The Pediatric Bougie for the First Tracheal Intubation Attempt in Critically Ill Children.

Study Objective: Bougie use during emergency tracheal intubation has not been well studied in children.

Methods: This was a 10-year observational study of pediatric intubations (<18 years of age) in the emergency department (ED) of an academic institution. Bougie training and use are standard in our ED, including for emergency medicine residents.

Adjunct Devices for the Pediatric Difficult Airway: A Case Report.

This is a case report of a pediatric patient with a difficult airway, in which several airway adjuncts were used simultaneously to successfully provide adequate oxygenation and ventilation during cardiac arrest. Difficult airways are low-incidence, high-risk emergencies in children, and airway adjuncts may be used infrequently, let alone in combination. Included in the discussion of this case are a description of each airway adjunct and a discussion of the process needed to incorporate airway adjuncts safely and effectively into patient care.

Cardiac Emergencies in Kids.

Encountering a child with congenital heart disease after surgical palliation in the emergency department, specifically the single-ventricle or ventricular assist device, without a basic familiarity of these surgeries can be extremely anxiety provoking. Knowing what common conditions or complications may cause these children to visit the emergency department and how to stabilize will improve the chance for survival and is the premise for this article, regardless of practice setting.

An unusual case of epistaxis in a four month old.

Epistaxis is a routine complaint in Emergency Medicine and presents most commonly in adults and children and its incidence increases with age. It is rare in infants and neonates. We discuss a case of epistaxis in a four-month-old male who presented to a critical access hospital.

Spectrum and frequency of critical procedures performed at a Level I adult and pediatric trauma center.

Objectives: The primary objective of this study was to provide physician-level data about the frequency of critical procedures at a combined adult and pediatric Level I trauma center, high-acuity, high-volume academic ED. The inspiration for this study question came from a previous study by Mittiga et al. (2013) describing pediatric critical procedure data at a similar high-acuity, high-volume, pediatric-only academic ED.

Emergency Care of Pediatric Burns.

Although the overall incidence of and mortality rate associated with burn injury have decreased in recent decades, burns remain a significant source of morbidity and mortality in children. Children with major burns require emergent resuscitation. Resuscitation is similar to that for adults, including pain control, airway management, and administration of intravenous fluid.

The Use, Safety, and Efficacy of Olanzapine in a Level I Pediatric Trauma Center Emergency Department Over a 10-Year Period.

Objectives: Olanzapine is a second-generation antipsychotic increasingly used in emergency medicine for many indications. Literature on its use in children is sparse. Our objectives were to describe the use, safety, and efficacy of olanzapine in pediatric emergency patients.

A Survey of Graduates of Combined Emergency Medicine-Pediatrics Residency Programs: An Update.

Background: In 1998, emergency medicine-pediatrics (EM-PEDS) graduates were no longer eligible for the pediatric emergency medicine (PEM) sub-board certification examination. There is a paucity of guidance regarding the various training options for medical students who are interested in PEM.

Objectives: We sought to to determine attitudes and personal satisfaction of graduates from EM-PEDS combined training programs.

Use of a Supraglottic Airway to Relieve Ventilation-Impeding Gastric Insufflation During Emergency Airway Management in an Infant.

Positive-pressure bag-valve-mask ventilation during emergency airway management often results in significant gastric insufflation, which may impede adequate ventilation and oxygenation. Current-generation supraglottic airways have beneficial features, such as channels for gastric decompression while ventilation is ongoing. A 5-week-old female infant required resuscitation for hypoxemic respiratory failure caused by rhinovirus with pneumonia.

The Critically Ill Infant with Congenital Heart Disease.

This article presents an approach for identification of infants with congenital heart disorders. These disorders are difficult to diagnose because of the complexity and variety of cardiac malformations; additionally presentation can be complicated by age-dependent physiology. By compiling data from the history and the physical examination, the emergency physician can identify lesion category and initiate stabilization procedures.

Emergent diagnostic testing for pediatric nonfebrile seizures.

Background: Guidelines from the American Academy of Neurology recommend laboratory studies or computed tomography (CT) for children who experience a nonfebrile seizure if anything in their history suggests a clinically significant abnormality.

Objective: To ascertain if any patient or seizure characteristics are associated with a greater likelihood that laboratory studies or CT scan will yield clinically significant results.

Methods: This retrospective case series reviewed 93 children with nonfebrile seizure, who were evaluated in an urban pediatric emergency department (ED) between July 2007 and June 2011.