The practice of Pediatric Emergency Medicine requires us to stay up to date with a immense amount of information. This column can help us relearn many of those items that seemed to slip out of our brains.
Work from the 2020 Section Grant “Managing Childbirth and Newborn Resuscitation Toolkit for the EMS Provider” has been completed. Section members Denise Whitfield, MD, MBA, and Marianne Gausche-Hill, MD, were jointly awarded this grant to complete work products on behalf of the Pediatric Emergency Medicine Section and Emergency Medical Services- Prehospital Care Section.
A video toolkit was developed consisting of 3 educational programs to serve as a resource for the individual paramedic looking for continuing education, a framework for educators hosting training for EMS personnel, and a just-in-time resource for providers caring for patients in the field.
Anthony Del Zotto, DO, Charleston Area Medical Center and Jaryd Zummer, MD , University of Kentucky
Better late than never. It is still winter, and we are all trying to stay warm inside while awaiting warmer days to arrive! We thought this would be a fitting time to review CO toxicity, with some pearls and management tips.
Carbon monoxide (CO) is the true “silent” killer. A major contributor to indoor fire-related incidents, it is responsible for up to 500 deaths per year in the US and has both significant short and long-term morbidity. This colorless, tasteless, and odorless gas is formed via the incomplete combustion of carbon-containing fuels. Most common implicated devices include furnaces, fireplaces, space heaters, stoves, and automobile or boats, especially in poorly ventilated areas or with faulty or blocked exhaust systems. Hemoglobin’s affinity for CO is approximately 200-250 times stronger than that of oxygen. When hemoglobin binds CO to form carboxyhemoglobin, it effectively reduces hemoglobin’s O2 carrying capacity (leftward shift of the oxyhemoglobin dissociation curve) and delivery of O2 to vital tissues. This tissue hypoxia not only causes a shift to anaerobic metabolism and consequently lactate production, but also increases cerebral blood flow and capillary permeability to cause cerebral edema in the most severe cases.read more
In November 2020, the US Food and Drug Administration (FDA) provided Emergency Use Authorizations (EUA) for virus-neutralizing monoclonal antibody therapies for the treatment of mild to moderate COVID-19 in high-risk groups of adolescents 12-17 years and adults. Multiple studies have shown that this treatment significantly decreased the risk of subsequent emergency department (ED) visits and hospitalizations in adult patients over 18 years. It has become a game changer in the treatment of adult patients. With the first waves of the pandemic a relatively small proportion of COVID-19 infections occurred in pediatric patients, thereby limiting the experience with monoclonal antibody therapy in patients 12-17 years of age.read more
For anyone interested in a Pediatric Emergency Medicine Fellowship, the ACEP Pediatric Section and AAP held 2 webinars where Program Directors were available to answer questions. You can listen to the webinars here.