The 28th Bubble Wrap

Cite this article as:
Grace Leo. The 28th Bubble Wrap, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18569

With millions upon millions of journal articles being published every year it is impossible to keep up.  Every month we ask some of our friends from PERUKI (Paediatric Emergency Research in UK and Ireland) to point out something that has caught their eye.

Article 1: To glue or not to glue?

Ste-Marie-Lestage et al. Complications following chin laceration reparation using tissue adhesive compared to suture in children. Injury. 2019 Mar 29. pii: S0020-1383(19)30165-2. doi: 10.1016/j.injury.2019.03.047. [Epub ahead of print]

Why does it matter?

Children, adorable as they are, are a bit clumsy, and often fall over resulting in facial lacerations. These minor traumas often present to ED, and majority are repaired using tissue adhesive, which is fast and pain free. This study aims to determine if the dehiscence rate differed amongst simple wounds repaired with tissue adhesive compared with sutures.

What’s it about?

The electronic records of children presenting to a tertiary paediatric centre (between Dec 2015 and Nov 2017) with a diagnosis of traumatic facial/head lacerations were reviewed. Children who had wounds at risk of infection (i.e. animal bites, heavily soiled, required debridement) or complex wounds (i.e. greater than 5cm, in high mobility areas, extended to muscle layers) were excluded.

A total of 2044 children were eligible, and 89% of the wounds were repaired using tissue adhesive. The primary outcome was dehiscence in the 30 days after repair, with the secondary outcome was infection. Electronic records were reviewed, and parents of eligible children were called and asked about wound healing.

For facial lacerations, there was no statistically significant difference in rates of dehiscence or infection between tissue adhesive and sutures. The same was found for chin lacerations, which have a 5x higher rate of dehiscence compared with other facial lacerations.

Clinically Relevant Bottom Line

As no guidelines exist to guide our decision-making process for using tissue adhesive or sutures, we use our clinical judgement. It is reassuring to know that tissue adhesive does not have statistically significant higher complication rates for low risk wounds, and thus should continue being the first choice for repair.

Reviewed by: Tina Abi Abdallah

Article 2: Long-Term Follow-Up of Infants After a Brief Resolved Unexplained Event–Related Hospitalization

Ari A, Atias Y, Amir J. Long-Term Follow-Up of Infants After a Brief Resolved Unexplained Event-Related Hospitalization. Pediatr Emerg Care. 2019 April 3. doi: 10.1097/PEC.0000000000001816. [Epub ahead of print]

What’s it about?

The change of the terminology of an ALTE (acute life threatening event) to a BRUE (brief resolved unexplained event) by the American Academy of Pediatrics was a welcome change for those who believed a more pragmatic approach to this, not uncommon, presentation was needed. However the change in definition did mean that some children previously categorised as an ALTE may not have had the investigations or observation they would normally have received. This study looked at the outcomes of infants at 5 years following their presentation with a BRUE.

A brief resolved unexplained event (BRUE) is defined as “an event occurring in an infant <1 year of age when the observer reports a sudden, brief and now resolved episode of ≥1 of the following:

  • Cyanosis or pallor
  • Absent, decreased or irregular breathing
  • Marked changes in tone
  • Altered level of responsiveness

Importantly although parental attempts at resuscitation are obviously acknowledged a BRUE diagnosis is based on how the clinician defines the event, and not on a caregiver’s perception that this was a life-threatening event.

This was single-centre retrospective study performed in a relatively large children’s Emergency Department (54,000 children a year) in Israel from 2009-13. These dates are important as (i) data collection very retrospective meaning that it’s difficult to know what the clinicians definitely did and (ii) it predates the emergence of the term BRUE so while strict BRUE criteria were applied to selected patients the concept wasn’t a working diagnosis for clinicians at that time. It is also important to note that only hospitalised children were included i.e. those discharged from ED were not part of the cases. This means that the findings of this study may not be comparable to other centres who discharge directly or admit to an ED short stay unit.

Essentially of 87 child who were followed up via telephone questionnaire 71 (81.6%) were described as having normal development, one (1.1%) child had global developmental delay, 12 (13.8%) had verbal delay and 3 (3.4%) had autistic spectrum disorder. These, apart from a 1% ASD incidence are not grossly different from population statistics. In this cohort 2.3% had had a febrile seizures and 1.15% a non-febrile seizures, again not dissimilar from population norms.

