Pediatric Spinal Epidural Abscess: Recognition and Management in the Emergency Department

CME Objectives

1. Develop a differential diagnosis that includes spinal epidural abscess (SEA) when a patient presents with concerning symptoms or for nonspecific complaints
2. Discuss the emergent nature of SEA and the importance of prompt diagnosis
3. Order testing and imaging to aid in diagnosis
4. Initiate early empiric treatment when SEA is suspected, even without definitive diagnosis.

CME Information

Date of Original Release: June 1, 2022. Date of most recent review: May 1, 2022. Termination date: June 1, 2025.

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 Credits^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Specialty CME: Not applicable. For more information, please call Customer Service at 678-366-7933.

ACEP Accreditation: Pediatric Emergency Medicine Practice is approved by the American College of Emergency Physicians for 48 hours of ACEP Category I credit per annual subscription.

AAP Accreditation: This continuing medical education activity has been reviewed by the American Academy of Pediatrics and is acceptable for a maximum of 48 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of Pediatrics.

AOA Accreditation: Pediatric Emergency Medicine Practice is eligible for up to 48 American Osteopathic Association Category 2-A or 2-B credit hours per year.

Needs Assessment: The need for this educational activity was determined by a practice gap analysis; a survey of medical staff, including the editorial board of this publication; review of morbidity and mortality data from the CDC, AHA, NCHS, and ACEP; and evaluation responses from prior educational activities for emergency physicians.

Target Audience: This enduring material is designed for emergency medicine physicians, physician assistants, nurse practitioners, and residents.

Goals: Upon completion of this activity, you should be able to: (1) identify areas in practice that require modification to be consistent with current evidence in order to improve competence and performance; (2) develop strategies to accurately diagnose and treat both common and critical ED presentations; and (3) demonstrate informed medical decision-making based on the strongest clinical evidence.

CME Objectives: Upon completion of this activity, you should be able to (1) develop a differential diagnosis that includes spinal epidural abscess (SEA) when a patient presents with concerning symptoms or for nonspecific complaints; (2) discuss the emergent nature of SEA and the importance of prompt diagnosis; (3) order testing and imaging to aid in diagnosis; and (4) initiate early empiric treatment when SEA is suspected, even without definitive diagnosis.

Discussion of Investigational Information: As part of the journal, faculty may be presenting investigational information about pharmaceutical products that is outside Food and Drug Administration approved labeling. Information presented as part of this activity is intended solely as continuing medical education and is not intended to promote off-label use of any pharmaceutical product.

Faculty Disclosure: It is the policy of EB Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME activities. All faculty participating in the planning or implementation of a CME activity are expected to disclose to the participants any relevant financial relationships and to assist in mitigating the relationships. In compliance with all ACCME accreditation requirements and policies, all faculty for this CME activity were asked to complete a full financial disclosure statement. The information received is as follows: the authors, Dr. Bahareh Ravandi and Dr. Christine S. Cho; the peer reviewers, Dr. Winnie Whitaker and Dr. Amy Z. Zhou; the Editors-in-Chief, Dr. Ilene Claudius and Dr. Tim Horeczko; the Pharmacy Editor, Dr. Aimee Mishler; and the CME Editor, Dr. Brian Skrainka, report no relevant financial relationships with ineligible companies.

Commercial Support: This issue of Pediatric Emergency Medicine Practice did not receive any commercial support.

Earning Credit: (1) Go online to www.ebmedicine.net/CME and click on the title of the test you wish to take. When completed, a CME certificate will be emailed to you.

Hardware/Software Requirements: You will need a Macintosh or PC with internet capabilities to access the website.

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