RCEM Learning July 2025
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Jul 24, 2025 In this lively discussion, experts dive into the role of parental concern in predicting pediatric critical illness, highlighting its impact on clinical decision-making. They also tackle the management of acute behavioral issues in children, emphasizing de-escalation techniques. Additionally, the conversation shifts to innovative approaches in clearing pediatric C-spine injuries with CT imaging. Listeners gain insights into the importance of thorough documentation and collaborative care in high-risk scenarios, all while exploring the latest in emergency medicine research.
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Parental Concern Predicts Critical Illness
- Parental concern about clinical deterioration strongly correlates with pediatric ICU admission and mechanical ventilation.
- This concern can precede abnormal vital signs by a median of 7.3 hours, emphasizing its predictive value.
Ask About Parental Concern
- Routinely ask caregivers if they are worried about their child getting worse to help identify critical illness early.
- Positive parental concern should prompt at least senior clinician review within 30 minutes, though more research is needed on outcomes.
Balancing Parental Concern and Workload
- Mandatory senior reviews for caregiver concerns may increase workload and risk decision threshold creep.
- Parental concerns must be balanced with clinical judgment to avoid unnecessary interventions.