediatric Ortho Cases 007 December 2022; Elbow injuries. Pediatric Orthopedic case interpretation with Haley Dusek, Danielle Sutton, and Virginia Casey

Pediatrics

Pediatrics Dislocations Radiology Radiology

Choosing Wisely – Investigations for Paediatric Patients presenting with Psychiatric Symptoms

Don't Forget the Bubbles

SEPTEMBER 6, 2023

A 2022 CDC report showed an overall trend of increasing mental health-related ED visits for children and young people aged 0-17 from 2019 to 2022. A comparative analysis of pediatric mental health-related emergency department utilization in Montréal, Canada, before and during the COVID-19 pandemic. Published 2022 Jun 13.

Psychiatric

Psychiatric Sexual Assault Emergency Department Pediatrics

Perichondritis of the Ear in Children

Pediatric EM Morsels

AUGUST 11, 2023

2022 Sep;68(9):661-663. Pediatr Emerg Care. The post Perichondritis of the Ear in Children appeared first on Pediatric EM Morsels. Close follow-up or outright admission is needed to ensure this does not become a permanent deformity! References: Kim MM, Goldman RD. Ear-piercing complications in children and adolescents.

Burns

Burns Pediatrics EMS Outcomes

Pediatric Septic Shock

EB Medicine

JANUARY 3, 2023

See the summary here. In this episode, Sam Ashoo, MD, interviews Ara Festekjian, MD, one of the authors of the November 2022 Pediatric Emergency Medicine Practice article on Pediatric Septic Shock in the Emergency Department Introduction: How common is sepsis in kids and what is the mortality rate in the US?

Shock

Shock Pediatrics Airway Management Sepsis

"Sepsis bundles": No good evidence of benefit

PulmCCM

APRIL 14, 2025

The chest society’s 2022 letter to CMS in support of SEP-1 made the case that this would be unethical or unsafe. “SEP-1 protocol to manage severe sepsis and septic shock”, Chest/ACCP website, 2022. . “thoracic” society has not taken a formal position that we are aware of.

Sepsis

Sepsis Infectious Diseases Administration Shock

Fluoroquinolone Use In Children

Pediatric EM Morsels

AUGUST 18, 2023

Jackson 2016) A systematic review of safety data for over 16000 pediatric patients did show MAEs were the most frequently reported event. 451 pediatric patients were included. Morley 2022) This myth is: BUSTED. Pediatrics. Clin Pediatr. Arthropathy was seen in 13.7% of the Ciprofloxacin group vs 9.5% 55(2):107-10.

Pediatrics

Pediatrics Infectious Diseases Seizures Hospitals

PEM POCUS Series: Pediatric Renal and Bladder Ultrasound

ALiEM

MARCH 7, 2024

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric renal and bladder ultrasonography. Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1).

Ultrasounds

Ultrasounds Pediatrics Radiology Radiology

Sternal Osteomyelitis

Don't Forget the Bubbles

AUGUST 19, 2024

Sept 5, 2022. Primary osteomyelitis of the sternum in the pediatric age group: report of a new case and comprehensive analysis of seventy-four cases. Primary osteomyelitis of the sternum in the pediatric age group: report of a new case and comprehensive analysis of seventy-four cases. Pediatr Infect Dis J. 2022-01449.eng.

Infectious Diseases

Infectious Diseases Pediatrics Emergency Department Hospitals

SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Ultrasonography or radiography for suspected pediatric distal forearm fractures. Ultrasonography or radiography for suspected pediatric distal forearm fractures. Background: We have covered pediatric wrist fractures a few times on the SGEM. Ultrasonography or radiography for suspected pediatric distal forearm fractures.

