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Changes in Pediatric Intensive Care Unit Utilization and Clinical Trends during the Coronavirus Pandemic
We examined the indirect impact of the pandemic on a population of critically ill children in the United States.RESEARCH QUESTION: Were there significantly fewer critically ill children admitted to PICUs during the 2nd quarter of 2020, and were there significant changes in the types of diseases admitted?STUDY DESIGN AND METHODS: Retrospective observational cohort study using the Virtual Pediatric Systems (VPS, LLC) database. Participants were 160,295 children admitted to the Pediatric Intensive Care Unit (PICU) at 77 sites in the United States during quarters 1 (Q1) and 2 (Q2) of 2017-2019 (pre-COVID) and 2020 (COVID).RESU...
Source: Chest - March 17, 2021 Category: Respiratory Medicine Authors: Janine Zee-Cheng Casey K McCluskey Margaret J Klein Matthew C Scanlon Alexandre T Rotta Steven L Shein Jose A Pineda Kenneth E Remy Christopher L Carroll Source Type: research

Research and Reviews in the Fastlane 100
This study, using skin tests, found that 0 out of 211 patients demonstrated cross-reactivity between penicillin and aztreonam. The authors recommend skin testing prior to administration and skin testing isn’t a perfect surrogate for a systemic reaction upon IV administration but the best evidence we have shows that cross-reactivity is highly unlikely. Recommended by: Anand Swaminathan Pediatrics Park G et al. Randomized single-blinded clinical trial on effects of nursery songs for infants and young children’s anxiety before and during head computed tomography. Am J Emerg Med. 2015. PMID: 26314215 This RCT randomi...
Source: Life in the Fast Lane - September 16, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Education Emergency Medicine Emergency Medicine Update Haematology Immunology Infectious Disease Intensive Care Palliative care Pediatrics R&R in the FASTLANE critical care literature recommendations research and r Source Type: blogs

Research and Reviews in the Fastlane 133
This study certainly suggests a benefit to using Dexmedetomidine in these patients. Recommended by: Nudrat Rashid The Best of the Rest Emergency Medicine Beadle KL et al. Isopropyl alcohol nasal inhalation for nausea in the Emergency Department: A randomized controlled trial. Ann Emerg Med. 2015. PMID: 26679977 This is a small double-blinded RCT comparing inhaled isopropyl alcohol to saline placebo for short-term relief of nausea in the ED. Although it is hard to believe patients (and possibly investigators) were truly blinded to the odor of isopropanol, this study found isopropanol superior to placebo for improvement...
Source: Life in the Fast Lane - May 4, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Education Emergency Medicine Intensive Care Neurology Neurosurgery critical care examination R&R in the FASTLANE recommendations research and reviews Resuscitation Source Type: blogs

Research and Reviews in the Fastlane 149
Welcome to the 149th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check o...
Source: Life in the Fast Lane - August 31, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Emergency Medicine Infectious Disease Intensive Care Neurology Palliative care Pre-hospital / Retrieval R&R in the FASTLANE Radiology Respiratory critical care recommendations research and reviews Resuscitation Source Type: blogs

Sports-Related Concussions in Children: Differences in Care and Expectations When Seen in an Emergency Department Versus a Sports Medicine Clinic
Conclusions Patients and parents who presented to a pediatric ED for sports-related head injury had a trend toward higher expectations of a CT scan being necessary to diagnose concussion and did have a higher rate of CT scans performed. Education of athletes and parents engaging in organized sports may be worthwhile to assist in setting expectations in diagnosis of concussion.
Source: Pediatric Emergency Care - May 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Implementation of a Bedside Point-of-Care Ultrasound Program in a Large Academic Neonatal Intensive Care Unit
Conclusions Implementation of a POCUS program is feasible in a large academic NICU and can benefit from a team approach. Establishing a program in any NICU requires didactic opportunities, a defined scope of practice, and imaging review with quality assurance. Bedside clinician performed ultrasound findings can provide valuable information in the NICU and impact clinical management. Key Points [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: American Journal of Perinatology - June 12, 2022 Category: Perinatology & Neonatology Authors: Pai, Vidya V. Noh, Caroline Y. Dasani, Reedhi Vallandingham, Shelby Manipon, Christine Haileselassie, Bereketeab Profit, Jochen Balasundaram, Malathi Davis, Alexis S. Bhombal, Shazia Tags: Original Article Source Type: research

