Ep 212 PECARN Febrile Young Infant Prediction Tool: When To Safely Forgo LP and Empiric Antibiotics
About this episode
This episode discusses the updated approach to managing febrile young infants, focusing on when to safely forgo lumbar puncture and empiric antibiotics.
If you’ve been practicing EM for more than a decade, your approach to the febrile young infant has (appropriately) evolved. For years, the default was LP + empiric antibiotics + admission for almost everyone. That approach prevented missing meningitis, but at the cost of a lot of harm: invasive testing, unnecessary antibiotics, and hospitalization-related complications. The modern approach is a paradigm shift toward risk stratification, biomarkers, and shared decision-making, while still respecting one immutable truth: Missing neonatal bacterial meningitis can be catastrophic. This episode revisits the framework from a prior EM Cases episode and updates it with a landmark study that directly informs how far we can safely go—especially in the 0–28 day group, with the father of multiple well-known PECARN rules Dr. Nathan Kuppermann and lead author Dr. Brett Burstein...
More episodes of Emergency Medicine Cases
- Ep 216 Cardiac Arrest Update: Beyond the 2025 ACLS Guidelines Part 2 – Medications, Airway, Termination and Post-ROSC Care
- Ep 215 Cardiac Arrest Update: Beyond the 2025 Guidelines Part 1: CPR, Defibrillation and Ventilation
- EM Quick Hits 71 EMC²: Fever Without a Source, Coaching the EM Mind Part 1, Traumatic Pneumothorax Part 2, PECARN C-spine Rule, Medetomidine Withdrawal, EMS Handover
- Ep 214 Bridging the Gap in Endometriosis Care: Recognition, Risk Stratification, and ED-Initiated Management
- Ep 213 Update in Management of Status Epilepticus
- EM Quick Hits 70 MedMal Cases Upper Back Pain, Traumatic Pneumothorax/Hemothorax Decision Making, Risk Stratification of ICH for Consultation, Post-Circumcision Bleeds, IV Contrast Allergy, Emotional Contagion
Explore listener stats, chart rankings, contacts and more on the Emergency Medicine Cases podcast page.