Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. . + Procalcitonin (PCT) Etiology: PCT was first discovered in 1984. However, it was not until a 1993 study that its significance was realized.

Infectious Diseases 89

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

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. Nasopharyngeal PCR testing is positive for Influenza A.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

ACEP Now

AUGUST 11, 2024

A 41-year-old woman arrived in a Hawaii emergency department with her husband early in the morning. Hospitalization may be necessary for persistent symptoms. Hospitalization may be necessary for persistent symptoms. References WHO Department of Food Safety and Zoonoses. Centers for Disease Control and Prevention.

Poisoning 52

Poisoning Infectious Diseases EKG/ECG Emergency Department 52

ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). Radecki (@emlitofnote) i s an emergency physician and informatician with Christchurch Hospital in Christchurch, New Zealand. Ann Emerg Med.

Emergency Department 52

Emergency Department Research Infectious Diseases Hospitals 52

ACEP Now

OCTOBER 26, 2023

The Case A two-year-old female, seen three days ago at different local emergency department (ED)—Children’s General—presents with fever, headache, and neck pain. The parents only have a copy of the discharge instructions, and your hospital and Children’s General do not share electronic health records. HHS website.

Infectious Diseases 52

Infectious Diseases Documentation/Coding Hospitals Emergency Department 52

EMDocs

JUNE 17, 2023

The Pediatric Infectious Disease Journal. Acute Periorbital Infections: Who Needs Emergent Imaging? swelling, chemosis, fever, etc.), swelling, chemosis, fever, etc.), She reports no vision changes or fever. She remembers rubbing and scratching around her eye a few days ago but does not recall any trauma. 2019;53(4):409-412.

EMS 91

EMS Infectious Diseases Pediatrics Emergency Department 91

ALiEM

JANUARY 22, 2024

A 40-year-old male, tailor by occupation, was brought to the Emergency Department with complaints of high-grade fever for the past 11 days. The patient during his hospital stay developed ARDS and was on mechanical ventilation for 20 days. Fever was documented to be 102°F and was not associated with any chills or rigors.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

Don't Forget the Bubbles

JANUARY 10, 2024

Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. Severe anaemia is a common and life-threatening cause of hospital admission in children in sub-Saharan Africa. 8% die in hospital, with a further 12% dying in the six months following discharge.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

ALiEM

MARCH 11, 2024

In July 2022, a 32-year-old male with a past medical history of HIV (on antiretroviral therapy, CD4 390, viral load undetectable) presented to the emergency department with constitutional symptoms and a rash for 4-5 days. The patient’s eye lesion and symptoms resolved and he was discharged on hospital day eight.

Academics 56

Academics Documentation/Coding Emergency Department Hospitals 56

ACEP Now

MAY 4, 2023

Case A 37-year-old white male with no past medical history presented to the emergency department (ED) for left testicular pain, redness, and swelling. Dr. Rader works at Ascension Macomb-Oakland Hospital. Dr. Fishman is an associate program director at Ascension Macomb-Oakland Hospital. J Emerg Trauma Shock.

Urgent Care 52

Urgent Care Ultrasounds Sepsis Emergency Department 52

ACEP Now

MARCH 6, 2024

7 The operators involved in the trial were mostly emergency medicine residents or critical care fellows, but this fact does not diminish the generalizability of these observations. Many clinicians staffing emergency departments intubate infrequently, as well, and these results are likely applicable to a wide scope of practice.

Research 52

Research Airway Management Stroke Outcomes 52

ALiEM

OCTOBER 16, 2023

An otherwise healthy 34-year-old male presented to the Emergency Department with two weeks of anterior neck pain. Patients with Lemierre Syndrome will require surgical consultation and hospital admission. Symptoms began with several days of pain in his mandibular molars, progressing to pain and swelling in the neck.

Academics 60

Academics Wellness Emergency Department Hospitals 60

Advanced Emergency Nursing from AENJ

JUNE 16, 2015

Ordinary hospital practice would be for admission orders to specify Isolation Cart, to ensure that the ward would have one delivered and restocked daily until no longer needed. This is not a feasible practice in the Emergency Department which must deal immediately with an undifferentiated patient.

PPE 40

PPE Infectious Diseases Emergency Nursing Operations 40

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). 9,23 Disposition: Dislocation : If successfully reduced in the emergency department may discharge with strict mobility restrictions and Orthopedic follow up.

