This is a new feature on PEMBlog. I will be summarizing recent articles in 50 words (or less). I know that all of you are busy, so I wanted to give a quick synopsis of current literature, and offer you a chance to see what’s out there. I highly encourage you to look at the individual studies to see what conclusions you’ll draw on your own of course.
Powell EC, Mahajan PV, Roosevelt G, Hoyle JD Jr., Gattu R, Cruz AT, Rogers AJ, Atabaki SM, Jaffe DM, Casper TC, Ramilo O, Kuppermann N; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN).
Ann Emerg Med, 2018
In a secondary analysis of a prospective observational study of febrile infants <60 days the prevalence of bacteremia was 3.1% (47/1,515) <28 days and 1.1% (37/3,246) 29-60 days. E. coli and GBS were the most common pathogens. Bacterial meningitis was seen in 1.3% of <28 days, and 0.2% 29-60 days.
Rosenfeld-Yehoshua N, Barkan S, Abu-Kishk I, Booch M, Suhami R, Kozer E
Eur J Pediatr, 2018
A systematic review showed that the risk of SBI was only slightly higher in older children if the temp is >40C, but in infants <3mo the OR was 6.3 (95% CI 4.44; 8.95). This review was limited by a small pool of adequate studies, and heterogeneous methods.
Mogensen CB, Wittenhoff L, Fruerhøj G, Hansen S
BMC Pediatr, 2018
This cross-sectional study defined fever >38C and noted that an ear thermometer was significantly better than temporal. The 95% limit for agreement for ear was +/-1C and temporal -1.2 to +1.5C. ear is OK for screening, temporal not – rectal is best 6 mos-5 years.
DiBrito SR, Cerullo M, Goldstein SD, Ziegfeld S, Stewart D, Nasr IW
J Pediatr Surg, 2018
A single center retrospective review of 5,306 trauma patients evaluated reliability between field and ED GCS. Pearson’s correlation was greatest for age <3 years (0.95 SD=2.4). The verbal score was least reliable.
Chumpitazi CE, Camp EA, Bhamidipati DR, Montillo AM, Chantal Caviness A, Mayorquin L, Pereira FA
Am J Emerg Med, 2018
A prospective study of patients undergoing procedural sedation compared fasting > and <6 hours for solids. There was no difference in rates of vomiting. This backs up what we know. You can fast as short as 2-3 in the right patient.