Clinically Relevant Bottom Line:

The longer term outcomes, in this small study, of child with a retrospective diagnosis of a BRUE are not alarming.  A prospective study is clearly needed to confirm this.

Reviewed by: Damian Roland (@damian_roland)

Article 3: Which medication is best for neonatal abstinence syndrome?

Disher at al. Pharmacological Treatments for Neonatal Abstinence Syndrome: A Systematic Review and Network Meta-analysis. JAMA Pediatrics. 2019 Mar; 173(3)

What’s it about?

The aim of this meta-analysis was to compare the different pharmacological agents available for the treatment of neonatal abstinence syndrome (NAS) and identify the most effective therapy in terms of reducing the length of treatment, the length of stay, need for adjuvant therapy and adverse events. The study analysed eighteen randomised clinical trials (N = 1072) which compared buprenorphine, clonidine, diluted tincture of opium and clonidine, diluted tincture of opium, morphine, methadone and phenobarbital. Buprenorphine was found to be the best treatment given the reduction in the length of treatment of 12.75 days (95% CI, -17.97 to -7.58) compared to morphine. Buprenorphine also reduced the length of stay but not the need for adjuvant treatment, compared to other pharmacological agents. On the other hand, morphine and phenobarbital were the worst treatments in terms of relative effects and rankings.

Why does it matter?

Morphine is the most commonly used pharmacological agent in the treatment of NAS, however this meta-analysis suggests that it may be the worst treatment choice in terms of length of treatment and hospital stay! The benefit of buprenorphine could be due to its longer half-life and therefore prevention of sudden withdrawal symptoms. It was also interesting to note the “less mainstream” therapy options, such as diluted tincture of opium, for the treatment of NAS in some centres.

Clinically relevant bottom line:

While the findings of this meta-analysis make us wonder whether buprenorphine should be used more widely as the first line treatment for NAS, the authors emphasise that there is a need for a large multisite trial that compares buprenorphine with other treatments before it can be accepted as the standard treatment for NAS. Watch this space!

Reviewed by: Jennifer Moon

Article 4: Sorry, where was I? I was a little distracted…

Westbrook JI, Raban MZ, Walter SR, Douglas H. Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study. BMJ Qual Saf. 2018 Aug; 1;27(8):655-63.

What’s it about?

A team of observers followed 36 emergency physicians around on shift and watched them, in three hour blocks, to codify how many times they were interrupted. By using  WOMBAT (Work Observation Method By Activity Timing) the observers were able to capture the minute-by-minute adventures of the physicians. They found that, on average, an emergency physician was interrupted 7.9 times per hour. They also looked at prescribing errors (by collecting the paper charts) and found 208 prescribing errors in 238 medication orders. Now it must be pointed out that a number of these errors were what is termed as legal errors (unapproved abbreviations for example) rather than clinical errors but this number is still very shocking. Drilling down further in the data it is apparent that interruptions whilst prescribing lead to a 2.82 x increase in clinical errors.

Why does it matter?

It seems that I can barely make it through my first coffee of the shift before someone is handing me an ECG to look at or asking me to review a patient. I’ve switched to drinking long blacks so it doesn’t matter if I have to leave my caffeine but what happens if I am doing something more important – charting medications, working out fluid regimes – for example? This research took place in a department using analog rather than digital prescriptions so one would hope the error rate might be less in this era of the dreaded EMR. For now, though, if I am writing something more than just paracetamol then I’ll try and remain laser-focussed on the task in hand.

Clinically-relevant bottom line?

Doctors get interrupted all the time at work. Whilst the interruptor might think it is a trivial task they have for you it is worth thinking about how you can change the culture to reduce the chance of significant prescribing errors occurring when you are asked to ‘just take a look at this ECG’.

We discussed this post with Casey and the gang at SMACC in Sydney.

Reviewed by: Andrew Tagg (@andrewjtagg)

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments! That’s it for this month. Many thanks to all of our reviewers who have taken the time to scour the literature so you don’t have to.