EMS 94

EMS Dislocations Fractures Operations 94

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Paediatr Int Child Health. 2024 Jan 11:1-7. Epub ahead of print.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

EMDocs

OCTOBER 5, 2024

A 62-year-old female patient with a history of recurrent urinary tract infections (UTIs) presents to the emergency department with fever, chills, and dysuria. They are found primarily in hospital specimens but are increasing in frequency in samples from the community. We’ll keep it short, while you keep that EM brain sharp.

EMS 93

EMS Infectious Diseases Sepsis Hospitals 93

Pediatric EM Morsels

SEPTEMBER 20, 2024

Diarrhea is one of the most common complaints in the pediatric emergency department, especially in the summer and early fall. Timing and utility of ultrasound in diarrhea-associated hemolytic uremic syndrome: 7-year experience of a large tertiary care hospital. References: Glatstein M, Miller E, Garcia-Bournissen F, Scolnik D.

Pediatrics 164

Pediatrics Ultrasounds Dehydration Emergency Department 164

Don't Forget the Bubbles

AUGUST 30, 2023

The parents of 9-month-old Josie bring her into the Emergency Department with coryzal symptoms and difficulty breathing. A secondary analysis of a nationwide study of Emergency Department attendance in America from 2006 to 2008 found that CXRs increase the average length of stay by 27 minutes. Am J Emerg Med.

Emergency Department 131

Emergency Department Pediatrics Infectious Diseases Research 131

Don't Forget the Bubbles

SEPTEMBER 27, 2023

The parents of two-year-old, previously healthy, Jamie bring him to the Emergency Department with coryzal symptoms, wheezing and difficulty breathing. There may be a role in viral respiratory panels for children admitted to the hospital or intensive care unit. SpO2 is 88%. Which children need a respiratory viral panel?

Emergency Department 84

Emergency Department Pediatrics Point-of-Care Testing Hospitals 84

RebelEM

MAY 15, 2024

Follow your hospital’s protocol (if available). High Risk Patients will need hospitalization and IV antibiotics. Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergency departments of cancer centers in three continents. Ann Emerg Med.

Infectious Diseases 90

Infectious Diseases Administration Sepsis Anaphylaxis 90

EMDocs

DECEMBER 18, 2023

1 The rationale for the shift away from normal saline in 2021 derived from multiple trials, including the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) and Saline Against Lactated Ringer’s or Plasma-Lyte in the Emergency Department (SALT ED). The patient currently resides at a skilled nursing facility.

Sepsis 83

Sepsis Fluid Resuscitation Resuscitation Shock 83

EMDocs

JANUARY 6, 2024

1 Indications for transplant include: Non-ischemic cardiomyopathy (49%) Ischemic cardiomyopathy (35%) Restrictive cardiomyopathy (4%) Retransplantation following failed prior transplant (3%) Hypertrophic cardiomyopathy (3%) Congenital heart disease (3%) Valvular cardiomyopathy (3%) The median survival after heart transplant is over 12 years.

EMS 80

EMS Infectious Diseases Shock Emergency Department 80

Don't Forget the Bubbles

JANUARY 22, 2024

Repeated GP and hospital attendance might stimulate increased testing and unnecessary prescriptions. Choosing Wisely in Paediatric Car e A trainee-led project in a UK tertiary paediatric emergency department looked at the usefulness of blood tests in 101 children. Archives of Disease in Childhood 2018; 103: A137-A138.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

EMDocs

MAY 29, 2023

Authors: Rachel Kelly, MD (EM Resident Physician, Stony Brook University Hospital) and Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Inflammatory biomarkers in hospitalized adults with suspected infection.

Infectious Diseases 55

Infectious Diseases Emergency Department EMS Hospitals 55

RebelEM

AUGUST 3, 2023

Literature including patients with penicillin allergies also show longer, more complicated hospital courses. Background: Many patients report a vague history of penicillin allergy. The vast majority of these self-reported allergies are untrue (< 5%) .

Anaphylaxis 52

Anaphylaxis Allergic Reactions Infectious Diseases Outcomes 52

PEMBlog

SEPTEMBER 27, 2023

The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Olivia Ostrow, MD Hospital for Sick Children Toronto, Ontario, Canada olivia.ostrow@sickkids.ca The clinical utility of respiratory viral testing in hospitalized children: a meta-analysis. JAMA Pediatr.

