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 127

Emergency Department Pediatrics Anaphylaxis Leadership 127

Pediatric EM Morsels

JULY 26, 2024

Higher titers in both CSF and serum were associated with poor outcomes. Make sure to consult your friendly neighborhood pediatric neurologist and/or rheumatologist! Earlier diagnosis leads to better outcomes. Younger Age at Onset Is Associated With Worse Long-term Behavioral Outcomes in Anti-NMDA Receptor Encephalitis.

Seizures 271

Seizures Psychiatric Outcomes Pediatrics 271

PEMBlog

JANUARY 21, 2025

The concurrent circulation of influenza, respiratory syncytial virus (RSV), COVID-19, and norovirus during peak viral seasons presents a diagnostic challenge in pediatric emergency settings. nausea, vomiting) occur more frequently in pediatric populations. References Boktor SW, Hafner JW.

Rapid Diagnostic Testing 52

Rapid Diagnostic Testing Pediatrics Dehydration Outcomes 52

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. Cuffed endotracheal tubes in pediatric intensive care.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

American Medical Compliance

NOVEMBER 29, 2024

Unlike traditional methods that rely on periodic fingerstick tests, CGM offers real-time insights into glucose levels, trends, and fluctuations, empowering proactive management and improving patient outcomes. However, to maximize its benefits, healthcare providers must be well-versed in the technology.

Outcomes 105

Outcomes Wellness Operations Pediatrics 105

The Skeptics' Guide to EM

OCTOBER 14, 2023

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. Background: We have looked at pediatric vital signs on the SGEM back in 2014 with PedEM superhero Dr. Anthony Crocco ( SGEM#98 ). Reference: Brennan L et al.

Pediatrics 103

Pediatrics Sepsis Urgent Care Emergency Department 103

Sensible Medicine

FEBRUARY 18, 2025

Treatment failure, the primary outcome, was defined differently for each group: A need for subsequent appendectomy in the antibiotic group and negative appendectomy for the controls. An RCT measures an intervention’s effect on a single outcome. In this study, different outcomes were assessed for each group.

Outcomes 86

Outcomes Research Emergency Department Pediatrics 86

NRC Health

MARCH 9, 2023

Peggy Greco, Chief Patient Experience Officer at Nemours Children’s Health, and NRC Health Customer Success Manager Cami Mitelman to discuss what diversity, equity, and inclusion outcomes look like in patient experience. The post The interesting connection between pediatric outcomes and DEI appeared first on NRC Health.

Outcomes 52

Outcomes Pediatrics 52

The Skeptics' Guide to EM

JUNE 1, 2024

2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC. Cochrane Database Syst Rev. Do you think he injured his neck?”

Pediatrics 87

Pediatrics EMS Emergency Department Research 87

Sensible Medicine

OCTOBER 19, 2023

A few months ago, a sensational letter came out in JAMA Pediatrics. Given the low risks to children from COVID‐19 and a potential for stigmatization, we questioned whether there was minimal risk to children participating in a recent study published in JAMA Pediatrics. Then a dog sniffed them to see if they had COVID19.

Documentation/Coding 129

Documentation/Coding Pediatrics Research Outcomes 129

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

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

EMDocs

DECEMBER 6, 2024

Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). 7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Antiemetics as needed.

Poisoning 94

Poisoning Fluid Resuscitation Seizures Resuscitation 94

EM Ottawa

JUNE 10, 2024

Pediatrics. Findings: The primary outcome of recurrence of UTI within 30 […] The post Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial appeared first on EMOttawa Blog. Methodology: 3.5/5 5 Usefulness: 2.5/5 5 Montini G, et al. 2024 Jan 1;153(1):e2023062598.

Pediatrics 63

Pediatrics Outcomes Infectious Diseases 63

The Skeptics' Guide to EM

JANUARY 20, 2024

JAMA Pediatr. JAMA Pediatr. Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences.

Pediatrics 74

Pediatrics Anaphylaxis Emergency Department Outcomes 74

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 137

Fractures Ultrasounds Pediatrics Outcomes 137

ACEP Now

OCTOBER 11, 2024

Pediatric submersion injuries are one of the leading causes of preventable morbidity and mortality in the pediatric population. 1,2 Clinical outcomes in submersion injuries are largely dependent on the degree of hypoxic injury experienced by the victim, making prehospital care of paramount importance. Ital J Pediatr.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

RebelEM

NOVEMBER 6, 2024

Medial epicondyle fractures in the pediatric population. J Emerg Med. 2018 Jun;54(6):849-854. doi: 10.1016/j.jemermed.2018.02.011. 2018.02.011. Epub 2018 Apr 19. PMID: 29681420 Gottschalk HP, Eisner E, Hosalkar HS. J Am Acad Orthop Surg. 2012 Apr;20(4):223-32. Doi: 10.5435/JAAOS-20-04-223. PMID: 22474092 Hankin FM.

Dislocations 107

Dislocations Fractures Soft Tissue Injuries Outcomes 107

Pediatric EM Morsels

JUNE 14, 2024

Pediatric transverse myelitis.” Clinical Approach to Pediatric Transverse Myelitis, Neuromyelitis Optica Spectrum Disorder and Acute Flaccid Myelitis.” Pediatric acute transverse myelitis overview and differential diagnosis.” ALWAYS rule out a compressive lesion, this is a medical emergency! first sign of MS). Neurology vol.

Pediatrics 143

Pediatrics EMS Outcomes 143

The Skeptics' Guide to EM

FEBRUARY 3, 2024

Systematic Review of CT Angiography in Guiding Management in Pediatric Oropharyngeal Trauma. March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital and George Washington University. Laryngoscope. Reference: Curry SD, et al.

