This week's Morsel: Review of the PRoMPT BOLUS study - NS vs LR - who wins?

Dr. Nate Kuppermann and Dr. Brett Burstein discuss a landmark JAMA study that suggests we might be able to safely skip the LP in many of our tiniest patients.

For decades, the teaching in pediatric emergency medicine has been consistent: “Young febrile infants (0-28 days) with fevers get a full sepsis workup.” This traditionally means blood, urine, and cerebrospinal fluid (CSF) cultures, followed by admission and antibiotics. The fear of missing bacterial meningitis—a devastating infection—has driven this aggressive approach. But is a lumbar puncture […]

This post is a summary and discussion of the following article from JAMA Pediatrics: Reed JL, Palmer CA, Casper TC, et al. Gonorrhea and Chlamydia Screening for Adolescents and Young Adults in Emergency Departments. JAMA Pediatr. Published online September 08, 2025. doi:10.1001/jamapediatrics.2025.2139

Introduction Evaluating children with blunt trauma for cervical spine injury (CSI) is a high-stakes and high-variability process. While CSI is rare, the consequences of missed injuries are serious, and so is the harm from overuse of imaging, especially CT. The PECARN CSI prediction rule is a promising tool

Introduction Evaluating children with blunt trauma for cervical spine injury (CSI) is a high-stakes and high-variability process. While CSI is rare, the consequences of missed injuries are serious, and so is the harm from overuse of imaging, especially CT. The PECARN CSI prediction rule is a promising tool

The PECARN Cervical Spine Injury Prediction Rule for Cervical Spine Imaging evaluates pediatric cervical spine injury risk.

We developed accurate, pragmatic severity risk prediction models among children with CAP. After future external validation, these models have the potential to provide individualised risk assessments t...