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Emergency Medicine Cases

Journal Jam 8 – Dilute Apple Juice for Pediatric Gastroenteritis

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7602 Ratings

🗓️ 8 November 2016

⏱️ 43 minutes

🧾️ Download transcript

Summary

This is EM Cases Journal Jam podcast on a randomized control trial of dilute apple juice vs PediaLyte for mild pediatric gastroenteritis. While IV rehydration is required in cases of severe gastroenteritis (which we rarely see in North America) and oral rehydration with electrolyte maintenance solutions is still the mainstay in treating moderate gastroenteritis, could better-tasting, more cost-effective fluids such as diluted apple juice be just as effective as traditional electrolyte solutions in milder cases? Listen to Dr. Justin Morgenstern (@First10EM) interviewing Dr. Stephen Freedman, the world-renowned pediatric EM researcher who put ondansetron for pediatric gastroenteritis on the map and who was one of our guest experts on our main episode on Pediatric Gastroenteritis, Constipation and Bowel Obstruction, about this practice-changing paper. This is followed by a hilarious rant on the topic from Dr. Anthony Crocco ("Ranthony"), the Division head and medical director of pediatric EM at Hamilton Health Sciences.

Transcript

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0:00.0

Welcome to EMKCase's ninth journal jam podcast, fall 2016 on oral rehydration strategies in pediatric gastroenteritis.

0:13.4

Anton Helman here.

0:14.7

This time around, we're going to have Justin Morgonstern interviewing the great pediatric EM researcher Stephen Friedman, and after

0:22.0

that Anthony Croco, the division head and medical director of pediatric EM at Health Sciences in

0:27.3

Hamilton, is going to give you his take on Dr. Friedman's paper. Here we go. Well, there's an early

0:35.7

frontrunner for my favorite paper of 2016.

0:38.7

It's practical, it's simple, and it challenges a myth.

0:42.2

Definitely some of my favorite things.

0:44.5

And I'll spoil the surprise a little bit.

0:46.3

This paper has already changed my practice.

0:48.9

The paper I'm talking about, and it's a bit of a mouthful,

0:51.1

is the effect of dilute apple juice and preferred fluids versus

0:55.2

electrolyte maintenance solution on treatment failure among children with mild gastroenteritis,

1:00.7

a randomized clinical trial. It was published in JAMMA this year, and I get the enormous

1:05.0

honor of speaking with the lead author, Dr. Stephen Friedman. Welcome to Journal Jam, Dr. Friedman.

1:10.5

It's a pleasure being here, and thanks so much for inviting me today. Dr. Friedman is a giant in the field of pediatric emergency medicine, and he has a list of publications as long as your arm. He's also previously been a guest on EM cases with some great insights on our episode on pediatric abdominal pain and appendicitis. Dr. Freeman, can you tell us a little bit about your

1:27.9

professional background? Yeah, it's a pleasure. So I trained as a pediatrician at the hospital

1:34.5

for sick children in Toronto for my residency, and then I went on to do fellowship in pediatric

1:40.4

emergency medicine at Children's Memorial Hospital in Chicago.

1:44.7

While I was down there, I did a master's in clinical investigation at Northwestern University.

1:49.5

And since then, I've returned to Canada and have spent the first eight years back in Toronto,

1:56.4

working at CICIDS again.

...

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