Bubble Wrap PLUS – April 2019

Cite this article as:
Anke Raaijmakers. Bubble Wrap PLUS – April 2019, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18568

Welcome to April’s Bubble Wrap Plus, our monthly paediatric journal club provided by Professor Jaan Toelen & his team of the University Hospitals in Leuven (Belgium). This comprehensive list of ‘articles to read’ comes from 34 journals, including Pediatrics, The Journal of Pediatrics, Archives of Disease in Childhood, JAMA Pediatrics, Journal of Paediatrics and Child Health, NEJM, and many more.

This month’s list features answers to intriguing questions (and maybe answers) such as: ‘Do pediatricians follow guidelines when managing status epilepticus in children?’, ‘Does antibiotic prophylaxis for UTI lead to fewer non-UTI infections?’, ‘Is intranasal fentanyl safe for procedural pain management in neonates?’ and ‘Does the early or late introduction of allergens change the development of atopic disease?’.

You will find the list broken down into four sections:

1.Reviews and opinion articles

Helicobacter pylori Infection.

Crowe SE. N Engl J Med. 2019 Mar 21;380(12):1158-1165.

Evaluation of the child with global developmental delay and intellectual disability.

Bélanger SA, et al. Paediatr Child Health. 2018 Sep;23(6):403-419.

Closing the Disclosure Gap: Medical Errors in Pediatrics.

Lin M, et al. Pediatrics. 2019 Mar 13.

Why, when, and how to give surfactant.

Jobe AH. Pediatr Res. 2019 Mar 12.

The pathogenesis and management of renal scarring in children with vesicoureteric reflux and pyelonephritis.

Murugapoopathy V, et al. Pediatr Nephrol. 2019 Mar 7.

Communication with children and adolescents about the diagnosis of a life-threatening condition in their parent.

Dalton L, et al. Lancet. 2019 Mar 16;393(10176):1164-1176.

Communication with children and adolescents about the diagnosis of their own life-threatening condition.

Stein A, et al. Lancet. 2019 Mar 16;393(10176):1150-1163.

Paediatric sarcoidosis.

Nathan N, et al.Paediatr Respir Rev. 2019 Feb;29:53-59.

Human milk as “chrononutrition”: implications for child health and development.

Hahn-Holbrook J, et al.Pediatr Res. 2019 Mar 11. 

2. Original clinical studies

Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016.

Norman M, et al. JAMA. 2019 Mar 26;321(12):1188-1199.

Management of status epilepticus in children prior to medical retrieval: Deviations from the guidelines.

Uppal P, et al. J Paediatr Child Health. 2019 Mar 28.

What Do NICU Fellows Identify as Important for Achieving Competency in Neonatal Intubation?

Brady J, et al.Neonatology. 2019 Mar 19;116(1):10-16.

Achieving Procedural Competency during Neonatal Fellowship Training: Can Trainees Teach Us How to Teach?

Marrs LK, et al.Neonatology. 2019 Mar 19;116(1):17-19.

Impact of Trimethoprim-sulfamethoxazole Urinary Tract Infection Prophylaxis on Non-UTI Infections.

Desai S, et al.Pediatr Infect Dis J. 2019 Apr;38(4):396-397.

Sleep Problems in Children With Autism and Other Developmental Disabilities: A Brief Report.

Valicenti-McDermott M, et al.J Child Neurol. 2019 Mar 17:883073819836541.

A Validated Scale for Assessing the Severity of Acute Infectious Mononucleosis.

Katz BZ, et al.J Pediatr. 2019 Mar 7.

Effect of Sustained Inflations vs Intermittent Positive Pressure Ventilation on Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants: The SAIL Randomized Clinical Trial.

Kirpalani H, et al. JAMA. 2019 Mar 26;321(12):1165-1175.

High-Dose Vitamin D Supplementation During Pregnancy and Asthma in Offspring at the Age of 6 Years.

Brustad N, et al. JAMA. 2019 Mar 12;321(10):1003-1005.

High-Dose Vitamin D Supplementation Does Not Prevent Allergic Sensitization of Infants.

Rosendahl J, et al. J Pediatr. 2019 Mar 19. pii: S0022-3476(19)30245-8.

Timing of introduction of allergenic solids for infants at high risk.

Abrams EM, et al. Paediatr Child Health. 2019 Feb;24(1):56-57.

The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods.

Greer FR, et al. Pediatrics. 2019 Mar 18. pii: e20190281.

Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): a randomised controlled, open-label, blinded-endpoints, phase 3 trial.

Hamada H, et al. Lancet. 2019 Mar 16;393(10176):1128-1137.

Pediatric Celiac Disease and Eosinophilic Esophagitis: Outcome of Dietary Therapy.

Patton T, et al. J Pediatr Gastroenterol Nutr. 2019 Mar 26.

Host and Bacterial Markers that Differ in Children with Cystitis and Pyelonephritis.

Shaikh N, et al. J Pediatr. 2019 Mar 21. pii: S0022-3476(19)30027-7.

Montelukast and Neuropsychiatric Events in Children with Asthma: A Nested Case-Control Study.

Glockler-Lauf SD, et al. J Pediatr. 2019 Mar 21. pii: S0022-3476(19)30198-2.

Physical Fitness, Physical Activity, and the Executive Function in Children with Overweight and Obesity.

Mora-Gonzalez J, et al. J Pediatr. 2019 Mar 19. pii: S0022-3476(18)31745-1.

Does discharging clinically well patients after one hour of treatment impact emergency department length of stay for asthma patients.

Lenko D, et al. J Paediatr Child Health. 2019 Mar 20.

Characterization of Esophageal Motility in Infants with Congenital Diaphragmatic Hernia using High Resolution Manometry.

Rayyan M, et al. J Pediatr Gastroenterol Nutr. 2019 Mar 5.

Effect of metronome guidance on infant cardiopulmonary resuscitation.

Kim CW, et al. Eur J Pediatr. 2019 Mar 8.

Expressions of Gratitude and Medical Team Performance.

Riskin A, Bamberger P, et al. Pediatrics. 2019 Mar 7.

A cohort study of intranasal fentanyl for procedural pain management in neonates.

McNair C, et al. Paediatr Child Health. 2018 Dec;23(8):e170-e175.

Traumatic brain injury in young children with isolated scalp haematoma.

Bressan S, et al. Arch Dis Child. 2019 Mar 4.

Association of Atopic Dermatitis With Sleep Quality in Children.

Ramirez FD, et al. JAMA Pediatr. 2019 Mar 4:e190025.

3. Guidelines and best evidence

Prevention of Drowning.

Denny SA, et al.Pediatrics. 2019 Mar 15.

Lack of Sleep and Sports Injuries in Adolescents: A Systematic Review and Meta-Analysis.

Gao B, et al. J Pediatr Orthop. 2018 Nov 28.

Guidelines for vitamin K prophylaxis in newborns.

Ng E, et al. Paediatr Child Health. 2018 Sep;23(6):394-402.

School, child care and camp exclusion policies for chickenpox: A rational approach.

Bridger NA. Paediatr Child Health. 2018 Sep;23(6):420-427.

4. Case reports

An 11-Month-Old Male With Acute-Onset Left-Sided Facial Paralysis.

Posa M, et al.Clin Pediatr (Phila). 2019 Mar 22:9922819837354.

A Lower-limb Skin Lesion in a 10-year-old Girl.

Koirala A, et al. Pediatr Infect Dis J. 2019 Apr;38(4):e79.

Exercise-Induced Purpura in Children.

Paul SS, et al.Pediatrics. 2019 Apr;143(4).

 

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments!

Please join us for our next #DFTB_JC on twitter…The DFTB/ADC Journal Club is a monthly collaboration between @DFTBubbles and @ADC_BMJ featuring a FREE access article from the latest issues of Archives of Disease of Childhood.

Bubble Wrap PLUS – February

Cite this article as:
Anke Raaijmakers. Bubble Wrap PLUS – February, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18007

Welcome to February’s Bubble Wrap Plus, our monthly paediatric journal club provided by Professor Jaan Toelen & his team of the University Hospitals in Leuven (Belgium). This comprehensive list of ‘articles to read’ comes from 34 journals, including Pediatrics, The Journal of Pediatrics, Archives of Disease in Childhood, JAMA Pediatrics, Journal of Paediatrics and Child Health, NEJM, and many more.

This month’s list features answers to intriguing questions (and maybe answers) such as: ‘Is inattention the main cause of medication errors in hospitalized newborns?’, ‘Which children have trouble falling asleep after concussion?’, ‘What are the determinants of low measles vaccination coverage in children?’, ‘Is new media usage associated with poorer sleep in toddlers?’ and ‘Is early fish introduction associated with a lower risk of asthma?’.

