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27 09, 2018

PECARN Study: Accuracy of Urinalysis for Febrile Infants ≤60 Days Old

2018-09-26T14:47:31+00:00

The reported accuracy of the urinalysis (UA) for diagnosing urinary tract infections (UTI) is febrile infants ≤ 60 days has been widely variable. Some guidelines specifically exclude these patients due to this variability or recommend urine culture as the primary test.1

Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger, published in Pediatrics in February of 2018, addressed this topic head-on.2 The authors sought to evaluate the accuracy of the UA by analyzing data in a planned secondary analysis of a prospectively collected data set, as part of the Pediatric Emergency Care Applied Research Network (PECARN). We review this publication and present a behind-the-scenes podcast interview with lead author Dr. Leah Tzimenatos.
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5 09, 2018

Trick of the Trade: Hair tourniquet removal using depilatory cream

2018-09-04T12:56:20+00:00

A hair tourniquet occurs when a strand of hair coils around a patient’s appendage. It can cause damage to the skin, nerves, or affect blood supply. It is more common in infants as their skin appendages are small which allows for hair or thread to trap inside. Because in some cases these pediatric patients can present with inconsolable crying, it is important to perform a thorough physical examination to evaluate for the presence of such a hair tourniquet. We present a simple trick for removing a hair tourniquet using depilatory cream!

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15 06, 2018

PEM Practice Changing Paper: Clinical Trial of Fluid Infusion Rates for Pediatric DKA

Most protocols for managing pediatric patients with diabetic ketoacidosis (DKA) are based on a theoretical association between fluid resuscitation and subsequent neurological decline. Although the evidence for an association between IV fluids and cerebral edema comes from retrospective reviews, for over 20 years, it is an accepted teaching principle of pediatric DKA.

Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis, published just days ago in the New England Journal of Medicine, challenges this teaching with the first randomized controlled trial designed to investigate the relationship between IV fluids and cerebral edema. We review this publication and present a behind-the-scenes podcast interview with lead authors Dr. Nathan Kuppermann and Dr. Nicole Glaser from the Pediatric Emergency Care Applied Research Network (PECARN). (more…)

7 02, 2018

PEM Pearls: Pediatric Ultrasound-Guided Peripheral IV Access

2018-02-05T21:18:43+00:00

Pediatric Ultrasound-Guided Peripheral IV AccessPediatric patients are not just little adults. Placing peripheral IVs in young patients can be challenging and comes with its own set of challenges. Presented are some basic and advanced tips to maximize success in establishing peripheral IV access in pediatric patients using ultrasonography.
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24 01, 2018

Infographic: Pocket PEM

2018-01-31T00:28:01+00:00

Pediatric Emergency Medicine can be intimidating for even some of the most seasoned providers, but Drs. Liz Fierro and Natasha Li (both PEM Fellows at Loma Linda University Health) have you covered! Their interactive infographic, Pocket PEM, reminds readers of some core PEM content, including pediatric fever, bronchiolitis, and the crashing neonate.

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22 01, 2018

PEM Pearls: Regional Facial Nerve Blocks

2018-01-21T21:11:01+00:00

facial nerve blocksRegional nerve blocks of the face and ear can be a wonderful choice of analgesia in a child, particularly for wounds that need to be repaired. The benefits include fewer local injections, improved cosmesis due to less wound margin distortion, and improved analgesia within the nerve region.1,2 The following blog post and brief video tutorial review the key elements of this technique.

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21 07, 2017

ALiEM’s Greatest Hits for Interns: A Curated Collection of High-Yield Topics

greatest hits for interns

Congratulations, you’ve made it! On July 1, thousands of medical students across the country made the transition to becoming Emergency Medicine residents. It was a particularly competitive year for Emergency Medicine, with 99.7% of first-year spots filled despite a whopping 2,047 positions being offered in 2017 (up by 152 spots compared to last year).1 Now begins the most crucial 3 or 4 years of your medical training that will prepare you for the rest of your career in Emergency Medicine.

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