There’s no shortage of new studies competing for your attention, but let’s be honest – most of us don’t have the time (or patience) to sift through it all. One of the ways I keep up is by writing for JournalFeed, where the goal is to distill new research into what actually matters at the bedside. In this post, I’ve pulled together a handful of recent articles, summarized by me for JournalFeed, that stood out. Think of this as a curated, no-fluff roundup of high-yield updates worth knowing. You’ll get the Spoon Feed summary and my take on how each study may change practice – but don’t stop there; I’d strongly encourage you to review the full JournalFeed write-ups and the original articles (both linked below) for a deeper dive.
Spoon Feed
In pediatric out-of-hospital cardiac arrest, the probability of survival drops below 1% after ~15 minutes of EMS CPR without ROSC, providing objective data to inform management and termination decisions.
How will this change my practice?
This study provides objective, time-based survival probabilities that can help frame one of the most difficult decisions in pediatric resuscitation: when continued CPR is unlikely to change outcomes. Once CPR extends beyond ~15 minutes without ROSC, survival becomes exceedingly rare (<1%), offering a useful anchor for clinical decision-making. These findings align with prior data demonstrating similarly steep declines in meaningful outcomes, such as neurologically favorable survival, with prolonged resuscitation. Together, these studies reinforce a consistent principle: time without ROSC is one of the strongest predictors of poor outcome, and integrating duration into a broader clinical context can help guide more informed, patient-centered decisions.
Read the full JournalFeed write-up
Spoon Feed
A simple 4-factor clinical decision rule accurately distinguished true bacteremia from contaminants in children with positive blood cultures, achieving 99% sensitivity while potentially reducing unnecessary hospitalizations.
How will this change my practice?
Callbacks for positive blood cultures on discharged patients can send you into a tailspin. Should I have even sent the culture? Am I making this patient come back in the middle of the night for something not even real? This study offers the potential for some structure and guidance in that stressful moment. Even more appealing is the simplicity and generalizability of it. We know all four data points when the lab calls with that positive culture. While there is still a need for external validation and real-world implementation studies, this study provides an evidence-based framework to support decisions about who really needs to come back, be admitted, and receive antibiotics—and who likely doesn’t. I look forward to additional studies that hopefully will allow us to reduce unnecessary admissions, antibiotic exposure, and family disruption, while maintaining safety.
Read the full JournalFeed write-up
Spoon Feed
Most infants with a brief resolved unexplained event (BRUE) are low risk and do not benefit from extensive testing or admission; careful risk stratification, focused evaluation, and shared decision-making can safely reduce unnecessary workup and hospitalization.
How will this change my practice?
Infants presenting with an event consistent with BRUE can be difficult to manage, both from a risk stratification standpoint (scary episode, looks great on exam) and a reassurance perspective (“We don’t know exactly what happened, but it’s probably OK”). This review reinforces that managing BRUEs is often about restraint, and that a routine workup should not be done just to do something. For infants meeting low-risk criteria with a reassuring exam, relying on the evidence will allow you to limit workup and avoid costly, likely unnecessary testing. One of the biggest parts of our job is communication, and this diagnosis provides a challenge; taking the time to sit with families and explain your approach can help reduce caregiver anxiety and build a therapeutic alliance.
Read the full JournalFeed write-up
Spoon Feed
Using EHR data from the first 4 hours of ED care, machine learning models accurately predicted which children would develop sepsis within 48 hours—before organ dysfunction was present.
How will this change my practice?
If recognition of sepsis is the cornerstone of the pediatric ER, then prediction of this life-threatening condition would be a paradigm shift. By predicting future Phoenix Sepsis Criteria-defined sepsis, the models created in this paper point toward a future where risk stratification mirrors our current sepsis definitions. This sets the stage for a world in which AI models can assist in recognizing and treating impending sepsis before patients even show signs of organ dysfunction.
AI models analyze and find patterns in large datasets better than humans. The EHR is ripe for this type of study. This may help us not only with sepsis but other conditions that are time-sensitive, diagnostically noisy, and rely on patterns across multiple (sometimes weak) signals. Appendicitis? Intussusception? DKA? I look forward to future work that pairs this kind of model with clinical gestalt to improve outcomes.
Read the full JournalFeed write-up
HipPEMcrates is proud to partner with JournalFeed to bring you concise, high-impact summaries of the latest pediatric emergency medicine literature. Through this collaboration, we’ll regularly feature JournalFeed synopses to keep you sharp, evidence-based, and up-to-date. Sign up for JournalFeed here.
Dr. Joshua Belfer, MD, is a Pediatric Emergency Medicine physician at the Children’s Hospital of Philadelphia, and is the Founder and Editor-in-Chief of HipPEMcrates. He can be reached at HipPEMcrates@gmail.com.