You will find the list broken down into four sections:

1.Reviews and opinion articles

New therapies for acute RSV infections: where are we?

Xing Y, Proesmans M. Eur J Pediatr. 2019 Feb;178(2):131-138.

ADHD in children and youth: Part 1-Etiology, diagnosis, and comorbidity.

Bélanger SA, et al. Paediatr Child Health. 2018 Nov;23(7):447-453.

ADHD in children and youth: Part 2-Treatment.

Feldman ME, et al. Paediatr Child Health. 2018 Nov;23(7):462-472.

Imaging of diseases of the vagina and external genitalia in children.

Matos J, et al. Pediatr Radiol. 2019 Jan 5.

Supporting breathing of preterm infants at birth: a narrative review.

Martherus T, et al. Arch Dis Child Fetal Neonatal Ed. 2019 Jan;104(1):F102-F107.

2. Original clinical studies

Incident reports versus direct observation to identify medication errors and risk factors in hospitalised newborns.

Palmero D, et al. Eur J Pediatr. 2019 Feb;178(2):259-266.

Risk prediction of severe reaction to oral challenge test of cow’s milk.

Kawahara T, et al. Eur J Pediatr. 2019 Feb;178(2):181-188.

Association Between Screen Time and Children’s Performance on a Developmental Screening Test.

Madigan S, et al. JAMA Pediatr. 2019 Jan 28.

Presentation and outcomes in hypertrophic pyloric stenosis: An 11-year review.

Vinycomb TI, et al. J Paediatr Child Health. 2019 Jan 24.

Trouble Falling Asleep After Concussion Is Associated With Higher Symptom Burden Among Children and Adolescents.

Howell DR, et al. J Child Neurol. 2019 Jan 22:883073818824000.

Effect of a Low Free Sugar Diet vs Usual Diet on Nonalcoholic Fatty Liver Disease in Adolescent Boys: A Randomized Clinical Trial.

Schwimmer JB, et al. JAMA. 2019 Jan 22;321(3):256-265.

Association of Rotavirus Vaccination With the Incidence of Type 1 Diabetes in Children.

Perrett KP, et al. JAMA Pediatr. 2019 Jan 22.

Questions and Concerns About HPV Vaccine: A Communication Experiment.

Shah PD, et al. Pediatrics. 2019 Jan 22.

Three Important Findings From a Study on HPV “Real World” Effectiveness.

Dempsey AF. Pediatrics. 2019 Jan 22.

Human Papillomavirus Vaccine Effectiveness and Herd Protection in Young Women.

Spinner C, et al. Pediatrics. 2019 Jan 22.

High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis.

Lin J, et al. Arch Dis Child. 2019 Jan 17.

Determinants of low measles vaccination coverage in children living in an endemic area.

Lo Vecchio A, et al. Eur J Pediatr. 2019 Feb;178(2):243-251.

Factors Associated With Rotavirus Vaccine Coverage.

Aliabadi N, et al. Pediatrics. 2019 Jan 17.

Recognizing critically ill children with a modified pediatric early warning score at the emergency department, a feasibility study.

Vredebregt SJ, et al. Eur J Pediatr. 2019 Feb;178(2):229-234.

Calprotectin instability may lead to undertreatment in children with IBD.

Haisma SM, et al. Arch Dis Child. 2019 Jan 17.

Psychogenic movement disorders in children and adolescents: an update.

Harris SR. Eur J Pediatr. 2019 Jan 11.

Sleep and new media usage in toddlers.

Chindamo S, et al. Eur J Pediatr. 2019 Jan 16.

Preventing Neonatal Group B Streptococcus Disease: The Limits of Success.

Mukhopadhyay S, et al. JAMA Pediatr. 2019 Jan 14.

Epidemiology of Invasive Early-Onset and Late-Onset Group B Streptococcal Disease in the United States, 2006 to 2015: Multistate Laboratory and Population-Based Surveillance.

Nanduri SA, et al. JAMA Pediatr. 2019 Jan 14.

Complications and risk factors for severe outcome in children with measles.

Lo Vecchio A, et al. Arch Dis Child. 2019 Jan 12.