Pediatrics 68

Pediatrics Radiology Radiology Head Injuries 68

The Skeptics' Guide to EM

DECEMBER 14, 2024

Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. Background: Pediatric sepsis is a major global health concern, causing an estimated 3.3 The 2005 International Pediatric Sepsis Consensus Conference (IPSCC) criteria were established based on expert consensus and used for diagnosis.

Sepsis 101

Sepsis Shock Pediatrics Hospitals 101

The Trauma Pro

OCTOBER 4, 2024

A pediatric multi-center study of study on adherence to activity restrictions was published last year. Ten Level I pediatric trauma centers in the US tabulated their experience with solid organ injuries over 3.75 And the more people I poll on what they do, the more and very different answers I get. Until now. years from 2013 to 2016.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

Emergency Medicine Cases

APRIL 9, 2019

Olivia Ostrow, Pediatric Emergency Physician at Hospital for Sick Children, Assistant professor at the University of Toronto and a Medical Safety Leader with an academic focus in quality improvement, discusses a case that exemplifies how indiscriminate work up of pediatric UTI can lead to over-testing, over-treating and even worse outcomes.

Pediatrics 52

Pediatrics Academics EMS Outcomes 52

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

Don't Forget the Bubbles

JUNE 19, 2023

It is useful to know that there are two kinds of weight curves: Descriptive , in which nearly all mothers and their children are included with few exclusion criteria, and Prescriptive , in which groups of women with pathologies that affect neonatal morbidity and mortality outcomes have been excluded. J Pediatr 2018;196:71-6.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

Sensible Medicine

OCTOBER 19, 2023

A few months ago, a sensational letter came out in JAMA Pediatrics. Given the low risks to children from COVID‐19 and a potential for stigmatization, we questioned whether there was minimal risk to children participating in a recent study published in JAMA Pediatrics. Then a dog sniffed them to see if they had COVID19.

Documentation/Coding 91

Documentation/Coding Pediatrics Research Outcomes 91

EB Medicine

NOVEMBER 3, 2022

In this episode, Sam Ashoo, MD, interviews Ami Shah, MD, MPH, and Don Walker, MD, about eye injuries in the pediatric population. Why ocular injuries? Topical anesthetics Visual acuity apps In this episode, Sam Ashoo, MD, interviews Ami Shah, MD, MPH, and Don Walker, MD, about eye injuries in the pediatric population.

Pediatrics 52

Pediatrics Fractures EMS Outcomes 52

The Skeptics' Guide to EM

FEBRUARY 22, 2025

Excluded: Pediatric patients, COVID-19 patients, non-diagnostic studies (ie studies evaluating only the prognostic role of MDW), non-English studies and case reports and reviews. Outcome: Diagnostic accuracy of MDW for early sepsis detection, measured by pooled sensitivity, specificity, and likelihood ratios.

Sepsis 60

Sepsis Infectious Diseases Emergency Department Pediatrics 60

NRC Health

NOVEMBER 28, 2023

When a healthcare team respects a patient’s uniqueness, the patient, in turn, receives the safest care with the best outcomes. During October’s Becker’s Healthcare podcast, two prominent pediatric leaders discussed the critical nature of intentional practices and the importance of family-centered care.

Pediatrics 52

Pediatrics Outcomes 52

Pediatric Emergency Playbook

AUGUST 1, 2017

Pediatr Rev. Intestinal Malrotation – Not Just the Pediatric Surgeon’s Problem. Pediatr Surg Int. Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? Eur J Pediatr Surg 2016; 26:192. Pediatrics 1977; 60:457. J Pediatr Gastroenterol Nutr 2008; 46:13. J Pediatr 2005; 146:787.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Pediatric Emergency Playbook

NOVEMBER 1, 2016

Elbow Interpretation Roadmap: CRITOE More pragmatic and utilitarian than a prosaic mnemonic, CRITOE helps us to remember the order of ossification of the pediatric elbow. Acute compartment syndrome of the upper extremity in children: diagnosis, management, and outcomes. J Pediatr Orthop. Pediatrics. Ann R Coll Surg Engl.

Pediatrics 52

Pediatrics Fractures Dislocations Radiology 52

EMDocs

SEPTEMBER 4, 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.

Pediatrics 97

Pediatrics Outcomes Operations Hospitals 97

EMDocs

MAY 4, 2024

The current analysis showed that EVT was superior in functional outcomes across a variety of ischemic severities and penumbra profiles on imaging. 3: Could Teleconsultation Reduce Pediatric Transfers? Source Pediatric Patients Discharged After Transfer to a Pediatric Emergency Department: Opportunities for Telehealth?

Documentation/Coding 95

Documentation/Coding Stroke Emergency Department Pediatrics 95

The Skeptics' Guide to EM

APRIL 2, 2022

Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. She is the cofounder of FOAMcast and is a pulmonary embolism […] The post SGEM#363: View Master – Virtual Reality Immersion Tool to Reduce Pediatric Anxiety first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Emergency Department Outcomes Research 52

The Skeptics' Guide to EM

JULY 17, 2018

Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma. Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

Sensible Medicine

MAY 28, 2024

A 2008 Cochrane review found adult depression screening does not improve outcomes. The last two trials convincingly demonstrate that when patients with postpartum depression have better access to mental health services, outcomes improve. Screening had no impact on depression, anxiety, or a host of other mental health outcomes.

Military 144

Military Outcomes Psychiatric Wellness 144

EMDocs

OCTOBER 19, 2024

CT scans are typically not recommended in pediatric patients, but can be useful in adults with concern for tracheal stenosis or recurrent tracheitis, however airway stabilization takes precedence. [2][3] 2][3][9] Glucocorticoid were not shown to alter clinical course or patient outcomes. [2][3] Hospital Pediatrics.

EMS 106

EMS Pediatrics Sepsis Airway Management 106