Pediatric EM Morsels

NOVEMBER 3, 2023

Acute Kidney Injury Is Common in Pediatric Severe Malaria and Is Associated with Increased Mortality. Pediatric Malaria: Global and North American Perspectives. Pediatr Clin N Am 69 (2022) 47–64. Higher Rates of Misdiagnosis in Pediatric Patients versus Adults Hospitalized with Imported Malaria. Pediatr Emerg Care.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

Pediatric EM Morsels

MAY 24, 2024

One of the most difficult and most satisfying parts of pediatric emergency medicine is using one’s history, exam and clinical tools to make an informed decision and spare children from unnecessary pain , uncomfortable exams, painful procedures and medical imaging. Low Risk Inta-Adbominal Trauma: Pediatric Trauma is Dangerous!

Pediatrics 164

Pediatrics Blood Transfusions EMS Fractures 164

ACEP Now

JANUARY 5, 2025

Fibrinogen levels should also be obtained, where available, if severe hemorrhage suggests the potential need for administration of fibrinogen concentrate. Int J Pediatr Otorhinolaryngol. Anesthetic management of the pediatric bleeding tonsil. mcg/kg IV may be considered, especially if von Willebrand disease is suspected.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

Broome Docs

NOVEMBER 17, 2024

Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arrest. Antibiotic prophylaxis in pediatric dog bite injuries: Infection rates and prescribing practices. Palatinus HN, Johnson MA, Wang HE, Hoareau GL, Youngquist ST. Resuscitation. 2024 Aug;201:110266. 2024.110266.

Administration 61

Administration Resuscitation Radiology Radiology 61

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 154

Pediatrics Head Injuries Airway Management Administration 154

ACEP Now

OCTOBER 11, 2024

Pediatric submersion injuries are one of the leading causes of preventable morbidity and mortality in the pediatric population. Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. 9,11 As with many pediatric issues, prevention is key.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

EMDocs

DECEMBER 6, 2024

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). Tenenbein M.

Poisoning 94

Poisoning Fluid Resuscitation Seizures Resuscitation 94

ACEP Now

MARCH 10, 2025

Often, the role and responsibilities are added to the ED medical director job description, though other specialists including family practitioners, obstetricians and gynecologists, and pediatrics may serve as medical directors. For pediatric programs, it is preferred that the medical director be trained as a child abuse pediatrician.

Sexual Assault 52

Sexual Assault Forensics Leadership Pediatrics 52

PEMBlog

JUNE 7, 2023

Marianne Gausche-Hill New England EMSC: New England Regional Behavioral Health Toolkit Disclaimer The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S.

Pediatrics 123

Pediatrics Psychiatric Emergency Department EMS 123

Don't Forget the Bubbles

OCTOBER 18, 2024

Midlines are preferred over routine peripheral cannulas for IV drug administration lasting more than four days. They are not suitable for CT contrast administration. Midline Compared With Peripheral Intravenous Catheters for Therapy of 4 Days or Longer in Pediatric Patients: A Randomized Clinical Trial. JAMA Pediatr.

Administration 89

Administration Pediatrics Ultrasounds Burns 89

PEMBlog

MAY 31, 2023

Marianne Gausche-Hill New England EMSC: New England Regional Behavioral Health Toolkit Disclaimer The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Acad Pediatr. Erratum in: West J Emerg Med. 2019 Jul;20(4):688-689.

Psychiatric 93

Psychiatric Emergency Department Pediatrics Administration 93

EM Literature of Note

SEPTEMBER 13, 2024

These are each awful, of course, in their own way from a patient- and parent-oriented standpoint, but they’re also quite awful at the population level, overburdening limited pediatric and emergency department resources. “Nirsevimab and Acute Bronchiolitis Episodes in Pediatric Emergency Departments” [link] Tweet

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

Pediatric Emergency Playbook

AUGUST 1, 2017

Pediatr Rev. Intestinal Malrotation – Not Just the Pediatric Surgeon’s Problem. Pediatr Surg Int. Eur J Pediatr Surg 2016; 26:192. Pediatrics 1977; 60:457. J Pediatr Gastroenterol Nutr 2008; 46:13. J Pediatr 2005; 146:787. Pediatr Surg Int 2003; 19:439. Pediatr Surg Int 2003; 19:247.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

EMDocs

JANUARY 11, 2025

A) Administration of IV morphine for pain control B) Admission to general surgery for IV antibiotics C) Discharge home on lactulose D) Emergent surgical consultation for exploratory laparotomy E) Manual disimpaction Correct answer: E Although uncommon, stercoral colitis is a potentially life-threatening complication of chronic constipation.