RSV hospitalization in infancy increases the risk of current wheeze at age 6 in late preterm born children without atopic predisposition.

Korsten K, et al. Eur J Pediatr. 2019 Jan 12.

Cognitive Outcomes and Positional Plagiocephaly.

Collett BR, et al. Pediatrics. 2019 Jan 11.

Retinal Findings in Young Children With Increased Intracranial Pressure From Nontraumatic Causes.

Shi A, et al. Pediatrics. 2019 Jan 10.

Introduction of fish and other foods during infancy and risk of asthma in the All Babies In Southeast Sweden cohort study.

Klingberg S, et al. Eur J Pediatr. 2019 Jan 7.

Nebulised hypertonic saline in children with bronchiolitis admitted to the paediatric intensive care unit: A retrospective study.

Stobbelaar K, et al. J Paediatr Child Health. 2019 Jan 6.

Black Race Is Associated with a Lower Risk of Bronchopulmonary Dysplasia.

Ryan RM, et al. J Pediatr. 2019 Jan 4.

Exposure to and use of mobile devices in children aged 1-60 months.

Kılıç AO, et al. Eur J Pediatr. 2019 Feb;178(2):221-227.

Patterns of Prenatal Alcohol Use That Predict Infant Growth and Development.

Bandoli G, et al. Pediatrics. 2019 Jan 4.

Wide variation in severe neonatal morbidity among very preterm infants in European regions.

Edstedt Bonamy AK, et al. Arch Dis Child Fetal Neonatal Ed. 2019 Jan;104(1):F36-F45.

Follow-up and outcome of symptomatic partial or absolute IgA deficiency in children.

Moschese V, et al. Eur J Pediatr. 2019 Jan;178(1):51-60.

The problem of defecation disorders in children is underestimated and easily goes unrecognized: a cross-sectional study.

Timmerman MEW, et al. Eur J Pediatr. 2019 Jan;178(1):33-39.

Meningococcal Disease Among College-Aged Young Adults: 2014-2016.

Mbaeyi SA, et al. Pediatrics. 2019 Jan;143(1).

3. Guidelines and best evidence

Diagnosis and Management of Kawasaki Disease.

Sosa T, et al. JAMA Pediatr. 2019 Jan 22.

Pharmacologic Treatments for Sleep Disorders in Children: A Systematic Review.

McDonagh MS, et al. J Child Neurol. 2019 Jan 23:883073818821030.

Development and Validation of a Cellulitis Risk Score: The Melbourne ASSET Score.

Ibrahim LF, et al. Pediatrics. 2019 Jan 3.

Nasal high flow therapy for neonates: Current evidence and future directions.

Hodgson KA, et al. J Paediatr Child Health. 2019 Jan 7.

Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum: US Preventive Services Task Force Reaffirmation Recommendation Statement.

US Preventive Services Task Force, Curry SJ, et al. JAMA. 2019 Jan 29;321(4):394-398.

4. Case reports

A Devil of a Case: Chest Pain in an Adolescent.

Bruehl MJ, et al. Clin Pediatr (Phila). 2019 Jan 28:9922819826102

 

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments!

Please join us for our next #DFTB_JC on twitter…The DFTB/ADC Journal Club is a monthly collaboration between @DFTBubbles and @ADC_BMJ featuring a FREE access article from the latest issues of Archives of Disease of Childhood. January’s pick  is ‘ Can we use POCUS to Diagnose Pneumonia?’ Read the article here: bit.ly/2TMDf2M The chat will happen on twitter at Tue 22/1/19 at UTC2000hrs (That’s Wednesday 0700 23/1 AEST), just search the hashtag #DFTB_JC

The 26th Bubble Wrap

Cite this article as:
Leo, G. The 26th Bubble Wrap, Don't Forget the Bubbles, 2019. Available at:
https://dontforgetthebubbles.com/26th-bubble-wrap/

With millions upon millions of journal articles being published every year it is impossible to keep up.  Every month we ask some of our friends from PERUKI (Paediatric Emergency Research in UK and Ireland) to point out something that has caught their eye.

This month to ease us into the new clinical year; this bubble wrap will featuring a couple of new papers but also a few flashback reviews of some papers we’ve explored in other posts in case you missed them the first time around!