Fractures

Fractures Ultrasounds Pediatrics Outcomes

Stings and envenomations – a buzz-worthy podcast

PEMBlog

JUNE 27, 2023

In this episode, Dr. Ben Grebber, a pediatric resident at Boston Children’s Hospital/Tufts Children’s Hospital, discusses Bee Stings and Spider Bites. Updated 2022 Jun 22]. Pediatrics in review, 20(5), 147-151. Pediatrics in Review, 41(7), 348-356. It is summertime, so the bees and bugs are out! Pansare, M.,

Urgent Care

Urgent Care Pediatrics Emergency Department Hospitals

Pediatric Firearm Injuries to the Extremity

EB Medicine

OCTOBER 2, 2022

In this episode, Sam Ashoo, MD interviews Rawad Rayes, MD and Eva Tovar Hirashima, MD, MPH – two of the authors of the August 2022 PEMP article on Pediatric Firearm Injuries to the Extremity: Management in the Emergency Department. Episode Outline: How common are pediatric firearm injuries?

Pediatrics

Pediatrics Emergency Department Resuscitation Hospitals

PECARN STELAR Podcast – Episode 2: Food Insecurity

EMDocs

JULY 9, 2024

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. Acad Pediatr. Epub 2022 Jan 5.

Pediatrics

Pediatrics Emergency Department Research Burns

First10EM Journal Club: December 2023

Broome Docs

DECEMBER 9, 2023

Choosing wisely for kids From the American Academy of Pediatrics and the Canadian Association of Emergency Physicians, we have the Choosing Wisely recommendations for pediatric emergency medicine. 2022 Nov;63(5):645-650. Epub 2022 Oct 12. 2022 Oct 25;7(1):e000886. doi: 10.1136/tsaco-2022-000886. 2023 Oct 12.

Infectious Diseases

Infectious Diseases Emergency Department Stroke Pediatrics

SGEM#378: Keepin’ It REaL when Treating Pediatric Migraine Patients

The Skeptics' Guide to EM

OCTOBER 1, 2022

Date: September 28th, 2022 Reference: Hartford et al. Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. AEM September 2022. Date: September 28th, 2022 Reference: Hartford et al. AEM September 2022. AEM September 2022.

Pediatrics

Pediatrics Emergency Department Documentation/Coding Research

Multifaceted quality improvement initiatives improve rate of pediatric hand injury reduction

EM Ottawa

MAY 10, 2023

2022 Jun;24(4):426-433. Question & methods: Whether quality improvement interventions could decrease the rate of repeat reductions in pediatric hand injuries by plastic surgeons. Methodology: 2/5 Usefulness: 3/5 Market M, et al.

Pediatrics

SGEM#363: View Master – Virtual Reality Immersion Tool to Reduce Pediatric Anxiety

The Skeptics' Guide to EM

APRIL 2, 2022

Date: March 31st, 2022 Reference: Butt et al. Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. Date: March 31st, 2022 Reference: Butt et al. Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department.

Pediatrics

Pediatrics Emergency Department Outcomes Research

Sickle Cell Disease and Stroke

Pediatric EM Morsels

APRIL 7, 2023

There are many conditions that we would like to think belong only to the “ adult patient problem DDx; ” however, as we have discussed several times previously, pediatric patients can experience many “adult conditions” (see, Aortic Dissection , Kidney Stones , and Cholecystitis ). Updated 2022 Jul 18].

Stroke

Stroke Pediatrics Seizures Sepsis

Proximal Tibiofibular Joint Dislocation in Children

Pediatric EM Morsels

JULY 7, 2023

May have: Pain with knee extension Visual deformity Crepitance Locking or popping In Children, should consider it when: [ Sacchetti, 2022 ] Patient refuses to bear weight, Has Painless Range of Motion of the Knee, and Tenderness over the Fibular Head. 2022 Apr;54:328.e3-328.e4. References: Sacchetti A, Verbaro J. Am J Emerg Med.