EMS 94

EMS Sepsis Shock Fluid Resuscitation 94

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Pediatric Crit Care Med.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

PEMBlog

JUNE 14, 2023

Marianne Gausche-Hill New England EMSC: New England Regional Behavioral Health Toolkit Disclaimer The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Leyenaar; Pediatric Mental Health Boarding. JAMA Pediatr. Pediatrics.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

Emergency Medicine Cases

MAY 5, 2020

The post EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors appeared first on Emergency Medicine Cases.

Sepsis 52

Sepsis Pediatrics EMS Fractures 52

The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. She is a Professor of Pediatrics and Interim Chief of the Section of Pediatric Emergency Medicine at the Medical College of Wisconsin.

Emergency Department 74

Emergency Department Pediatrics Head Injuries Administration 74

EMDocs

NOVEMBER 19, 2024

Second-generation antipsychotic medications: Pharmacology, administration, and side effects. Low-dose lipid emulsion for pediatric vasoplegic shock due to quetiapine and fluvoxamine overdose: a case report. Atypical neuroleptic malignant syndrome precipitated by clozapine and quetiapine overdose: a diagnostic challenge. Published 2023.

Poisoning 108

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 108

Taming the SRU

SEPTEMBER 20, 2023

EKG QUICK Hits: electrolyte abnormalities - air care grand rounds - pediatric pain and procedural sedation EKG Quick hits: electrolyte abnormalities WITH Dr. Baez Potassium Hyperkalemia Peaked T-waves (there is tall and spiked T-waves, that you “wouldn’t want to sit on”) PR interval increases Widening of the QRS Can lead to a sine wave Hypokalemia (..)

EKG/ECG 77

EKG/ECG Pediatrics Administration Wellness 77

Taming the SRU

MAY 11, 2024

Validity Evidence for a Team-Leading Assessment Tool in Pediatric Emergency Resuscitation Using Video Review (Hartwell et al.) Assessed and provided feedback of pediatric resuscitations based on video review. 3% HTS appears to be safe for peripheral IV administration and does not require a central line. Is it effective?

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

EMDocs

NOVEMBER 6, 2023

Naloxone administration may reverse respiratory arrest, preventing progression to cardiac arrest. Standard advanced life support with the addition of administration of sodium bicarbonate is appropriate for the treatment of life-threatening dysrhythmias caused by cocaine or other sodium channel blockers. COR 2a, LOE B-NR.

Poisoning 112

Poisoning Hyperthermia / Hypothermia Seizures Administration 112

EMDocs

JUNE 2, 2023

Route of administration If the patient is cooperative, offer oral medications first. Pediatric Agitation in the Emergency Department: A Survey of Pediatric Emergency Care Coordinators. Acad Pediatr. If a patient has a PRN on their med list do that! This can give the patient a sense of some control. 2019 Jul;20(4):688-689.

Psychiatric 85

Psychiatric Pediatrics Emergency Department Administration 85

Taming the SRU

NOVEMBER 21, 2023

airway grand rounds - r1 clinical knowledge: heavy metals - consultant corner: acute leukemia - pediatric sim - pediatric cases airway grand rounds WITH dr. carleton Difficult airway algorithm: when should we RSI? While we are often cautious with IVF, volume and rate of fluid administration does not cause cerebral edema.

Pediatrics 91

Pediatrics EKG/ECG Resuscitation Dehydration 91

The Skeptics' Guide to EM

MARCH 18, 2023

JAMA Pediatr. Guest Skeptic: Dr. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children’s National Hospital in Washington, DC. She is also the […] The post SGEM #397: Give a Little Bit…of Oseltamivir to Pediatric Patients Admitted with Influenza first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

PEMBlog

MAY 17, 2023

Most children who present to Pediatric Emergency Departments these days with mental health concerns – including agitation – have a known psychiatric problem or diagnosis. Pediatrics 2021; 147. Diagnostic yield of head CT in pediatric emergency department patients with acute psychosis or hallucinations.

