The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers.  To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations.  Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.

Myocarditis is a challenging diagnosis to make. With advent of newer diagnostic modalities and an improved understanding of the disease and its progression, there is a genuine hope that outcomes of pediatric myocarditis will be improved. The first step, however, is for medical providers to consider this entity in the differential diagnosis of patients with concerning presentation or illness history.

Background: Pediatric emergency medicine (PEM) point-of-care ultrasound (POCUS) fellowships exist to provide learners with expertise in ultrasound (US) education, administration, and research oversight. Currently, there are no standardized goals or objectives for these programs, resulting in considerable variability in PEM POCUS fellowship training. Methods: A modified Delphi survey of PEM and general emergency medicine (EM) POCUS experts in Canada and the United States was conducted to obtain consensus regarding the most important curricular components of a PEM POCUS fellowship training program. Participants were solicited from the P2 Network mailing list and from PEM and EM POCUS fellowship directors listed on the Society of Clinical Ultrasound Fellowships and the Canadian Society of POCUS-EM Fellowships websites. Curricular components considered as part of the survey included US skills, educational skills, administrative skills, and research requirements. Consensus was considered to have been reached when ≥80% of respondents agreed to either include or exclude the component in fellowship training.Results: Round 1 of the survey was sent to 311 participants. A total of 118 (37.9%) completed eligibility for the survey, and 92 (78.0%) met eligibility criteria. Of those, 80 (67.8% of eligible participants) completed the first round of the survey. Round 2 of the survey was sent to those who completed part 1, and 64 (80.0%) completed that round. During Round 1, consensus was achieved for 15 of 75 US applications, seven of seven educational skills, nine of 11 administrative skills, and four of six research requirements. In Round 2 of the survey, consensus was reached on two additional US skills, but no additional administrative skills or research requirements.From the

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Herein, we report a case of a 12-year-old girl who presented with diabetic ketoacidosis and a leukemoid reaction. Although this association has been described in a few adult patients, pediatric cases have not been reported. A leukemoid reaction is commonly defined as an elevation in the white blood cell count greater than 50,000/μL in response to severe illness or stress other than hematologic malignancy; it is considered to be mediated by various hormones, cytokines, and factors that are released in response to inciting triggers, such as acidosis. As highlighted in our report, distinguishing a benign leukemoid reaction from a hematologic malignancy and even tumor lysis syndrome, particularly in a setting of diabetic ketoacidosis, is crucial to ensuring safe and efficacious therapeutic interventions.