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New Bottom Line Recommendations: Urinary Tract Information

A urinary tract infection (UTI) is among the most common serious bacterial infections seen in infants and children. UTI with fever indicates an upper tract infection/pyelonephritis, as opposed to afebrile cystitis. It is important to diagnose and empirically treat febrile UTIs in infants and children, as delayed treatment may increase the risk of bacteremia. There are a number of risk factors a...

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New Bottom Line Recommendation: Fever in Young Infants

Neonates and young infants with fever account for a significant number of emergency department visits. Most of these infants have self-limited viral illnesses, however up to 10-13% of febrile young infants have a serious bacterial infection. Our Bottom Line Recommendations (BLR) for fever in young infants are now available in English and French! See our BLR for key facts and management reco...

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Brain Injury Awareness Month 2019

June is Brain Injury Awareness Month (BIAM)! BIAM is all about raising awareness about the prevalence of acquired brain injury, the impact on individuals and families, the ways we can make changes and do better, and how everyone can support a person in their community. Our evidence repository is full of resources for treating and managing pediatric concussion and severe head trauma in the ED. ...

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TREKK Board Announcement

On behalf of Dr. Terry Klassen, Network Director, Translating Emergency Knowledge for Kids (TREKK), we are pleased to announce that Dr. Douglas Sinclair took on the role of Chair, Board of Directors for the TREKK Network, starting January 2019.

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UPDATE: Asthma Pocket Card

It has come to our attention that there was a discrepancy in the PRAM score between the pocket card in our asthma Pediatric Packages (PedsPacs) and the algorithm poster. Please discard the asthma pocket card and refer to the algorithm. The asthma pocket card is being updated and will be available shortly. If you have downloaded the TREKK app, please make sure you have the most up-to-date res...

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Updated resource - Gastroenteritis Bottom Line Recommendations

Our Bottom Line Recommendations for gastroenteritis have recently gone through their two-year review and update. As a part of our resource development process, all of our TREKK resources are reviewed and updated based on the latest evidence every two years. Gastroenteritis is an infection of the bowel (intestines) caused by a virus or bacteria that can cause diarrhea and vomiting. It is ...

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Updated resource - Croup Bottom Line Recommendations

Our Bottom Line Recommendations for croup have recently gone through their two year review and update. As a part of our resource development process, all of our TREKK resources are reviewed and updated based on the latest evidence every two years. Croup is a common respiratory illness caused by a viral infection in the airway. Accompanied by a barky cough and respiratory distress, this i...

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CanadiEM blog: TREKK Series | Bronchiolitis

TREKK and CanadiEM have come together to translate the latest PEM guidelines on bronchiolitis.

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CanadiEM Blog: TREKK Series | Multisystem Trauma

TREKK and CanadiEM have come together to translate the latest guidelines in pediatric emergency medicine. The second post in this blog series is on multisystem trauma. Join Drs. Ashley Lubberdink, Kaif Pardhan & Sue Beno, as they translate the TREKK Bottom Line Recommendation and run through the case - a 10 year old boy brought into the Pediatric ED after he has been in a collision on an ATV. ...

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Building a connection: TREKK and NENA

June 2015 - Read the latest TREKK blog about connections made at this years NENA conference. Written by Manitoba Coordinator Laura Ebenspanger

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Crisis Interventions for Pediatric Mental Health Presentations in the Emergency Department

May 25, 2015 - This week's blog is contributed from the Cochrane Child Health Field and is about ED-based interventions for mental health presentations.

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Identifying kids at high risk for diabetic ketoacidosis

May 18, 2015 - This week's blog is contributed from the Cochrane Child Health Field and is about identifying kids at high risk for diabetic ketoacidosis.

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To CT, or not to CT? Clinical Decision Rules for Concussion

May 11, 2015 - This week's blog is contributed from the Cochrane Child Health Field and is about clinical decision rules for concussion.

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Crisis Interventions in the Emergency Department | Cochrane Child Health Twitter Journal Club – #CochraneChild

The #CochraneChild Twitter Journal Club on crisis interventions for pediatric mental health in the ED was hosted by Dr. Terry Klassen & Dr. Amanda Newton.

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Does a child's cough sound like a barking seal? Could be croup

May 4, 2015 - This week's blog is contributed from the Cochrane Child Health Field and is about managing croup.

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Evidence-Based Treatments for Acute Otitis Media

April 27, 2015 - This week's blog is contributed from the Cochrane Child Health Field and is about treating acute otitis media (middle ear infection).

