Over the past several weeks I posted brief reviews of the Top Ten Articles Presented at the 2014 AAP NCE in San Diego. You can check out links to all of the individual posts here, along with the main take home point for each article.

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Are you giving asthmatics prednisone when you could be prescribing dexamethasone instead?

TWO days of Dexamethasone is equivalent to FIVE days of oral prednisone in the treatment of asthma exacerbations in the Pediatric Emergency Department
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Ultrasonography/MRI versus CT for diagnosing appendicitis

In children with suspected acute appendicitis and an inconclusive ultrasound MRI is comparable to CT as follow up imaging
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Recurrence rates after intussusception enema reduction: a meta-analysis

The risk of recurrence within 48 hours after successful air contrast enema reduction is low for well appearing children – therefore, consider discharging them home form the ED
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Association of traumatic brain injuries with vomiting in children with blunt head trauma

The risk of TBI in children with head injury and isolated vomiting is very low, and thus many children can be observed in lieu of obtaining a head CT
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Impact of increasing ondansetron use on clinical outcomes in children with gastroenteritis

We are giving too much ondansetron, especially to kids who aren’t really in need of or at risk for needing IV rehydration
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Isolated loss of consciousness in children with minor blunt head trauma

Loss of consciousness is common in head injuries presenting to the ED, but unless it occurs with other worrisome symptoms or historical factors the risk of clinically important traumatic brain injuries is very low and CT scans are likely not necessary
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Lorazepam vs Diazepam for Pediatric Status Epilepticus

Lorazepam and diazepam are equally efficacious and safe choices for the treatment of status epilepticus in pediatric patients
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Delayed Antimicrobial Therapy Increases Mortality and Organ Dysfunction Duration in Pediatric Sepsis

Early administration of antibiotics in sepsis reduces mortality
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Nebulized hypertonic saline for bronchiolitis: a randomized clinical trial AND Nebulized hypertonic saline for bronchiolitis in the emergency department: a randomized clinical trial

Hypertonic saline might help reduce the risk of admission in bronchiolitis, but then again it might not
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Automated Urinalysis and Urine Dipstick in the Emergency Evaluation of Young Febrile Children

Automated urinalysis is probably as good as dipstick testing for the diagnosis of urinary tract infections
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