CME CREDIT NOW AVAILABLE-1.0 AMA PRA Category 1 Credit FOR EACH ISSUE (2 ARTICLES)!!!!!!
BY Mike Mallory
A 3-year-old comes to your office with a fever and a limp. Parents noticed a little discomfort yesterday, but it’s worse today and now the child doesn’t want to bear weight. What is the work up that we need to do? That is the question that the recently finalized Musculoskeletal (MSK) Infection clinical practice guideline attempts to answer.
The first question that the guideline asks us is to determine our level of suspicion for risk of MSK infection. The following historical and exam features should raise suspicion of MSK infection.
Pain, fever, inability to bear weight, gait disturbance/limp, limited use of extremity, immobility of extremity, travel to area with endemic Lyme disease.
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David Banks, MD email@example.com
In the late 1990’s, as pediatric MRI imaging services came of age, pediatric hospitals were faced with a growing need for quality pediatric sedation services. Many institutions met this need initially by assembling experienced nurses and having them manage the sedations. By the early 2000’s, the nurse-run services were being replaced by physician services, as the Joint Commission developed new standards for deep sedation services. In compliance with Joint Commission standards, both Children’s campuses Scottish Rite and Egleston developed physician run sedation services. Pediatric Sedation Services (PSS) was developed on the Scottish Rite campus by the PEMA physician group, and Children’s Sedation Services (CSS) was formed as a combined effort by the critical care and pediatric emergency medicine teams at the Egleston campus. Both PSS and CSS have grown in volume and scope of services and, as a system, represent one of the largest pediatric procedural sedation services, performing over 11,000 cases per year.