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Making Medical Procedures Less Painful for Kids - Evidence for Clinicians

April 20, 2015 - This week's blog is contributed from the Cochrane Child Health Field and is about making medical procedures less painful.

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Treating Gastroenteritis: Evidence for Clinicians

April 13, 2015 - This week's blog is contributed from the Cochrane Child Health Field and is about treatments for gastroenteritis.

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Bicycle helmets – now that’s using your head!

April 6, 2015 - This week's blog is contributed from the Cochrane Child Health Field and is about bicycle helmet safety for children.

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Brain Awareness Week

March 11-17 is Brain Awareness Week (BAW)! BAW is the global campaign to increase public awareness of the progress and benefits of brain research. Concussion is “a traumatic brain injury, induced by biomechanical forces”. Concussion results from acceleration and deceleration forces which may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an 'impulsive' ...

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Canadian Anaphylaxis Action Plan for Kids

The Canadian Anaphylaxis Action Plan for Kids (Kids’ CAP) is a tool to educate children and caregivers about anaphylaxis. The main focus of this tool is to answer two questions: 1) How to recognize the symptoms of anaphylaxis; 2) What are the appropriate treatment steps of a child experiencing an anaphylactic reaction.

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New PedsPac!

We have a new Pediatric Pack (PedsPac) available: Diabetic Ketoacidosis is a complication of new or existing Type 1 Diabetes. Pediatric DKA may be complicated by cerebral edema and due to this risk, is treated differently than adult DKA. Health care providers must follow a published pediatric-specific protocol when treating pediatric DKA. Early communication with the diabetes specialist at y...

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Publication highlight: Creation of an Integrated Knowledge Translation Process to Improve Pediatric Emergency Care in Canada

Can an integrated KT process address an information gap in healthcare practice? Check out this TREKK publication describing the methods for developing and disseminating the TREKK Evidence Repository to improve pediatric emergency care in Canada. Learn more about our process here.

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New PedsPacs!

We have two new Pediatric Packs (PedsPacs) available online: Asthma is the most common chronic disease in children, and acute exacerbations of asthma are one of the most common reasons for children to seek emergency care and require urgent hospitalization. Our practical tools for severe asthma include a pocket card, management algorithm, pre-printed order set, and a transport checklist. View...

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Updated Resources - Revised PedsPacs

Our practical tools, Pediatric Packs (PedsPacs) have recently undergone minor revisions for consistency and formatting. The updated resources are listed below: Sepsis Status epilepticus Anaphylaxis These updates have only been applied to the English versions, the French updates are coming soon! Please ensure you have the most up-to-date versions of these resources – click the buttons b...

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Multicenter trial of a combination probiotic for children with gastroenteritis

Gastroenteritis accounts for approximately 1.7 million visits to the emergency department (ED) by children in the United States every year. Data to determine whether the use of probiotics improves outcomes in these children are lacking. Dr. Stephen Freedman from Pediatric Emergency Research Canada and TREKK content advisor for gastroenteritis led this fantastic multicenter trial looking at the ...

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VOTING NOW OPEN: Ear infection video for parents

Voting for the CIHR IHDCYH Talks Video Competition is now open! Check out this video, created in partnership with ECHO and ARCHE, which aims to help parents and caregivers help when their child has an ear infection. Log into either a YouTube or Gmail account and click "thumbs up" to vote for our entry. Click here to vote for and watch the video.

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UPDATE: Fever Bottom Line Recommendation

It has come to our attention that the ceftriaxone dosing on the Fever Bottom Line Recommendation is not clear and may cause confusion on the frequency of the dose. We have removed the resource from our website while we update it. It will be available again shortly. In the meantime, if you have downloaded a copy of the Fever Bottom Line Recommendation, please discard or refer to your local drug ...

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Updated sepsis algorithm

Our sepsis algorithm has a new look! We simplified the colour scheme of the algorithm to make it easier to read and follow. Click here to see the new design.

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New Bottom Line Recommendation: Anaphylaxis

Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Although fatalities are rare, anaphylaxis must always be considered a medical emergency requiring immediate treatment. Our Bottom Line Recommendation for pediatric anaphylaxis is here! Learn how to establish the diagnosis of anaphylaxis, as well as the risk factors for severe anaphylaxis and tips for mana...

