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One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. The aim of TTM is to control the body and brain’s temperature, thus reducing secondary brain injury and improving the neurological outcome. What do the guidelines recommend?
To begin, a 2012 prospective pediatric study found a failure rate of 16.9 A 2016 multicenter prospective study evaluated 1,036 pediatric patients for shunt failure who received CSF shunts over a four-year period. 3 This study was conducted at six institutions in the Hydrocephalus Clinical Research Network. J Neurosurg Pediatr.
Kendra Jackson and Rebecca Raffler While we’ve gotten to snack on a Morsel on this subject before , new guidelines and research surrounding DKA and cerebral edema have come to light since the first go ‘round! Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. Pediatr Diabetes.
We have mentioned the Glasgow Coma Scale in multiple delicious morsels: Minor closed head injuries in <3 month olds and in the rebaked morsel , Blunt cerebrovascular injury , Cerebral edema in DKA , Pediatric Trauma Pitfalls , and Carbon monoxide poisoning. When is it useful and what does it tell us?
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. Her research focuses on prehospital care of children with anaphylaxis.
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.
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.
A few months ago, a sensational letter came out in JAMA Pediatrics. To the editor: Subpart D of 45 Code of Federal Regulations Section §46.404 states that research involving children should not entail greater than minimal risk, meaning that harm or discomfort should be no greater than those encountered in everyday life.
1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent. Serious patient-oriented outcomes such as cardiac arrest were rare, but almost all occurred in the oxygen mask cohort. The obvious winner was NIPPV, whose 9.1
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. She is also a member of the Don’t’ Forget the Bubbles team where she serves as the editor for the monthly research round up, Bubble WRAP. It seems awfully high.
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?”
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.
A few months ago, a sensational letter came out in JAMA Pediatrics. To the editor: Subpart D of 45 Code of Federal Regulations Section §46.404 states that research involving children should not entail greater than minimal risk, meaning that harm or discomfort should be no greater than those encountered in everyday life.
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.
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 They bide their time waiting for new, published research that they can lean on for their changes. Until now.
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.
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.
Interpreting ResearchOutcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. There are primary, secondary, composite , and safety outcomes. What are these outcomes? What should you focus on?
What outcomes did they look at? The patients were identified through site leads from the PERUKI research network. Was the outcome accurately measured to minimise bias? The inability to test for SARS-CoV-2 antibodies may have led to an underestimation of the impact of the virus on the reported outcomes.
If not treated early, then increased risk of poor outcomes and death. The post Congenital Syphilis appeared first on Pediatric EM Morsels. Maternal screening early in pregnancy is the best means to prevent congenital syphilis. Penicillin is 98% effective at preventing congenital syphilis. Can identify T. A case of congenital syphilis.
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.
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.
Every year, the volume of published research continues to outpace capacity to consume. 4 Repeated trials have not shown alteplase to have any signal of better outcomes, nor tenecteplase to have an association with increased adverse events. Gotta catch ‘em all!” How Best to Stop the Bleeding in Trauma? percent to 38.3
r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Assessed and provided feedback of pediatric resuscitations based on video review.
Intensive Care Research , 1 (3-4), pp.60-64. In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. Pediatric Endotracheal Intubations for Airway Management in the Emergency Department. This article is based on: Mayberry, H., Burgart, A.M.
Mortality is high, between 16-43.5% , and neurological outcomes are generally poor amongst survivors. These poor outcomes are related to both the SRSE itself and as a result of the prolonged PICU stay. One study suggests remission in 6 out of 7 patients where it was used, but long-term clinical outcomes remained poor.
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. Pediatr Emerg Care. Pediatr Emerg Care.
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.
7 This has also been observed in a pediatric patient population. Certified interpreter use can improve communication and patient outcomes. Rockville: Agency for Healthcare Research and Quality. Pediatrics. Conducting research regarding best practices for improving health outcomes for NELP patients.
In adult trauma cases, there has been significant research to help decide which patients require X-ray or CT imaging for possible cervical spine injuries, leading to the development of the National Emergency X-Ray (NEXUS) prediction rule and the Canadian C-Spine Rule (CCR). Why is this study needed?
Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. JAMA Pediatr. Guest Skeptic: Dr. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children’s National Hospital in Washington, DC. JAMA Pediatr. JAMA Pediatr.
Historical practice recommends rest to prevent adverse outcomes; however, evidence suggests strict rest is harmful. Pediatrics. Symptom reporting was the most common outcome in the included studies. Primary Outcome: Effect of Physical Activity on Symptom Resolution: Seven studies informed the meta-analysis on symptom resolution.
These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. There are at least 600 TBI-related hospitalizations and 175 TBI-related deaths per day.
The factorial design chosen by Dr Maitland and her research group means that several comparisons in transfusion practice could be carried out at the same time. What were the research questions? Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. N Engl J Med. 2019;381(5):407-419.
The symptoms in this age group can mimic other common pediatric skin conditions like eczema or diaper rash, leading to potential misdiagnosis. While research in this area is still in its infancy, preliminary studies have shown promising results. A key benefit of using AI is the potential for increased accuracy and consistency.
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Eur J Pediatr. Eur J Pediatr. J Pediatr Gastroenterol Nutr. Eur J Pediatr. J Pediatr Gastroenterol Nutr. J Pediatr Gastroenterol Nutr.
In this main episode podcast Anton discusses with world expert and bronchiolitis researcher Dr. Suzanne Schuh, the challenges of the diagnosis and management of bronchiolitis during a time of crisis in pediatric emergency medicine and offers some evidence-based solutions to improving outcomes while minimizing valuable resources, as part of our 'Best (..)
A 2015 Nature (PediatricResearch) paper by Nils J. Bergman summarizes a body of research that confirms the benefits of sleeping on the belly. Research by Collett et al (2018) shows that, despite some improvement in PP by 18 months, the deformations persist beyond 36 months. This may not be true for infants.
To determine the effectiveness of ultrasound, a recent study compared its diagnostic capabilities to radiography for distal forearm fractures in children and adolescents, with the primary outcome of functional recovery of the arm. Ultrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures. N Engl J Med.
Prior to medical school, she received her MBA in Healthcare Management and currently works on health policy and outcomes-based research. Pediatr Emerg Care. Isha Joshi (@ISHAJOSHIII) is a third-year medical student at Penn State College of Medicine in Hershey, Pa. Hershey Medical Center and the associate editor of ACEP Now.
Nonetheless, research has consistently shown that healthcare environments demonstrate higher-than-average levels of workplace incivility. High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. Pediatrics. Conclusion Critical care resuscitation is stressful. BMC medicine.
These cases illustrate some of the common issues associated with each shunt type, but what does the evidence say about outcomes? Researchers also looked at neurodevelopmental status three years after the operation. The baby progresses to Stage 2 reconstruction when they are four months old. What is the best option for repair?
Pediatrics 2022;150(4). Thoughts: The original dataset was collected as a convenience sample, ie probably collected when research staff were available for enrollment, which is likely during business hours. Mahajan P, VanBuren JM, Tzimenatos L, et al. 10.1542/peds.2021-055633 2016.9207).
JAMA 2023 Guest Skeptic: Dr. Michael Falk is a Pediatric Emergency Medicine attending at Mount Sinai Medical Center […] The post SGEM #401: Hey Ho! We have covered the use of HFNC in pediatrics a few times on the SGEM including SGEM #228 and SGEM #379. He is interested in simulation and medical education.
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