Algorithm for ED Evaluation and Management of Pediatric UTI
When should urinary tract infections (UTI) be included in the differential diagnosis for febrile infants and young children? The EM Committee on Quality Transformation in the American Academy of Pediatrics (AAP) thoughtfully outlines a clinical algorithm to help guide clinicians towards a standardized, evidence-based approach. Thanks to the expert content team (Drs. Shabnam Jain, Anne Stack, Scott Barron, Pradip Chaudhari, and Kathy Shaw) for sharing this clinical algorithm.
A patient presents to your ED with an all too common complaint – chest pain. After a focused history and physical exam, you have an extremely low clinical suspicion for thoracic aortic dissection, pulmonary embolism, pneumonia, pneumothorax, pericarditis/myocarditis, and Boerhaave’s syndrome. When the labs (including a troponin), an ECG, and chest x-ray yield normal results, questions often arise. Can you discharge her with a single troponin if she is low risk? How do you define low risk? And lastly, does she need urgent provocative testing after discharge?
Accidental hypothermia is a life threatening condition that can lead to a challenging resuscitation. The very young, old, and intoxicated patient are at high risk to developing hypothermia, even in temperate climates. The pathophysiologic changes from hypothermia make the standard ACLS approach insufficient to care for the hypothermic patient. This article will discuss the physiology of hypothermia and how you should alter your approach in the hypothermic patient, including early consideration of extracorporeal membrane oxygenation (ECMO).