Pediatrics 52

Pediatrics Hospitals Emergency Department Outcomes 52

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. Conventionally IV antibiotics have been limited to in-hospital use.

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

PEMBlog

JULY 10, 2024

This is Emily Labudde, originally from Detroit, at the time of recording this episode, a third year categorical pediatric resident at Cincinnati Children’s and a soon to be pediatric emergency medicine fellow in Atlanta. I’m going to pass the mic to you, Emily. Today’s podcast is going to cover acquired syphilis infection.

Pediatrics 52

Pediatrics CDC Seizures Emergency Department 52

Pediatric EM Morsels

FEBRUARY 2, 2024

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries. A “Syndromic” Approach for Diagnosing and Managing Travel-Related Infectious Diseases in Children. Pediatr Emerg Care. 9(1):25-30.

Infectious Diseases 164

Infectious Diseases Pediatrics Sepsis Documentation/Coding 164

PEMBlog

AUGUST 30, 2023

The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Michele Nypaver, MD University of Michigan Ann Arbor, MI, USA michelen@med.umich.edu Jennifer Thull-Freedman, MD Alberta Children’s Hospital Calgary, Alberta, Canada Jennifer.Thull-Freedman@albertahealthservices.ca

Pediatrics 52

Pediatrics Best Practices Hospitals Emergency Department 52

RebelEM

OCTOBER 26, 2023

Enrollment: Recruited patients from primary care offices, emergency departments, and inpatient wards at Children’s Hospital of Philadelphia and UPMC Children’s Hospital of Pittsburgh. Hospitalization for bacteremia. Diagnosed with UTI. Admission to the intensive care unit. Pediatrics. 2011;128:595-610.

Pediatrics 81

Pediatrics Infectious Diseases Outcomes Research 81

PEMBlog

JANUARY 17, 2024

Camargo, Clinical Trial: Comparative Effectiveness of Cephalexin Plus Trimethoprim-Sulfamethoxazole Versus Cephalexin Alone for Treatment of Uncomplicated Cellulitis: A Randomized Controlled Trial, Clinical Infectious Diseases, Volume 56, Issue 12, 15 June 2013, Pages 1754–1762, [link] Liu C, Bayer A, Cosgrove SE, et al.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

PulmCCM

JUNE 19, 2023

No drug or combination improved the primary outcome (a composite outcome of hypoxemia, visit to the emergency department, hospitalization, or death). That was in NEJM Aug 18 2022. Metformin also has positive immune-modulatory effects (on cytokine profiles and T-cell immunity).

Infectious Diseases 52

Infectious Diseases Hyperthermia / Hypothermia Outcomes Sepsis 52

Don't Forget the Bubbles

SEPTEMBER 18, 2024

. ■ Case 1 focuses on a case seen in the emergency department and explores the common parental query of a “weak immune system” in a young child who has had several recurrent upper respirator tract infections back-to-back but is otherwise well. A 3 year old boy is brought to emergency department and treated for viral induced wheeze.

Emergency Department 98

Emergency Department Wellness Infectious Diseases Pediatrics 98

EB Medicine

DECEMBER 1, 2018

Jeff: The information contained in this article comes from articles found on pubmed, the cochrane database, center for disease control, and the world health organization. Additionally, guidelines were reviewed from the american college of emergency physicians, infectious disease society of america, and the american academy of pediatrics.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

Taming the SRU

JUNE 12, 2023

Although not every person seeks health care for these injuries, the majority of those that do end up in the emergency department. In 2008, this led to greater than 316,000 emergency department (ED) visits and about 9,500 hospitalizations [1]. Clinical Infectious Diseases. Annals of Emergency Medicine.

Infectious Diseases 103

Infectious Diseases Emergency Department Administration Academics 103

PEMBlog

OCTOBER 31, 2024

every year, leading to emergency department visits and hospitalizations. A new study conducted by the Pediatric Emergency Care Applied Research Network (PECARN) aimed to determine whether LGG could reduce the severity of gastroenteritis in children. emergency departments. vs. 12.6%, respectively).

Outcomes 105

Outcomes Pediatrics Emergency Department Research 105