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The Fifth Law Of Trauma – Pediatric

The Trauma Pro

Any time I give a pediatric talk, I mention it. Bottom line: It’s so easy to go down the sepsis path with sick kids, especially those who can’t talk yet. And another law to end the first week! This one applies to anyone who takes care of children, and is particularly important to EMS / prehospital providers and emergency physicians.

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"Sepsis bundles": No good evidence of benefit

PulmCCM

SEP-1, the Centers for Medicare & Medicaid Services (CMS)’s much-maligned sepsis “quality” measure, was the brainchild of a small group of insiders conceived in the early- to mid-2000s. SEP-1 was pushed through without waiting for the outcomes of three ongoing multicenter trials testing goal-directed therapy for sepsis.

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SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis

The Skeptics' Guide to EM

Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis. Background: Rapid and accurate diagnosis of sepsis is critical, as early intervention can significantly reduce patient mortality. Reference: Agnello et al. His WBC is elevated at 23,000 with a left shift.

Sepsis 61
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EM@3AM: Pediatric Osteomyelitis

EMDocs

This is thought to be secondary to increased microtrauma for boys 1 In pediatric patients long bones (femur, tibia) are more commonly infected nearing 75% of the time. Pediatric osteomyelitis treatment algorithm. Bacterial osteomyelitis in pediatric patients: a comprehensive review. Osteoarticular infections in pediatrics.

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Rebaked: Inborn Errors of Metabolism presenting in the ED

Pediatric EM Morsels

Pediatrics. Pediatr Rev (2022) 43 (7): 371–383. link] The post Rebaked: Inborn Errors of Metabolism presenting in the ED appeared first on Pediatric EM Morsels. Incidence of inborn errors of metabolism in British Columbia, 1969–1996. 2000; 105:e 10. Inborn Errors of Metabolism: Becoming Ready for Rare. Samantha A.

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But Can You Just PO?

Taming the SRU

There is substantial evidence that IV fluids can be beneficial in patients with sepsis complicated by hypotension and labor. This has been particularly validated in pediatric literature; however, this can be applicable to the adult patient population within the right circumstances i.e

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Cuffed Endotracheal Tubes for Children: ReBaked Morsel

Pediatric EM Morsels

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.