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Shortage of doctors in emergency departments (EDs) is a root issue in maintaining ED-based residency programs. This study describes the efficiency of emergency practice according to board certification; 3 board-certified physicians versus a pediatric resident. Of 342 children, we found no differences as per the board certification in the ED length of stay, acuity, and return visits with more frequent hospitalization by the board-certified physicians. This result suggests that with a proper residency program, both board-certified physicians and residents can make a decision on hospitalization.

A big infectious wave overwhelmingly spread from February 2022 in South Korea after the COVID-19 outbreak was managed. Therefore, we analysed electroencephalogram (EEG) findings and serologic inflammatory markers in pediatric patients with COVID-19 by retrospectively reviewing medical records of 41 patients who visited Gyeongsang National University Changwon Hospital from March to May 2022 and were diagnosed with COVID-19; all serologic tests were performed within 24 hours after presenting with fever or seizure. The median patient age and average number of hospitalisation days were 3.6 (0.08–14.00) years and 3.71 (1.0–7.0) days, respectively. Interleukin-6 (IL-6) were elevated above the normal range in all patients (median value, 43.18 [7.0–190.0] pg/ml) and were higher among patients with seizures. Among 41 patients, 17 (41.5%) with a mean age of 5.4 years had higher complaints of seizures. Three patients had prolonged seizures for > 30 minutes and received intravenous lorazepam injections and eight had a complex type of febrile convulsion. Nine patients underwent EEG, and five showed abnormal findings in the initial EEG. In the linear regression model, serum IL-6 and blood lymphocyte counts were correlated with prolonged seizure duration. These findings underscore that several immune cascade-related serologic markers were elevated in children with COVID-19-related febrile seizures. We may assume that COVID-19 presents similarities and differences in the mechanisms that provoke seizures and fever in children.

Background: Uncontrolled status epilepticus (SE) causes damage to all organs, especially the brain. Although there are guidelines regarding the management of convulsive SE, the timing for administering first-line rescue medications (RMeds) remains unclear. Therefore, we analyzed patients with persistent SE lasting for >30 min, who visited the pediatric emergency department (pED), to determine clinical features and risk factors and provide directions for management on arrival to the pED. Methods: This study was conducted by retrospectively reviewing medical charts of patients aged 0–19 years diagnosed with SE and accompanying motor seizures, who visited the pED between January 2010 and December 2019. After arrival at the pED, patients were divided into two groups, namely ≥30 min (n = 12) and Results: Seizures lasting for 5 min, which was statistically significant; hence, more hospitalizations in the ICU were observed when RMed administration was delayed (p = 0.047). In acute symptomatic SE such as encephalitis, more than three doses of RMeds were needed to control seizures. Conclusions: Patients with convulsive SE should arrive at the pED as soon as possible and immediately receive RMeds after arrival at the pED for good outcomes.

Pyruvate dehydrogenase (PDH) deficiency is an inherited metabolic disorder caused by a defect in any subunit of the pyruvate dehydrogenase complex (PDHC), which has an essential role in glucose metabolism. The causes of disease progression in PDH deficiency are not fully understood yet. Based on repeated observations of a patient with PDH deficiency at our center, we hypothesized that stress-induced gluconeogenesis contributes to rapid exacerbation of the disease. This link has not been established previously.