Dislocations

Dislocations Fractures Pediatrics EMS

EM@3AM: Kawasaki Disease

EMDocs

JULY 1, 2023

BMC Pediatrics. UpToDate;2022. Accessed December 31, 2022. Accessed December 31, 2022. Upon further research in the 1970’s, retrospective data from autopsies of those patients showed coronary aneurysms 5 Pathophysiology: Kawasaki Disease is a vasculitis of medium sized arteries. Lakhani, N. 2018;18(334). Newburger, J.,

EMS

EMS Infectious Diseases Pediatrics Research

First10EM Journal Club: July 2022

Broome Docs

AUGUST 2, 2022

2022 Jun 23;386(25):2387-2398. 2022 Jan;175(1):20-28. 2022 Jan;175(1):29-35. JAMA Pediatr. 2022 May 1;176(5):486-492. 2022 Mar;135(3):369-379.e1. 2022 Mar 16;56:10-12. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. N Engl J Med. doi: 10.1056/NEJMoa2200644. Ann Intern Med.

Sepsis

Sepsis Emergency Department Radiology Radiology

Fetal Growth Restriction and Small for Gestational Age Babies

Don't Forget the Bubbles

JUNE 19, 2023

J Pediatr 2018;196:71-6. Pediatrics 2022;149:e2021053413. Curr Pediatr Rev 2018;14:212–8. Eur J Pediatr 2016;175:1047-57. Up To Date, [link] Accessed on: 11 August 2022. Recommendations from the pediatric endocrine society for evaluation and management of persistent hypoglycemia in neonates, infants, and children.

Pediatrics

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis

SGEM#375: Only One versus Two-Dose Dexamethasone for Mild to Moderate Pediatric Asthma Exacerbations

The Skeptics' Guide to EM

SEPTEMBER 10, 2022

Date: August 25th, 2022 Reference: Martin et al. Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergency department. Pediatr Emerg Care. 2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children’s National Hospital.

Pediatrics

Pediatrics Emergency Department Urgent Care Hospitals

The Broselow-Luten System

Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Webinars

Trending Sources

Neurogenic Shock in Children

Webinars

SGEM #425: Are You Ready for This? Pediatric Readiness of Emergency Departments

Rebaked: Inborn Errors of Metabolism presenting in the ED

SAEM Clinical Images Series: Pediatric Genitourinary Bleeding

Food Protein Induced Enterocolitis Syndrome (FPIES)

Lung Abscess in Children

Safely reducing abdominal/pelvic computed tomography imaging in pediatric trauma: a quality improvement initiative

For obese kids, the USPSTF recommends diet and exercise; the American Academy of Pediatrics recommends surgery and ozempic

Cuffed Endotracheal Tubes for Children: ReBaked Morsel

PEM POCUS Series: Pediatric Lung Ultrasound

Contrast Media Shortage of 2022 – Lessons Learned

Return to Learn / Return to Sport after Concussion

Anti-NMDA Receptor Encephalitis in Children and Adolescents

Elbow Dislocations

SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis

Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

But Can You Just PO?

Acute Esophageal Variceal Bleeding in Children

ToxCard: Second Generation Antipsychotic Overdose

Choosing Wisely – Investigations for seizures that have returned to baseline

Pediatric Ortho Cases 007

Choosing Wisely – Investigations for Paediatric Patients presenting with Psychiatric Symptoms

Perichondritis of the Ear in Children

Pediatric Septic Shock

"Sepsis bundles": No good evidence of benefit

Fluoroquinolone Use In Children

PEM POCUS Series: Pediatric Renal and Bladder Ultrasound

Sternal Osteomyelitis

SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures

Stings and envenomations – a buzz-worthy podcast

Pediatric Firearm Injuries to the Extremity

PECARN STELAR Podcast – Episode 2: Food Insecurity

First10EM Journal Club: December 2023

SGEM#378: Keepin’ It REaL when Treating Pediatric Migraine Patients

Multifaceted quality improvement initiatives improve rate of pediatric hand injury reduction

SGEM#363: View Master – Virtual Reality Immersion Tool to Reduce Pediatric Anxiety

Sickle Cell Disease and Stroke

Proximal Tibiofibular Joint Dislocation in Children

EM@3AM: Kawasaki Disease

First10EM Journal Club: July 2022

Fetal Growth Restriction and Small for Gestational Age Babies

SGEM#375: Only One versus Two-Dose Dexamethasone for Mild to Moderate Pediatric Asthma Exacerbations

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