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Physicians: .25 AMA PRA Category I CreditsTM
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Alan Ehrlich, MD
Dr. Ehrlich, Dr. Fleming, DynaMed Editorial Team members, and the staff of Antidote Education Company have disclosed that they have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity.
ACCME: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Antidote Education Company and EBSCO Publishing. Antidote is accredited by the ACCME to provide continuing medical education for physicians. Antidote Education Company designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Last week 513 journal articles were evaluated via DynaMed's Systematic Literature Surveillance and summaries of 252 articles were added to DynaMed content.
Pulse oximetry is routinely used in the assessment and monitoring of children with bronchiolitis. It is a safe and convenient way of measuring oxygenation status, and may detect hypoxemia before it becomes clinically apparent. The American Academy of Pediatrics (AAP) guideline currently recommends that supplemental oxygen should be used in children with bronchiolitis with oxygen saturation persistently ≤ 89% on pulse oximetry (Pediatrics 2006 Oct;118(4):1774 full-text). However, the role of oximetry as part of the decision on whether to admit children to hospital is unclear. A recent randomized trial of 213 infants aged 1-12 months with mild-to-moderate bronchiolitis evaluated the effect of oximetry readings on hospitalization rates.
Pulse oximetry is one of several different factors used in evaluating the need to admit an infant with bronchiolitis to the hospital, and clinical findings such as respiratory distress or feeding difficulties may indicate a need for hospital admission irrespective of oxygen saturation values. The findings from this trial are consistent with those of a previous observational study that found that oxygen saturation levels were a significant predictor of hospital admission after emergency department evaluation for moderate-to-severe bronchiolitis (Pediatr Emerg Care 2012 Feb;28(2):99). However, the ability to interpret these new results is limited by the fact that most infants in the study had near-normal oxygen saturation at baseline (mean oxygen saturation was 97%, and only 13% overall had oxygen saturation < 94%). Nonetheless, these findings suggest that there may be an overreliance on pulse oximetry in deciding whether to admit infants with mild-to-moderate bronchiolitis to the hospital. These data highlight the need to avoid weighing a single finding in isolation, rather than viewing it as one piece of a larger clinical picture.
EBSCO Health Launches Pediatric Clinical Information Mobile App
PEMSoft Now Available For iPhone, iPad, and Android Devices
A mobile app designed specifically for pediatricians, emergency department physicians, physicians-in-training and other medical providers caring for children with acute illnesses and injury, is now available from EBSCO Health, the leading provider of clinical decision support solutions for the healthcare industry.
Call for Peer Reviews
We are currently seeking subspecialty reviewers for our Patient Education Resource Center (PERC). PERC provides fact sheets and discharge instructions for patients leaving the hospital or emergency room. These hand-outs fulfill the meaningful use requirements for the Medicare & Medicare Services Incentive Programs.
DynaMed Contribution Opportunities
Looking for a change? The DynaMed editorial team is expanding and looking for talented and driven individuals. Visit the links below to learn about these exciting opportunities.