@pecarn.bsky.social
Quick reminder: imaging rules
Consider CT Factors
- GCS 3-8
- unresponsive on AVPU
- Abnormal ABC's
- Focal neuro deficit
Consider XR Factors
- Neck pain
- GCS 9-14 / AVPU V or P
- Substantial torso
- Substantial head injuries
- Midline neck TTP
This rule has a high sensitivity and negative predictive value
If applied to the study group, CT use would decrease by more than 50% without missing important injury!
Thanks for participating!
Correct answer: A - no imaging
The new PECARN c-spine imaging clinical algorithm provides guidance about who should get imaging & what kind - taking into account 9 clinical risk factors
✨Mechanism of injury is not included
www.mdcalc.com/calc/10552/p...
A 12 y/o M presents after an MVC, +airbag deployment. He experienced "whiplash". He has a mild HA, no neck pain. Exam: GCS 15, nml neuro exam, no neck pain, +full ROM. What imaging do you order?
1️⃣ No Imaging
2️⃣ Neck XR
3️⃣ CT Neck
4️⃣ Other
📊 Show results
Did you know @pecarn.bsky.social has a blog?
Current posts include:
🧠 AI for community perspectives in clinical trials
💨 Magnesium dosing in pediatric asthma
🩸 Arginine for sickle cell disease pain treatment
Check out pecarn.org/news for the latest! #PedsEM
Who doesn't love using @mdcalc.com to make decisions during a shift? 🤔
This new calculator incorporates @pecarn.bsky.social rules for cervical spine #imaging.
Check it out at: www.mdcalc.com/calc/...
In our June issue: Predicting paediatric pneumonia severity in the emergency department: a multinational prospective cohort study of the Pediatric Emergency Research Network
🔗 buff.ly/HcZcAEd
#MedSky #PedSky #IDSky #Pneumonia @pecarn.bsky.social Todd Florin
PECARN’s @julmagana.bsky.social joins the Kids Considered podcast to discuss pediatric cervical spine injuries—how to recognize, evaluate, and talk about risk with families.
Share with your friends, family & patients!
🎧 health.ucdavis.edu/b...
📊What did they find?
📉No significant drop in blood pressure was seen with either magnesium dose
⚕️More research is needed to understand the best dose
💊We have a pharmacokinetics model to use in future research
Bottom line: Both 50 and 75 mg/kg were well-tolerated in the ED setting
☑️What was the study?
✨49 children with moderate to severe asthma exacerbations were enrolled at 3 children’s hospitals
✨Randomized to placebo, 50 mg/kg, or 75 mg/kg of IV magnesium sulfate (max doses: 2000 mg and 3000 mg, respectively)
🌬️ >1 million children present to U.S. EDs yearly with #asthma
💉 When albuterol, ipratropium, & steroids aren’t enough, IV magnesium sulfate (MgSO₄) is considered
❔ But what dose? Is it safe?
This @pecarn.bsky.social study asks those ❔'s
onlinelibrary.wiley....
📊 The future:
LLMs won’t replace human judgment—but they can amplify our ability to listen at scale in clinical trial design and oversight
@nature.com
@catherinecounts.bsky.social
✅ What we found:
👍LLMs showed substantial agreement with human reviewers on both sentiment and thematic classification
🤝LLMs may help investigators and IRBs rapidly identify concerns, spot patterns, and enhance decision-making—especially in large, complex EFIC datasets
📍 Why it matters
EFIC requires community stakeholder input via interviews, often w/ 100s of responses & many sites
🧠 What we did
-Used LLMs (ex.GPT-4) to analyze > 3,600 responses from the PediDOSE trial at 9 sites
-Assessed how well LLMs matched humans in rating sentiment & organizing themes
#AI & Community Perspectives & Clinical Trials?
This study explores how large language models (LLMs) can support the Exception from Informed Consent (EFIC) process in emergency research—when traditional consent isn’t possible
www.nature.com/artic...
Dr. @aaronkornblithk
🚑 Happy #EMSWeek from all of us at PECARN!
We’re proud to collaborate with our EMS partners who deliver critical, life-saving care every day.
Your dedication to pediatric emergency care makes all the difference.
Thank you to the @PECARNteam Analgesia and Sedation Workgroup for your contributions
Specifically:
@coumbiaem.bsky.social
@pedisedationdoc.bsky.social
@dukemedschool.bsky.social
Tag more!
Thank you to the @PECARNteam Analgesia and Sedation Workgroup for your contributions
Specifically:
@coumbiaem.bsky.social
@pedisedationdoc.bsky.social
@dukemedschool.bsky.social
Tag more!
Pain stinks - how do you optimize pediatric #pain management?
A @PECARNteam workgroup is working helping kids in pain in the #ED
✨Step #1:Understand the issues
✨Action #1:29 experts identified 10 priority research topics
Read here:
onlinelibrary.wiley....
Pain stinks - how do you optimize pediatric #pain management?
A @PECARNteam workgroup is working helping kids in pain in the #ED
✨Step #1:Understand the issues
✨Action #1:29 experts identified 10 priority research topics
Read here:
onlinelibrary.wiley....
In these heartbreaking abuse cases, the @EMSCImprovement resources provide direct access to evidence-based screening tools
✨TEN-4-FACESp
& Management guidelines
✨TREKK trauma, fracture, head injury recs
https://bit.ly/3N3RSMO
Caring for a physically abused child is complex
EMSC developed resources to help navigate these situations including
✨History taking tips
✨Concerning PE findings
✨Initial eval & management
✨Communication strategies
✨Dispo
https://bit.ly/3N3RSMO #PEAKChildAbuse #NAT
"How does this relate to the NEW PECARN C-SPINE Tool?
💥found that 🚑 has different priorities for immobilizing kids ... need to look into if we can safely reduce SMR and C-collars in kids with blunt trauma...
STAY TUNED FOR MORE RESEARCH "
"Which kids got 🚑 C-collar in this study????
- Severe MOI
- ⬇️age = ⬆️collar
- ⬆️EMS suspicion of injury = ⬆️collar+backboard (full SMR)"
">13K children with blunt trauma BIB 🚑
(trauma activation & OR C-spine imaging)...
>7K convenience sample enrolled
(EMS & ED surveys filled out)
💥41.5% got collared (1/3 with backboard)
💥1.6% with C-spine injury "
"Which kids with blunt trauma are getting collared in the field and why?
PECARN is at it again... 🧵
@EMSCImprovement @traumadoctors @NAEMSP
pubmed.ncbi.nlm.nih...."
*EFIC = Exemption from Informed Consent
@Nature
@AaronKornblith @Drtoddchang @dknishijima @catherinecounts
#AI & clinical trials?
This study shows how large language models (ie GPT-4) can support EFIC* to identify sentiment & themes in community interviews
LLM had agreement w/ human reviewers-may help investigators/ethics boards “hear” the community at scale
pubmed.ncbi.nlm.nih....
🚨Adverse events from procedural #sedation are rare - occurring <1% of the time.
High-quality care can mitigate the risk of adverse outcomes.
Review these resources from @EMSCImprovement
Pediatric Education and Advocacy Kit (PEAK): Procedural Sedation
https://bit.ly/4hBpjo2
💉How prepared is your ED to handle pediatric pain, anxiety & stress during procedures?
Best practices and resources exist to ensure a smooth #sedation from EMSC Improvement
bit.ly/4hBpjo2
#PEAKProceduralSedation #EmergencyPreparedness
