News and Blogs

Finding the Right Dose: New PECARN Study Reveals Target Levels for IV Magnesium in Pediatric Asthma

Background Pediatric asthma exacerbations represent a significant burden on emergency departments, with over 1.2 million ED visits and 110,000 hospitalizations annually in the United States. While many treatment options exist for the emergency care of asthma (such as albuterol, ipratropium bromide, and corticosteroids), some children continue to have persistent symptoms and require hospitalization despite these […]

Novel Potential Approach to Pain Management in Sickle Cell Disease: Arginine Therapy

Introduction Vaso-occlusive episodes (VOEs) remain the primary cause of morbidity in sickle cell disease (SCD), with management heavily reliant on opioid analgesics. Early literature suggests that VOEs may be related to an arginine deficiency. Arginine produces nitric oxide (a potent vasodilator), improves mitochondrial function, and decreases oxidative stress. It is also the precursor for kyotorphin, […]

24-Hour Warning Signs for Suicide Attempt

Background With adolescent suicide rates increasing by 50% since 2001 and approximately 10% of U.S. high school students reporting a suicide attempt within a 12-month period, identifying imminent warning signs is crucial. This PECARN study addresses a critical knowledge gap by examining the 24-hour warning signs preceding adolescent suicide attempts [1]. Study Question What warning […]

Respiratory Distress is the Best Predictor of Pneumonia on Chest X-ray in Febrile Infants

Febrile infants aged 60 days and younger present unique challenges for emergency physicians, with serious bacterial infections (SBI) posing a significant risk. Among the various potential infections, pneumonia is a critical concern, with prevalence ranging from 0.1% to 8% in these young infants. Current diagnostic practices, primarily relying on clinical evaluation, struggle to identify pneumonia […]

Probiotics Do Not Improve the Outcomes in Pediatric Acute Gastroenteritis

Introduction Acute gastroenteritis affects millions of children in the U.S. every year, leading to emergency department visits and hospitalizations. Probiotics, particularly Lactobacillus rhamnosus GG (LGG), have been commonly used as a treatment, but evidence supporting their effectiveness has been limited [1-3]. A new study conducted by the Pediatric Emergency Care Applied Research Network (PECARN) aimed […]

A New PECARN Clinical Decision Rule Minimizes Unnecessary Imaging for Pediatric Cervical Spine Injuries

Author(s): Bashar Shihabuddin, MD, MS, FAAP, FACEP

Introduction Each year, more than 8 million children in the U.S. are evaluated in emergency departments (EDs) following blunt trauma, but less than 1% are diagnosed with cervical spine injuries (CSI). Computed tomography (CT) scans are often used to evaluate for CSIs. This exposes children to ionizing radiation increasing their lifetime risk of cancer. A […]

Press Release: Study Finds Neck Injury Prediction Rule Could Decrease Imaging Exposure in Children

Author(s): Emily Lemiska

COLUMBUS, Ohio – Cervical spine injuries in children are relatively rare but can have serious consequences, like paralysis. The standard method for detecting these injuries involves X-rays and computed tomography (CT) scans, which expose children to radiation and may pose long-term health risks. In a study published today in The Lancet Child & Adolescent Health, researchers […]

STArT Study: Arginine and sickle cell crisis

Author(s): Bashar Shihabuddin, MD, MS, FAAP, FACEP

Introduction Children with sickle cell anemia often present to the emergency department with vaso-occlusive pain episodes (VOE), also referred to as pain crisis. In these patients, pain develops when red blood cells become sickle shaped, causing them to not be able to pass through the smaller blood vessels in joints and bones. This leads to severe […]

Intranasal Fentanyl: A Breath of Fresh Air in Sickle Cell Pain Management

Author(s): Michelle Lin, MD

Introduction Sickle cell disease (SCD) and the associated vaso-occlusive episodes (VOEs) remain a significant health challenge, particularly among children. Additionally, the National Heart, Lung, and Blood Institute recommended that parenteral opioids be given within 30 minutes from triage or 60 minutes from emergency department (ED) registration. Realistically, these are challenging benchmarks to meet, partly because […]

Role of Procalcitonin Level for Serious Bacterial Illness in Febrile Infants

Author(s): Julia Magaña, MD

Introduction Each year, U.S. emergency departments face the challenge of evaluating around 200,000 infants aged 60 days and younger, with 8-10% having serious bacterial infections, including the serious categories of bacteremia and bacterial meningitis. The PECARN febrile infant working group previously derived a clinical prediction rule to identify febrile infants at low risk for serious […]