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Corticosteroid Use in Management of Pediatric Emergency Conditions

Corticosteroid Use in Management of Pediatric Emergency Conditions

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  Issue Info

Authors: Asalim Thabet, MD; Tyler Greenfield, DO; Richard M. Cantor, MD, FAAP, FACEP

Peer Reviewers: Augusta Saulys, MD, FAAP, FACEP; Catherine Sellinger, MD

Publication Date: March 1, 2018

CME Expiration Date: March 1, 2021

CME Credits: 4 AMA PRA Category 1 CreditsTM, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2A or 2B Credits.  Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME credits.

PubMed ID: 29490126

  About this Issue

Although corticosteroids have been used for over half a century, their use for management of many pediatric conditions is controversial. In this issue, you will learn:

  • The mechanisms of corticosteroid effects
  • Which corticosteroids are used to treat pediatric conditions, their associated properties, and recommended pediatric dosing
  • Evidence-based recommendations for whether or not to use corticosteroids in the management of pediatric patients with an asthma exacerbation, croup, acute pharyngitis, anaphylaxis, acute spinal injury, or bacterial meningitis
  • Preferred routes, dosages, and corticosteroids, as well as alternate choices
  • Which adverse effects have been shown to be associated with corticosteroid use
  Issue Features
  Table of Contents
  1. Abstract
  2. Case Presentations
  3. Introduction
  4. Critical Appraisal of the Literature
  5. Mechanisms of Corticosteroid Effects
  6. Prehospital Care
  7. Corticosteroids for the Management of Pediatric Conditions
    1. Asthma
      1. Management of Asthma
      2. Summary
    2. Croup
      1. Management of Croup
      2. Summary
    3. Acute Pharyngitis
      1. Management of Acute Pharyngitis in Children
      2. Summary
    4. Anaphylaxis
      1. Management of Anaphylaxis
      2. Summary
    5. Acute Spinal Cord Injury
      1. Management of Acute Spinal Cord Injury
      2. Summary
    6. Bacterial Meningitis
      1. Management of Bacterial Meningitis
      2. Summary
  8. Adverse Effects
    1. No Adverse Effects
    2. Cerebral Thrombosis
    3. Gastrointestinal Bleeding
    4. Growth Restriction
    5. Bacterial Tracheitis
    6. Behavioral Changes
  9. Controversies
  10. Special Populations
  11. Summary
  12. Risk Management Pitfalls for Using Corticosteroids to Manage Pediatric Conditions
  13. Time- and Cost-Effective Strategies
  14. Case Conclusions
  15. Tables
    1. Table 1. Types of Corticosteroids Used to Treat Pediatric Conditions, Their Associated Properties, and Recommended Pediatric Dosing
    2. Table 2. Comparison of Studies Evaluating the Use of Corticosteroids for Management of Acute Pharyngitis
    3. Table 3. Comparison of Studies Evaluating the Use of Corticosteroids for Management of Bacterial Meningitis
  16. References

 

  CME Information

Accreditation: EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the ACCME.

Credit Designation: EB Medicine designates this enduring material for a maximum of 4 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Specialty CME: Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME credits, subject to your state and institutional approval.

Faculty Disclosures: It is the policy of EB Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. In compliance with all ACCME Essentials, Standards, and Guidelines, all faculty for this CME activity were asked to complete a full disclosure statement. The information received is as follows: Dr. Thabet, Dr. Greenfield, Dr. Cantor, Dr. Saulys, Dr. Sellinger, Dr. Claudius, Dr. Horeczko, Dr. Mishler, and their related parties report no significant financial interest or other relationship with the manufacturer(s) of any commercial product(s) discussed in this educational presentation. Dr. Jagoda made the following disclosures: Consultant, Daiichi Sankyo Inc; Consultant, Pfizer Inc; Consultant, Banyan Biomarkers Inc; Consulting fees, EB Medicine.

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Last Modified: 05/24/2018
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