Q. Given that CT imaging of head-injured children has risks of radiation-induced malignancy, are there ways to identify children at very low risk of clinically-important traumatic brain injuries (ciTBI) for whom CT might be unnecessary? 

The question of oral analgesia for children is an important one and this journal club will focus on some recent articles discussing the use of ibuprofen for pain control. Many of us anecdotally realize that Tylenol with codeine is not very effective, yet we continue to write for this pain medication. Hopefully these studies will make us feel supported when we tell families that ibuprofen is superior to acetaminophen with codeine.

Elements of the definition of acute otitis media (AOM) are all of the following:

• Recent, usually abrupt, onset of signs and symptoms of middle-ear inflammation and MEE
• The presence of a middle ear effusion that is indicated by any of the following:
• Bulging of the tympanic membrane
• Limited or absent mobility of the tympanic membrane
• Air-fluid level behind the tympanic membrane Otorrhea

Def. Apparent Life-Threatening Event (ALTE)* – “An episode that is frightening to the observer, that is characterized by some combination of apnea (centrally or occasionally obstructive), color change (usually cyanotic or pallid, but occasionally erythematous or plethoric), marked change in muscle tone (usually marked limpness), choking or gagging”.  This journal club will review some articles on Apparent Life-Threatening Events.
*As established at the 1986 National Institute of Health Consensus Development conference on Infantile Apnea and Home Monitoring