Psychiatric 80

Psychiatric Pediatrics Emergency Department Best Practices 80

Don't Forget the Bubbles

JUNE 30, 2023

Tranexamic acid administration to pediatric trauma patients in a combat setting: the pediatric trauma and tranexamic acid study (PED-TRAX). Effectiveness and safety of tranexamic acid in pediatric trauma: A systematic review and meta-analysis. Safety of Tranexamic Acid During Pediatric Trauma: A Nationwide Database Study.

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

Don't Forget the Bubbles

NOVEMBER 27, 2023

Myth busting: Is peripheral administration safe? Adverse events associated with administration of vasopressor medications through a peripheral intravenous catheter: a systematic review and meta-analysis. Clinical Signs to Categorize Shock and Target Vasoactive Medications in Warm Versus Cold Pediatric Septic Shock.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Don't Forget the Bubbles

NOVEMBER 29, 2023

Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). Pediatric Emergency Care 28(11): p 1129-1131, November 2012. |

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Don't Forget the Bubbles

MAY 17, 2023

’, ‘ Who can best score postoperative pain: parents or the children? ’, ‘ Is functional constipation associated with hypohydration? ’, ‘ Who is best at assessing foreign body aspiration on chest X-ray: pediatric pulmonologists, pediatric residents, or radiologists? ’ Eur J Pediatr. Eur J Pediatr. Eur J Pediatr.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

EMDocs

JANUARY 17, 2024

The US Food and Drug Administration (FDA) approved benzonatate in 1958 for cough relief in patients ≥ 10 years. 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9) 9) In 2019, benzonatate accounted for ~ 10% of all pediatric antitussive prescriptions dispensed via retail pharmacies. (9) Pediatr Emerg Care.

Poisoning 81

Poisoning Seizures Pediatrics EMS 81

EM Literature of Note

AUGUST 25, 2024

A heartening trend for a simpler administration and adherence strategy – and non-inferior, overall, while entirely reasonable to judiciously select a higher-risk patient in whom it might be plausible to prescribe prednisone/prednisolone instead. of asthma visits to 17.3% – and the rates are over double that in children.

Emergency Department 94

Emergency Department Administration Wellness Pediatrics 94

EMDocs

JUNE 9, 2023

These protocols are often developed in collaboration with multiple stakeholders that can include EMS staff and administration, legal counsel, community members, law enforcement. If you have restraints in your ambulance, are those restraints appropriately sized for pediatric patients?

EMS 95

EMS Documentation/Coding Pediatrics Psychiatric 95

EMDocs

JULY 1, 2023

This is the only situation in which aspirin is recommended for administration in children, as the benefits outweigh the risks of Reye syndrome. BMC Pediatrics. Early consultation with a specialist is recommended in these cases 7,8 Workup: Lab tests can support the diagnosis of KD, especially in incomplete KD cases as above. Lakhani, N.

EMS 84

EMS Infectious Diseases Pediatrics Research 84

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The patient’s symptoms begin to improve after initial intravenous (IV) fluid administration of one litre of 0.9% That was an episode covering the practice changing randomized control trial published in NEJM by Dr. Nathan Kuppermann from the PECARN Team for pediatric DKA [3]. Blood glucose in triage is 489 mg/dl (27.2

Diabetic Emergencies 102

Diabetic Emergencies Operations Hospitals Research 102

JournalFeed

APRIL 15, 2023

Ketamine ICP Safety Spoon Feed This retrospective study of thirty-three pediatric patients with severe traumatic brain injury (sTBI) demonstrated no increase in intracranial pressure (ICP) after administration of ketamine.

Academics 52

Academics Pediatrics Operations Emergency Department 52

ACEP Now

JULY 7, 2023

Since 2020 to 2021, the Drug Enforcement Administration has reported a sharp rise in xylazine use across the U.S., US Department of Justice, Drug Enforcement Administration. Pediatr Emerg Care. Xylazine is a veterinary sedative that has been increasingly implicated in overdose deaths throughout the United States. Available here.

Forensics 98

Forensics Airway Management Emergency Department Administration 98