PEM Pearls: 2017 AAP Section of EM’s Guide to Pediatric Community Acquired Pneumonia

Pediatric community-acquired pneumonia (CAP) is an acute, common, and potentially serious infection of the pulmonary parenchyma in children. In November 2010, the American Academy of Pediatrics endorsed “The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.” [PDF]¹Based on this guideline, the American Academy of Pediatrics (AAP) Section on Emergency Medicine’s Committee on Quality Transformation developed a clinical algorithm for CAP in the ED setting.

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By Shabnam Jain, MD, MPH|2019-09-05T17:28:22-07:00Mar 16, 2017|Pediatrics, PEM Pearls, Pulmonary|

AIR Series: Respiratory Module (2017)

Welcome to the Respiratory Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index the ALiEM AIR Team is proud to present the highest quality procedure content. Below we have listed our selection of the 12 highest quality blog posts within the past 12 months (as of August 2016) related to Respiratory emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 4 AIRs and 8 Honorable Mentions. We recommend programs give 4 hours (about 20 minutes per article) of III credit for this module.

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By Andrew Grock, MD|2020-09-04T10:59:39-07:00Feb 6, 2017|Approved Instructional Resources (AIR series), Pulmonary|

PV Card: Algorithm for acute bronchiolitis management

Bronchiolitis is a common lower respiratory tract infection in children less than 2 years old, and especially in those 3-6 months old. In a collaboration with the American Academy of Pediatrics’ (AAP) Section on Emergency Medicine Committee on Quality Transformation, we present a PV card summarizing the Section’s “Clinical Algorithm for Bronchiolitis in the Emergency Department Setting” (reproduced with permission).¹ Dr. Shabnam Jain sums it up best in her expert peer review below: “In bronchiolitis, less is more.”
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By Michelle Lin, MD|2021-10-04T09:31:54-07:00Nov 7, 2016|ALiEM Cards, Expert Peer Reviewed (Clinical), Pediatrics, Pulmonary|

AIR Series: Respiratory Part 2 (2015)

We found an enormous amount of respiratory content and thus have divided the respiratory module into two modules. While the first module focused on general respiratory issues, this second module is focused on airway and pulmonary embolism. Below we have listed our selection of the 15 highest quality blog posts within the past 12 months (current as of March 2015) related to respiratory, curated and approved for residency training by the AIR Series Board. In this module we have 4 AIRs and 11 Honorable Mentions. We strive for comprehensiveness by selecting from a broad spectrum of blogs from the top 50 listing per the Social Media Index.

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By Andrew Grock, MD|2017-03-05T14:18:42-08:00Jul 28, 2015|Approved Instructional Resources (AIR series), Pulmonary|

AIR Series: Respiratory Part 1 (2015)

We found an enormous amount of posts on respiratory topics and thus have divided the content into two modules. This first module will focus on general respiratory issues with airway and pulmonary embolism covered in the second module. Below we have listed our selection of the 15 highest quality blog posts within the past 12 months (current as of April 2015) related to respiratory, curated and approved for residency training by the AIR Series Board. In this module we have 4 AIRs and 11 Honorable Mentions. We strive for comprehensiveness by selecting from a broad spectrum of blogs from the top 50 listing per the Social Media Index.

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By Andrew Grock, MD|2017-03-05T14:14:15-08:00Jun 17, 2015|Approved Instructional Resources (AIR series), Pulmonary|

Adenosine in reactive airway disease

Adenosine

A 44-year old woman presents via EMS with a chief complaint of a racing heartbeat. She is placed on a cardiac monitor, which displays a heart rate of 192, and a subsequent EKG reveals she is in SVT. She also complains of chest discomfort and shortness of breath. Her blood pressure is stable, and you decide to treat her with adenosine. As you take a more thorough past medical history, you learn your patient has a history of asthma. One of the EM residents mentions that he thought adenosine should not be given to patients with reactive airway disease.

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By Marian Gaviola, PharmD|2018-11-02T10:41:55-07:00Mar 30, 2015|Expert Peer Reviewed (Clinical), Pulmonary, Tox & Medications|

PV Card: Focused Lung Ultrasound

Bedside pulmonary ultrasonography is becoming increasingly popular in the Emergency Department. You can you use it to assess for pneumothoraces, pleural effusion, pneumonia, pulmonary edema, and other etiologies. There are subtle nuances to help you differentiate these diagnoses. What are A-lines and B-lines? This PV card on the focused lung ultrasound by Drs. Anne Aspler, Clare Heslop, and Mike Stone outline some great bedside tips.

PV Card: Focused Lung Ultrasound

Adapted from [1–3]

References

Blaivas M, Lyon M, Duggal S. A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med. 2005;12(9):844-849. [PubMed]
Liteplo A, Marill K, Villen T, et al. Emergency thoracic ultrasound in the differentiation of the etiology of shortness of breath (ETUDES): sonographic B-lines and N-terminal pro-brain-type natriuretic peptide in diagnosing congestive heart failure. Acad Emerg Med. 2009;16(3):201-210. [PubMed]
Volpicelli G. Lung sonography. J Ultrasound Med. 2013;32(1):165-171. [PubMed]

By Scott Kobner|2021-10-06T09:48:34-07:00Feb 4, 2015|ALiEM Cards, Pulmonary, Ultrasound|

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