🧪IF you draw labs on a febrile 61-90-day-old infant, use these predictive values

✨PCT ≤ 0.24 ng/mL
✨ANC ≤ 10,710/mm³


➡️ 100% sensitivity + 100% NPV for IBIs.


Next step: Prospective validation before widespread use

#PRIME

There is practice variability re: labs for febrile👶 61-90d
#PECARN asked, who is low risk for IBI?

CART analysis to ID low-risk infants:
🧪 UA negative 🌡️ Tmax ≤38.9°C

➡️ NPV ~99.5% for IBI
⚠️ But ~1% (14 infants) w/ IBI would be missed
👉 pubmed.ncbi.nlm.nih....
#ID

#PRIME

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!

📊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)