October 2015: Pediatric Potpourri

This month JC welcomes our pediatric EM colleagues. We are going to take a “potpourri” approach and instead of focusing on a single topic and look at a few areas of clinical interest.  First, what is the origin of the use of atropine as a pre-intubation medication in kids? Is its use still justified?  Included, are two articles that argue both sides of this debate.  Next, as bronchiolitis season approaches there are always a host of management questions. These authors took a sly approach and challenged reliance on pulse oximetry. Next, we will look at new data on the  applicability of therapeutic hypothermia in post-arrest pediatric patients. Finally, the recent HEAT trial, question the impact of aggressive use of acetaminophen in the adult ICU population. As always, we look forward collaborating with our Peds EM colleagues. Should make for an interesting JC

Fleming B, et al., Myth: Atropine should be administered before succinylcholine for neonatal and pediatric intubation. CJEM. 2005 Mar;7(2):114-7.

Jones P. et al.,The effect of atropine on rhythm and conduction disturbances during 322 critical care intubations. Pediatr Crit Care Med. 2013 Jul;14(6) 289-97.      Article Appraisal

 Cunningham S, et al., Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial Lancet. 2015 Sep 12;386:1041-8       Article Appraisal

 Moler FW et al.,Therapeutic hypothermia after out-of-hospital cardiac arrest in children N Engl J Med. 2015 May 14;372(20):1898-908.            Article Appraisal

 Young P., Acetaminophen for Fever in Critically Ill Patients with Suspected Infection. N Engl J Med. 2015        Article Appraisal