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New Bottom Line Recommendation: Suspected Physical Child Maltreatment

Physical child maltreatment is any action by a caregiver resulting in or presenting a significant risk of physical harm to a child. Infants and toddlers are at the highest risk for death due to maltreatment. TREKK has developed a new Bottom Line Recommendation (BLR) to help healthcare providers better recognize and manage physical abuse in the ED. In addition to the BLR, Emergency Medicine C...

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New Evidence Repository: Urinary Tract Infections

We have a new evidence repository for urinary tract infections (UTI). A common diagnosis among infants and children, UTI can lead to renal scarring, hypertension and end stage renal disease (ESRD) if missed. Click here to see our resources for UTI, Bottom Line Recommendation coming soon!

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New Bottom Line Recommendation: Pain Treatment

We have a new Bottom Line Recommendation for the treatment and management of pediatric pain in the Emergency Department (ED)! Created by Drs. Samina Ali and Amy Drendel, the Bottom Line includes a pain scale to measure the child's pain and outlines the physical, psychological, and pharmacological ways to treat pain. Find the Bottom Line Recommendation here, now available in French and English!

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Updated Bottom Line Recommendations: Intussusception

Our Bottom Line Recommendation and Evidence Repository for intussusception have been updated as part of our two-year review process. Intussusception is the most common abdominal emergency of early childhood and is usually idiopathic. The vast majority of cases (80%) occur in children less than 2 years, with the most frequent age range being 5-10 months.

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Updated Bottom Line Recommendations: Concussion

Our Bottom Line Recommendation and Evidence Repository for pediatric concussion have been updated as part of our two-year review process. The updates include step-by-step strategies for returning back to school and physical activity, and a new Concussion Awareness Training Tool. See what's new here.

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Updated Bottom Line Recommendations: Concussion

Our Bottom Line Recommendations for pediatric concussion have been updated as part of our two-year review process. The updates include step-by-step strategies for returning back to school and physical activity, and a new Concussion Awareness Training Tool. See what's new here.

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New study: Do IV Fluids affect risk of Cerebral Edema in DKA?

A new study by Dr. Nathan Kupperman and the Pediatric Emergency Care Applied Research Network (PECARN) will change the standard of practice for the management of pediatric diabetic ketoacidosis (DKA). Through a randomized controlled trial across 13 centers, the study found that neither the rate of administration nor the sodium chloride content of IV fluids significantly influenced neurologic ou...

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Updated resources: Procedural Sedation Bottom Line Recommendation

To ensure our resources are up-to-date based on the latest evidence, we complete a two-year review for all of our Bottom Line Recommendations and our Evidence Repositories. The Bottom Line Recommendations for pediatric procedural sedation have recently been updated. See the new resources here.

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New Podcast: Pediatric Physical Abuse Recognition and Management

In this new EM Cases podcast Drs. Carmen Coombs (TREKK content advisor) and Alyson Holland discuss the recognition and management of child abuse in the ED

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Managing trauma patients in Community EDs

Check out this new whiteboard video on Trauma Care for Community Emergency Departments, created by the University of Toronto Trauma & ACS, Sunnybrook Hospital, SickKids, and St. Michael's Hospital. The video was primarily developed by Dr. Alun Ackery, Dr. Suzanne Beno, and Dr. Kealin Wong.

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Updated resources: Fractures Bottom Line Recommendations

As part of our two year review process, the Bottom Line Recommendations for pediatric fractures have been reviewed and updated based on the latest evidence. See the new Bottom Line Recommendations for fractures here.

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NENA Conference 2018

Experience emergency nursing education with nurses from across Canada. Registration for the 2018 National Emergency Nurses Association Conference is now open. Hosted at at the Delta Grand Okanagan Resort from April 20 to the 22, experience dynamic and engaging speakers during two and half days of learning, networking and playing.

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Rapid Review Series: DKA

In Emergency Medicine Cases new Rapid Review Video, get the key take home points from the original pediatric DKA podcast. Learning Objectives include: Review diagnostic pearls for DKA. Review definition and classification of DKA in pediatrics. Review general approach to pediatric DKA management. Watch the Rapid Review Video here.

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IWK implements TREKK sepsis PedsPac

Last week the IWK Health Centre in Halifax announced that they’re implementing the TREKK sepsis PedsPac in their ED. As sepsis is one of the leading causes of death in children worldwide, early recognition is critical. “It’s really important for people in the healthcare world to have early recognition of sepsis, so that we can save lives,” said Dr. Shannon MacPhee, the Chief of Pediatric Eme...

