Don't Forget the Bubbles

AUGUST 7, 2023

Heart rate (HR) and respiratory rate (RR) are THE major vital signs used in Advanced Paediatric Life Support ( APLS) guidance , sepsis guidelines , and Paediatric Early Warning Scores (e.g., Identify the percentage of children whose heart or respiratory rate would exceed the “severe” cut-off from the UK Sepsis Trust and NICE guidelines.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

EMDocs

NOVEMBER 25, 2023

Source Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. 3: High or Low Fluid Volume in Sepsis? Clay Smith at @spoonfedEM , and sign up for email updates here. #1: Am J Hematol.

Sepsis 71

Sepsis Emergency Department Pediatrics Academics 71

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

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. Reviewed by: John Coveney Article 2: How do we define sepsis in children?

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Don't Forget the Bubbles

MAY 6, 2024

Acad Pediatr. For a deep dive into intubation, see Intubation of the critically unwell Child in the emergency department – Don’t Forget the Bubbles (dontforgetthebubbles.com) For all things neonatal (lines and tubes), see Neonatal lines and tubes – Don’t Forget the Bubbles (dontforgetthebubbles.com) Why does it matter?

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

Natalie May trained as an emergency physician with subspecialty paediatric emergency medicine in the UK and worked in Manchester and Oxford before moving to Australia in 2015 to work for Sydney […] The post SGEM#190: Wee are the Champions of Pediatric Urine Samples first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Emergency Department Sepsis Wellness 52

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. Pediatr Rev. J Emerg Med.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Don't Forget the Bubbles

MAY 17, 2023

Eur J Pediatr. Original clinical studies The impact of the early onset neonatal sepsis calculator on antibiotic initiation: a single center study in Israel. Eur J Pediatr. J Pediatr Gastroenterol Nutr. Eur J Pediatr. J Pediatr Gastroenterol Nutr. J Pediatr Gastroenterol Nutr. Eur J Pediatr.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. Case: You are working night shift in the emergency department.

Sepsis 52

Sepsis Emergency Department Seizures Pediatrics 52

Don't Forget the Bubbles

MAY 8, 2024

An interesting study (JAMA Pediatrics) shows the benefits of newborn screening for spinal muscular atrophy (SMA), as initiating disease-modifying therapy earlier improves clinical outcomes. Pediatr Nephrol. Eur J Pediatr. Long COVID in pediatrics-epidemiology, diagnosis, and management. Eur J Pediatr. JAMA Pediatr.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

Taming the SRU

JANUARY 12, 2024

pediatric small groups WITH our cchmc colleagues Dermatologic emergencies Children can present with a wide range of rashes, many of which are benign, however identifying concerning rashes is very important. Use your resources to differentiate scary from benign! Children are not just small adults!

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

ACEP Now

JULY 8, 2023

To better address this question, we begin with a prospective observational cohort study of 239 children that evaluated the diagnostic ability of clinical recognition signs (CRS) to identify sepsis. Dr. Jones is assistant professor of pediatric emergency medicine at the University of Kentucky in Lexington. BMC Emerg Med.

Pediatrics 52

Pediatrics Poisoning Emergency Department Sepsis 52

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.

Infectious Diseases 89

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

Pediatric Emergency Playbook

APRIL 1, 2016

Read on to go from bread-and-butter pediatric blood work to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids? A fundamental tenet of emergency medicine: We balance our obligation to detect a dangerous condition with our suspicion of the disease in given patient. Cohen et al. Cohen et al.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Some may present with isolated tachycardia while others may present with profound sepsis – tachycardia, hypotension, and fever.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

PEMBlog

OCTOBER 18, 2023

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. Initially in the emergency department he was generally well-appearing with normal vital signs. rectally, prompting a sepsis workup given his age. Pediatr Dermatol. Labs were notable for: WBC 9.1

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

PEMBlog

AUGUST 20, 2024

ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals. ELSO guidelines for adult and pediatric extracorporeal membrane oxygenation circuits. Pediatric Emergency Care , 40(8), 618-622.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 10, 2018

Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. Case: Tom is a 4-year-old boy who comes into the emergency department with a wheeze following a viral illness. Tom has no other previous medical history.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

Broome Docs

AUGUST 2, 2022

Vitamin C in sepsis: STOP IT, we do not LOVE IT Lamontagne F, Masse MH, Menard J, et al; LOVIT Investigators and the Canadian Critical Care Trials Group. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. PMID: 35704292 Bottom line: Sepsis is not treated with vitamins. JAMA Pediatr. Am J Emerg Med.

Sepsis 52

Sepsis Emergency Department Radiology Radiology 52

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med. Am J Emerg Med. 2014;63(4):437-447.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

ACEP Now

AUGUST 25, 2023

Case A critically ill patient presents to the emergency department (ED) requiring an emergent, definitive airway. This might make the results more generalizable but could also mean that the results do not apply to the individual patient presenting to the emergency department. J Crit Care. 2023;77:154317.

