The Reading List 01: Tools, Trends, and Triage

Welcome to The Reading List, a quick collection of recent pediatric emergency medicine articles. These are short, spoiler-style summaries to help you decide what to read in full. Use them to spark a journal club discussion, stay up to date on the literature, or just browse for what is new and relevant to the care of ill and injured children. This series is my homage to the excellent and long-running PEMDatabase.org. Creating a Parent-Informed Pediatric ED Wait Time App Litwin S, Mohabir M, Kocak IS, Singh D. J Participat Med. 2025;17:e66644. doi:10.2196/66644. PMID:40882156. PubMed link This study used human-centered design to co-create an AI-enabled ED wait-time app with parents. Iterative testing identified key needs, transparency, literacy accessibility, uncertainty management, visible progress, fairness and the final tool enhanced clarity, trust, and caregiver engagement in the pediatric ED experience. Pediatric Emergency Care: Determinants and Systematic Barriers Soni P, Agrawal A. World J Clin Pediatr. 2025;14(3):108140. doi:10.5409/wjcp.v14.i3.108140. PMID:40881093. PubMed link This review identifies training, resource, diagnostic, and equity barriers in pediatric emergency care and evaluates interventions, telemedicine, AI diagnostics, simulation, quality improvement, and transport systems, to improve timeliness, accuracy, safety, and patient-family satisfaction. Pediatric Emergency Backpacks — Effects of Using xABCDE- and Broselow-Systems Brune B, Achenbach H, Heyne P, et al. Eur J Pediatr. 2025 Aug 29;184(9):582. doi:10.1007/s00431-025-06425-w. PMID:40879680. PubMed link In simulated pediatric resuscitations (n=115), the Broselow-size/weight-based backpack enabled faster retrieval of emergency items and better performance in simulations than the xABCDE-designed pack. Participants rated the Broselow approach and their own work higher—supporting size-based organization for pediatric emergency gear. Electrolyte Imbalance in Infants Younger Than 90 Days With Febrile UTI Serrano Oarbeaskoa M, Camarero Pagonabarraga M, Iriarte Uribeecheverria I, et al. Acta Paediatr. 2025. doi:10.1111/apa.70291. PMID:40879221. PubMed link Reviewing over 2,300 infants ≤90 days with febrile UTI, the study found exceedingly low rates of electrolyte abnormalities among well-appearing infants, comparable to healthy controls and with no kidney injury, suggesting routine electrolyte screening may be unnecessary in uncomplicated UTI cases. Identification of Child-Maltreatment-Related ED Visits from Electronic Health Records Holland ML, Hunter AA, Livingston N, Bechtel K. Acad Pediatr. 2025 Aug 26:103135. doi:10.1016/j.acap.2025.103135. PMID:40876626. PubMed link Analyzing 3,841 ED records flagged for maltreatment, this study found detection rates of 47% by ICD-10 codes, 65% by keywords in notes, and 58% by chief complaints. Combining codes and notes raised detection to 82%, illustrating the value of multi-modal EHR strategies to enhance case identification. Impact of Telemedicine on Mortality, Hospital Admissions, and Length of Stay in Pediatric Emergencies Alansari AN, Zaazouee MS, Messaoud M, Mani S, Elshanbary AA, Mohamed HY. Int J Emerg Med. 2025 Aug 27;18(1):160. doi:10.1186/s12245-025-00968-3. PMID:40866805. PubMed link Meta-analysis of 23 studies found telemedicine significantly reduced hospital length of stay (−1.01 days) and mortality (RR 0.17), with no difference in admission rates. Findings support telemedicine’s potential to improve outcomes and resource utilization in pediatric emergency care. Diagnosis and Management of Imported Malaria in the ED McQueen A, Mannheim J. Pediatr Emerg Care. 2025;41(9):748–753. doi:10.1097/PEC.0000000000003435. PMID:40867035. This review provides ED clinicians with practical guidance for imported malaria: key travel history, prompt diagnostic testing, species-specific considerations, early antimalarial treatment, and supportive care, with streamlined algorithms to minimize delay in non-endemic settings. Readmission Predictors After Pediatric ARI in Italy Baldazzi A, Turno F, et al. Pediatr Infect Dis J. 2025. PMID:40864667. PubMed link A two-year Italian cohort identified clinical markers and comorbidities associated with 72-hour ED readmission in ARI cases. Findings can guide targeted discharge planning and follow-up for higher-risk pediatric patients. Caffeine Associated With Shorter CPAP Treatment in Bronchiolitis Estalayo-Mendoza Á, et al. Acta Paediatr. 