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Sick All Night - A storybook on gastroenteritis

Learn about Salima and Ali's experiences with gastroenteritis through an interactive story book, created in partnership with Evidence in Child Health to Enhance Outcomes (ECHO) & Alberta Research Centre for Health Evidence. Browse through the interactive gastroenteritis page for information on the signs, symptoms, treatment, and management of gastroenteritis and what to do if you are a parent ...

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New resources

Have you heard? We have some new resources available for you in the Evidence Repository. As part of our two year review process, the concussion Evidence Repository was updated. The Bottom Line Recommendation for concussion is also being updated and will be up soon. Check out the new resources for concussion here. We have also added a new Evidence Repository for constipation. Bottom Line Rec...

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Why should Canada invest in the emergency care for children:

Are we ready to commit nationally to emergency care for children? When a child is sick or injured, our health system usually delivers excellent care. That’s good news. Yet the adage that “children are not small adults” – and have specific medical needs – reflects the challenge still facing most Canadian emergency departments. Check out the TREKK opinion piece that was published in P...

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WHA and WHO Name Sepsis a Global Priority

On May 26, 2017, the World Health Assembly (WHA), the decision-making body of the World Health Organization (WHO) established Sepsis as a global priority. The executive Board of the WHO unanimously recommended the resolution adopted by the WHA to improve, prevent, diagnose, and manage sepsis through a series of measures directed at developed and developing countries around the world. This co...

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New Evidence Repositories

There are three new Evidence Repositories on trekk.ca. Check them out by clicking the links below

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Bronchiolitis Bottom Line: Two Year Review

As part of our process, we review our resources every two years and update them based on any new evidence. The two year review of our bronchiolitis bottom line is now complete. Dr. Amy Plint, the content adviser for bronchiolitis, is based at the Children's Hospital of Eastern Ontario and her research is focused on managing bronchiolitis and adverse events in the emergency department.

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Learning to Live With Chronic Pain

Know pain - know gain. Parents, check out this storybook on chronic pain in children and how to manage the daily challenges that come with chronic pain. The book was created through a collaboration of researchers from ECHO, Stollery Children's Hospital, and the Women and Children's Health Research Institute. You can read the book here.

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Dr. Terry Klassen on CTV Morning Live Winnipeg

On March 10th, our Network Director, Dr. Terry Klassen, was on CTV Morning Live talking about croup and the important work we are doing pediatric for emergency medicine.

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TREKK on Global Morning Live

Dr. Terry Klassen was on Global Morning Live in Winnipeg this week talking about TREKK and our current and upcoming parent tools. If you haven't seen the interview yet, watch it here.

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TREKK featured in WAVE Magazine

“Kids coming here are doing a lot better, and I think TREKK has a lot to do with that” - Dr. David Pontin, Clinical Director of the Emergency Department, Stanton Territorial Hospital, Yellowknife Last month we were featured in WAVE magazine! Check out the article here and read about how TREKK was started and how we're helping staff in the emergency department.

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New video tells parents what to do about croup

The Winnipeg Free Press recently featured our croup video, saying it should be on every parents' "must-watch list". Click here to watch the video, which talks about the symptoms and treatments of croup, including what you can do at home, and when you need to go to the emergency room. Read the article here.

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TREKK Needs Assessment publication in CJEM

The results from our Needs Assessment on health care professionals pediatric preferences in the emergency department have now been published in the Canadian Journal of Emergency Medicine (CJME). See the full publication here.

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Gastroenteritis video wins runner-up prize

We're happy to announce that our gastroenteritis video won second place in the Canadian Institutes of Health Research IHDCYH Video Talks contest. This is a team success, as we partnered with the Alberta Research Centre for Health Evidence (ARCHE) and Evidence in Child Health to enhance Outcomes (ECHO) to produce it. Congratulations to all involved.

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Bronchiolitis resources

Bronchiolitis season is in full effect. See our resources for managing and treating bronchiolitis here.

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Croup video

We have a new resource available for parents! Watch our new video about croup to learn about symptoms to watch for, ways to manage croup at home and when you need to seek medical attention. Please feel free to share the video with colleagues and parents. Watch the croup video here and check out our other parent tools here.

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Gastroenteritis video for parents

Vote now for our latest parent resource! We are thrilled to have supported ECHO and ARCHE on the creation of this whiteboard video called "My Child is Vomiting and Has Diarrhea." This tool is for parents to help them decide when to take their child to the emergency department with gastroenteritis.