Dissemination and Use of Point-of-Care Ultrasound by Pediatricians in Europe: A Research in European Pediatric Emergency Medicine Network Collaborative Survey
Conclusions The dissemination of pediatric POCUS in the European and Israeli centers we surveyed is limited, and its applications are largely restricted to the Focused Assessment with Sonography in Trauma examination. This is likely related to lack of training programs. In contrast, the potential value of use of POCUS in PEM practice is recognized by the majority of respondents.
Source: Pediatric Emergency Care - October 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Effect of cerebral circulatory arrest on cerebral near‐infrared spectroscopy in pediatric patients
ConclusionscNIRS did detect cerebral circulatory arrest with high sensitivity. Specificity was, however, not high enough to confirm a cerebral circulatory arrest.
Source: Pediatric Anesthesia - December 20, 2013 Category: Anesthesiology Authors: Martin E. Blohm, Denise Obrecht, Jana Hartwich, Dominique Singer Tags: Original Article Source Type: research

Research and Reviews in the Fastlane 044
This study looks at the agreement between radiologists in reading CTPAs for pulmonary embolism. They found that more than 10% of studies initially read as positive were later read as either negative or indeterminate. Many of the change in read occurred in subsegmental embolisms. This study throws further doubt on starting patients on long term anticoagulation based on the presence of a subsegmental pulmonary embolism. Recommended by: Anand Swaminathan Education Raemer DB. Ignaz semmelweis redux? Simul Healthc. 2014 Jun;9(3):153-5. PMID: 24401925 As a rabid in situ simulationist it is good to be tempered now an then by a...
Source: Life in the Fast Lane - August 18, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Education Emergency Medicine Haematology Infectious Disease Intensive Care R&R in the FASTLANE Resuscitation critical care literature recommendations Research and Review Source Type: blogs

LITFL R&R – Best of 2015
This article is one more piece of the mounting evidence demonstrating a clear call to change what is the usual care in many  institutions in the U.S. Stop the madness! Chest pain is tough — it’s the second most ED common chief complaint, and it scares the heck out of us and our patients – partially because missed MI is one one of the top causes of litigation. But we also see a ton of resources spent on a terribly low yield from chest pain workups. This new study in JAMA-IM including Mike Weinstock (of Bounceback fame), Scott Weingart and David Newman looked at the bad outcomes of patients with normal ECG...
Source: Life in the Fast Lane - January 9, 2016 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Anaesthetics Cardiology Education Emergency Medicine Intensive Care Pre-hospital / Retrieval R&R in the FASTLANE Respiratory Resuscitation Trauma critical care examination research and reviews Source Type: blogs

Changes in Pediatric Intensive Care Unit Utilization and Clinical Trends during the Coronavirus Pandemic
We examined the indirect impact of the pandemic on a population of critically ill children in the United States.RESEARCH QUESTION: Were there significantly fewer critically ill children admitted to PICUs during the 2nd quarter of 2020, and were there significant changes in the types of diseases admitted?STUDY DESIGN AND METHODS: Retrospective observational cohort study using the Virtual Pediatric Systems (VPS, LLC) database. Participants were 160,295 children admitted to the Pediatric Intensive Care Unit (PICU) at 77 sites in the United States during quarters 1 (Q1) and 2 (Q2) of 2017-2019 (pre-COVID) and 2020 (COVID).RESU...
Source: Chest - March 17, 2021 Category: Respiratory Medicine Authors: Janine Zee-Cheng Casey K McCluskey Margaret J Klein Matthew C Scanlon Alexandre T Rotta Steven L Shein Jose A Pineda Kenneth E Remy Christopher L Carroll Source Type: research

Agreement With Pediatric Suprapatellar Bursa Effusion Assessments by Point-of-Care Ultrasound After Remote Training
Conclusions After a remote teleconference didactic session, PEM fellows were able to successfully diagnose SPB effusions using a longitudinal view with substantial interobserver reliability. Knee radiography exhibited limited sensitivity to rule out SPB effusions.
Source: Pediatric Emergency Care - February 1, 2022 Category: Emergency Medicine Tags: Original Research Article Source Type: research