Bedside Pediatric Guidelines 2022-2024
1. Common Acute Conditions
Febrile Illness:
Management of fever without a source (e.g., UTIs, occult bacteremia).
Criteria for sepsis recognition (e.g., qSOFA-peds, SIRS criteria).
Respiratory Emergencies:
Asthma exacerbations (GINA 2023 updates, use of BiPAP).
Bronchiolitis (controversies over hypertonic saline, high-flow oxygen).
Croup (dexamethasone dosing, heliox in severe cases).
Gastroenteritis:
WHO rehydration guidelines, zinc supplementation, and antiemetics.
2. Critical Care & Resuscitation
Pediatric Advanced Life Support (PALS):
2023 AHA updates (e.g., epinephrine dosing, ECMO in refractory arrest).
Shock Management:
Fluid resuscitation in septic shock (balanced crystalloids vs. saline).
Inotropes/vasopressors (norepinephrine, epinephrine).
Toxicology:
Naloxone for opioid overdoses, new antidotes (e.g., fomepizole for methanol).
3. Neonatal Emergencies
Hypoxic-Ischemic Encephalopathy (HIE):
Therapeutic hypothermia protocols.
Neonatal Sepsis:
Empiric antibiotics (e.g., ampicillin + gentamicin vs. broader coverage).
Prematurity Complications:
Management of apnea of prematurity, ROP screening.
4. Infectious Diseases
Antibiotic Stewardship:
Narrow-spectrum choices for otitis media, pneumonia, and SSTIs.
COVID-19 Updates:
Pediatric vaccine recommendations (Pfizer/Moderna 2023–2024 formulations).
Criteria for remdesivir/monoclonal antibodies in high-risk children.
Emerging Pathogens:
RSV prevention (nirsevimab monoclonal antibody, maternal vaccines).
5. Chronic Disease Management
Diabetes:
Insulin pump/CGM integration (e.g., closed-loop systems).
Asthma:
Biologics (e.g., omalizumab) for severe cases.
Epilepsy:
Rescue therapies for breakthrough seizures (intranasal midazolam).
6. Mental Health & Behavioral Crises
Suicide Risk Assessment:
PHQ-9/Columbia Protocol for adolescents.
Agitation Management:
De-escalation techniques, medication options (e.g., lorazepam).
7. Trauma & Injury
Concussion:
Return-to-learn/play protocols (CDC 2023 guidelines).
Burn Management:
Fluid resuscitation (Parkland formula), infection prevention.
Non-Accidental Injury:
Red flags for physical/sexual abuse.
8. Pain Management
Analgesia Dosing:
Weight-based acetaminophen/ibuprofen, opioid-sparing strategies.
Procedural Sedation:
Ketamine, nitrous oxide, and fasting guidelines.
9. Nutrition & Fluids
Dehydration:
IV vs. oral rehydration (low-osmolarity ORS).
Electrolyte Imbalances:
Hyponatremia/hypernatremia correction rates.
10. Diagnostic Tools
Imaging:
ALARA principles for radiation reduction.
POCUS (point-of-care ultrasound) for appendicitis, pneumonia.
Lab Interpretation:
Age-specific CRP/procalcitonin cutoffs for sepsis.