2025. PMID:40862534. PubMed link In infants ≤8 weeks hospitalized with bronchiolitis, caffeine exposure correlated with shorter CPAP duration, suggesting enhanced respiratory drive. Authors note need for trials to confirm causality and optimal dosing/timing. Site-Level Variation in Tracheal Intubation in the Pediatric ED (NEAR4PEM) Himebauch AS, Kerrey BT, et al.; NEAR4PEM Investigators. Pediatr Emerg Care. 2025. PMID:40860259. PubMed link A multicenter registry study revealed substantial inter-site differences in indication, technique, and first-pass success during pediatric ED intubations, highlighting areas for standardization and airway safety improvements. Age <24 Months Not an Independent Risk Factor for SBI in Febrile SCD Boddu SR, Cohen N, Jain S, et al. J Emerg Med. 2025. PMID:40856530. PubMed link In febrile children with sickle cell disease, age under 24 months was not independently associated with serious bacterial illness after adjusting for clinical/lab factors, supporting nuanced risk stratification beyond age alone. Poor Prognostic Factors in Pediatric ED Ataxia Aihara T, et al. Brain Dev. 2025. PMID:40857964. PubMed link Retrospective study showed that children ≥5 years or with >3-day duration of ataxia symptoms carried higher risk for adverse outcomes and intervention needs, highlighting the need for prompt evaluation in these cases. Prediction Rule for Low Risk IBI in 61–90 Day Old Febrile Infants Sharma P, Aronson PL, et al. Pediatrics. 2025. PMID:40854562. PubMed link This rule uses clinical appearance and select labs to identify low-risk febrile infants (61–90 days) for invasive bacterial infections, aiming to reduce unnecessary lumbar punctures, antibiotics, and admissions. Violence and Job Satisfaction in Pediatric ED Staff Butun A, Ozyurt M. BMC Emerg Med. 2025;25(1):167. doi:10.1186/s12873-025-01330-9. PMID:40847287. PubMed link Among 434 pediatric ED staff, 84% experienced violence (mostly verbal), which correlated with decreased job satisfaction, underscoring the urgency for violence prevention and staff support strategies. Pediatric Prehospital Decision Tool (PDTree) Effects on EMS Transport Lerner EB, et al. Prehosp Emerg Care. 2025. PMID:40856462. PubMed link Implementation of PDTree for EMS showed improved transport destination alignment and consistency, though the authors recommend monitoring for unintended delays or overtriage. Pneumonia Among Children Presenting to the ED With Chest Pain Neuman et al. Pediatr Emerg Care. 2025. PMID:40851116. PubMed link This study found a significant fraction of children presenting with chest pain had pneumonia—especially those with fever or respiratory symptoms, suggesting that routine imaging shouldn’t be universal, but targeted based on clinical cues. Interrater Reliability of Pediatric Respiratory Auscultation Findings Heine A, et al. Hosp Pediatr. 2025. PMID:40850688. PubMed link Assessment of clinician agreement on auscultation showed better reliability for wheeze than crackles, highlighting the value of training and objective tools to improve consistency in pediatric respiratory assessments. A Frostbite Treatment Guideline for Pediatric Patients Schuh JM, Abebrese EL, Morrison Z, Salazar JH. J Burn Care Res. 2025 Aug 24. doi:10.1093/jbcr/iraf166. PMID:40849731. PubMed link Expert consensus guideline with retrospective validation in 72 pediatric frostbite cases found that the protocol, including thrombolysis for certain grade-3 burns, reduced amputations offering an evidence-based ED treatment framework. Prehospital Triage in Pediatric Emergencies by Helicopter EMS Palmrose D, Matter-Wallace B, et al. Air Med J. 2025. PMID:40849150. PubMed link Population-based HEMS study showed both over- and under-triage in pediatric transports, with identified clinical factors predicting high-acuity dispatch, informing protocol refinement and training. Reducing Pediatric Facial Cellulitis Admissions via Ambulatory Protocol Mistry A, Shi H, et al. Am J Emerg Med. 2025. doi:10.1016/j.ajem.2025.08.040. PMID:40848476. PubMed link Implementation of an ambulatory management protocol for odontogenic facial cellulitis reduced hospital admissions by 62%, supporting safe outpatient treatment pathways with significant decreases in hospitalization. Low-Value CT Use in Pediatric ED: Repeated Cross-Sectional Study Lin MP, Atz A, et al. Pediatr Emerg Care. 2025. PMID:40847260. PubMed link Over multiple years, CT scans considered low-value continued to be used in children, though rates may be declining. Findings suggest room for improvement via guideline use, decision support, and performance feedback to reduce unnecessary radiation. National Simulation Program for Pediatric Emergency Medicine Fellows Moir CR, et al. Pediatr Emerg Care. 2025. PMID:40847185. PubMed link Describes creation of a mandatory national simulation curriculum for PEM fellows, with aligned competencies and assessments. Early feedback indicates feasibility and the potential to standardize procedural and crisis training. Disclaimer This post was created with the assistance of an AI language model (ChatGPT, GPT-5). The model helped organize, format, and summarize recent literature but did not generate or alter the original research findings. Clinical decisions should always be based on full review of the primary literature and current guidelines.