The issue of serious bacterial illness in children is an ongoing debate and new articles are emerging that help shed some light on the topic. This journal club will review lab tests that are better indicators of serious bacterial illness, how to reduce the rate of blood culture contaminants, the significance of the clinical examination for the diagnosis of meningitis and whether or not a routine lumbar puncture is necessary in children less than 18 months of age with a first time, simple febrile seizure.

Pediatric dehydration continues to be a significant cause of morbidity and mortality throughout the world and is a frequent issue encountered in the Emergency Department.   Traditionally, IV fluid hydration has been the mainstay of therapy.   However, it is often difficult to obtain intravenous (IV) access in children who have small, collapsed veins, and therefore, alternative therapies are being investigated. 

Are there any historical or physical examination findings that can help emergency physicians make the diagnosis of UTI? Read the article and take the Quiz for 1 CME credit hour.

Children often present to the emergency department with acute pain and the issue of rapid and effective pain control is a top priority for providers. This journal club evaluates the use of nebulized fentanyl as an effective medication that can be administered painlessly prior to the initiation of IVs.

As the search for the ideal sedative agent continues, ketamine continues to be a safe and effective choice.  This journal club will review the literature on NPO time, anti-emetics, atropine, and head injury in relation to ketamine use.

Is there benefit to routine hospital admission in children with blunt abdominal trauma who have a negative abdominal CT? Do we really have to worry about children with a “seat belt” sign? Are there physical examination findings that can help identify children at risk for intra-abdominal injury?

Parents and caregivers are becoming more involved in healthcare discussions and the internet era has led to significant concerns for providers as a little knowledge is worse than no knowledge at all. Parents will often have predetermined expectations of what the ED visit should entail and will already have their own differential diagnosis and treatment plan in mind...

Children often present to our emergency departments with buckle fractures, non-displaced fractures and minimally angulated fractures.  They are often placed in casts which can be difficult to care for and then patients return to the ED for cast-related issues. This journal club will review the latest articles on the use of removable splints for fracture care in children.