Outcomes 52

Outcomes Emergency Department Sepsis Hospitals 52

Pediatric Emergency Playbook

JUNE 1, 2016

Hypovolemic Shock The most common presentation of pediatric shock; look for decreased activity, decreased urine output, absence of tears, dry mucous membranes, sunken fontanelle. Distributive Shock The most common cause of distributive shock is sepsis, followed by anaphylactic, toxicologic, adrenal, and neurogenic causes. Pediatrics.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments. Epinephrine metered-dose inhaler for pediatric croup. Acad Emerg Med. N Engl J Med. 2023 Jan 21. doi: 10.1056/NEJMoa2212663.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Don't Forget the Bubbles

NOVEMBER 1, 2023

This month, Bubble Wrap has teamed up with Sheffield Children’s Hospital Emergency Department to have a look at what’s new in paediatric literature. Lactate as a screening tool for critical illness in a pediatric emergency department. Pediatric Emergency Care. 2023 Oct 1;39(10):735-8.

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

The Skeptics' Guide to EM

DECEMBER 14, 2024

Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed. He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed. Guest Skeptic: Prof.

Sepsis 103

Sepsis Pediatrics Shock Hospitals 103

ACEP Now

JANUARY 5, 2025

The PREOXI trial compared oxygen mask pre-oxygenation versus noninvasive positive-pressure ventilation (NIPPV) in patients requiring intubation in emergency departments (EDs) and intensive care units. Sepsis Robots or Sepsis Humans The proliferation of sepsis alerts in the ED has reached levels best described as obscene.

Sepsis 40

Sepsis Research Airway Management Stroke 40

The Skeptics' Guide to EM

OCTOBER 14, 2023

Vicki Currie is a paediatric emergency medicine registrar in the West Midlands in the United Kingdom. She is also a member […] The post SGEM #417: Everybody’s Changing…the Reference Ranges for Pediatric Vital Signs first appeared on The Skeptics Guide to Emergency Medicine. Does he have sepsis?” It seems awfully high.

Pediatrics 105

Pediatrics Sepsis Urgent Care Emergency Department 105

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. Jeff: Let’s move on to evaluation in the emergency department. Jeff: You’re right. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EMDocs

NOVEMBER 27, 2023

A 55-year-old male, with a previous medical history of hypertension, hyperlipidemia, and gout, presents to the emergency department for four days of fever and progressive rash. Obtain EKG if patient is presenting with chest pain. Am J Emerg Med. Case Rep Pediatr. Rule out confounding viral or autoimmune hepatitis.

EMS 97

EMS Sepsis Burns EKG/ECG 97

Don't Forget the Bubbles

JUNE 30, 2023

Importantly, there were no differences between the groups regarding complications, including acute respiratory distress syndrome, multiple organ failure, venous thromboembolism, sepsis, and transfusion-related complications. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this. c) Or, do both?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

EB Medicine

MARCH 4, 2020

Literature Review: There is abundant literature on pediatric AGE but sparse research on AGE in adults. Therefore, many recommendations are extrapolated from the pediatric literature. Higher sugar solutions can be diluted 50% Coconut water Half strength apple juice has been studied in pediatrics and decreased treatment failure.

Emergency Department 40

Emergency Department Dehydration Poisoning Allergic Reactions 40

EMDocs

OCTOBER 8, 2024

The full differential diagnosis of sinus tachycardia in isolation is extensive ranging from benign etiologies such as anxiety to severely life threatening etiologies such as sepsis. Unanticipated death after discharge home from the emergency department. Ann Emerg Med. Acad Emerg Med. Ann Emerg Med.

Shock 106

Shock Emergency Department Pediatrics EKG/ECG 106

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

PEMBlog

MARCH 27, 2024

This episode will help you better prepare for and manage children with inborn errors of metabolism in the Emergency Department. My special guest podcaster, Emily Groopman, is an actual Pediatric Geneticist in training and we hope that you will find this episode useful. Pediatr Rev. Pediatrics. doi: 10.1542/pir.2014-0122.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Carly Eastin is an Associate Professor, Division of Research and Evidence Based Medicine, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Case: A 45-year-old female in the emergency department is being admitted to the intensive care unit (ICU) for septic shock secondary to urinary tract infection (UTI).

Sepsis 52

Sepsis Shock Outcomes Stroke 52

Don't Forget the Bubbles

JULY 22, 2024

There is an increased risk of pneumonia and sepsis in the 31-90 days after prescription and an increased risk of fractures, GI bleeds and sub-optimal growth. Pediatr Pulmonol. Annals of Emergency Medicine. JAMA Pediatrics. Corticosteroids impact the child’s immune system. 2016 Aug;51(8):868–76. 2016 May;67(5):593-601.e3.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105