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New Bottom Line Recommendation: Procedural Pain

Minimizing procedure-related pain should be a routine part of emergency department care for children. Our new Bottom Line Recommendation on procedural pain was produced by TREKK content advisors Dr. Samina Ali and Dr. Amy Drendel and is available here. French version coming soon!

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Knowledge Nudge: How does TREKK transform the latest evidence into useful tools?

We translate the latest evidence in pediatric emergency care into tools for healthcare professionals, patients and families. How? TREKK Knowledge Broker Leah Crockett breaks our process down into 7 steps. To read the full article on how we do it, click here.

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New Evidence Repository

Our new Evidence Repository is acute otitis media — a common, symptomatic infection of the middle ear. Bottom Line Recommendations are coming soon, thanks to our content adviser, Dr. Nicole Le Saux, from the Children's Hospital of Eastern Ontario.

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Outstanding Mentor Award

Congratulations to Dr. Amy Plint, TREKK content advisor for bronchiolitis and TREKK Board of Directors member, for winning the Outstanding Mentor Award from the Children's Hospital of Eastern Ontario Research Institute. Find out more about Dr. Plint's award here.

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New Bottom Line Recommendation: Asthma

Asthma is the most common chronic disease in children. Our new Bottom Line Recommendation on asthma is now available in English!

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Updated gastroenteritis bottom line recommendation

The TREKK gastroenteritis bottom line recommendations have undergone their 2 year review with content advisor Stephen Freedman and the TREKK Steering committee. See the updated recommendations here. The updated French translation will be available soon.

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New website helps parents manage common childhood illnesses and injuries

A new resource to help parents manage common childhood illnesses and injuries that don’t require emergency department (ED) treatment is available online. Created by a team of emergency doctors and clinicians from Alberta Children's Hospital and Stollery Children's Hospital, Health Education and Learning (HEAL) aims to provide families across Alberta with easily accessible, reliable information ...

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New topic: febrile status epilepticus

Read up on our latest topic, febrile status epilepticus. The new resources, compiled by TREKK content advisor Dr. Lawrence Richer, include bottom line recommendations, clinical guidelines, systematic reviews, systematic review summaries and key studies.

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Pain Assessment and Management Initiative (PAMI)

Pain Assessment and Management Initiative (PAMI) is an e-Learning and patient safety educational project aimed at improving the safety of patients of all ages by developing tools and learning modules for health care providers to recognize, assess, and manage acute and chronic pain in acute care settings.

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Mona Jabbour receives the Michel Weber Education Award

Congratulations to TREKK co-director, Dr. Mona Jabbour, who received the Michel Weber Education Award for her significant and positive impact on learners in child and youth health.

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Federal Government Renews Support for TREKK

TREKK renewed by the Government of Canada

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TREKK croup story book

New tools for parents and families: find out about Michael and his parents' experience with croup through an interactive story book.

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Dr. Kathy Boutis and Dr. Amy Plint with landmark study on ankle injuries

Is it a fracture or a sprain? Boutis and colleagues debunk common presumptive diagnosis of SH1DF in children with lateral ankle injuries.

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Useful tips for parents this holiday season

When to take your child to the ED and when to stay home? TREKK's Stephen Porter outlines helpful tips for parents this holiday season.

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EM Cases - Emergency management of pediatric seizures

Drs. Lawrence Richer and Angelo Mikrogianakis discuss the emergency management of pediatric seizures in this new podcast by EM Cases.

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Pediatric Respiratory Assessment Measure (PRAM) App

New App now available for iPhone and Android to facilitate the use of the PRAM tool for the assessment and management of acute asthma.

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TREKK e-update: November 13th 2015

Get up to date on new TREKK resources and upcoming blog topics. Read our latest e-update!

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New Resources on trekk.ca!

5 new evidence repositories and 1 bottom line recommendation now live on trekk.ca!

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TREKK 2014-2015 Annual Report Highlights

TREKK 2014-2015 Annual Report Highlights - now available!

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TREKK co-director earns Royal Society honours

Dr. Shannon Scott, TREKK co-director, inducted into Canada's oldest and most prestigious scholarly institute.

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TREKK featured on CTV Winnipeg

TREKK featured on CTV Winnipeg's monthly segment: Small Wonders

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New resources available on trekk.ca!

July 2015 - New resources are available on trekk.ca, including bottom line recommendations for procedural sedation (French), severe head trauma, and an evidence repository on thoracoabdominal trauma. Also, check out the new podcast by Dr. Samina Ali and Dr. