Translating Emergency Knowledge for Kids

Most acutely ill and injured children are managed within emergency departments that are not part of a children’s hospital. Difficulties in getting the right resources and training have been cited as barriers to providing the best possible care in these settings. This has resulted in variable levels of emergency care for children. TREKK is a knowledge mobilization network established to address these critical knowledge gaps and improve emergency care for children. 

2018 AHA PALS Update – Nothing New


The optimal sequence of PALS interventions, including administration of antiarrhythmic drugs during resuscitation, and the preferred manner and timing of drug administration in relation to shock delivery are still not known. One study reported a statistically significant improvement in return of spontaneous circulation when lidocaine administration was compared with amiodarone for pediatric ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. However, no difference in survival to hospital discharge was observed among patients who received amiodarone, lidocaine, or no antiarrhythmic medication.

Parental Guidance in the Pediatric ED

  • My Emergency Medicine training taught me the importance of “return precautions.”
    • Educate the patients/families about the warning signs of impending doom.
    • Essentially, “come back if things get worse.”
  • In the Pediatric ED (or during acute care related complaints), I find that the combination fo the two is helpful.
    • In the ED, we are seeing only a brief period of time of the illness process. 
      • At the time you are seeing the kid, there may be no obvious emergent danger or urgent condition warranting therapy… but… 
      • Anticipate the potential trajectories that may exist and educate about them.

Slipped Capital Femoral Epiphysis (SCFE)

  • Image bilaterally as SCFE is often bilateral even in the absence of bilateral symptoms 
  • Patients may present with isolated knee or thigh pain without any hip pain, which can lead to delayed diagnosis and worse outcomes
  • More than 50% of SCFEs can be missed when the chief complaint is knee pain. Always range the hip and note the presence or absence of pain in patients presenting with knee pain
  • SCFE is usually seen in adolescent, obese patients. However, it can also be seen in tall, thin patients who have recently undergone a recent growth spurt

 

Developing and Implementing a Pediatric Emergency Care Curriculum for Providers at District Level Hospitals in Sub-Saharan Africa: A Case Study in Kenya

Developing and Implementing a Pediatric Emergency Care Curriculum for Providers at DistrictLevel Hospitals in Sub-Saharan Africa: A Case Study in Kenya.

Fant CD, Schwartz KR, Patel H, Fredricks K, Nelson BD, Ouma K, Burke TF.

Front Public Health. 2017 Dec 11;5:322. doi: 10.3389/fpubh.2017.00322. eCollection 2017.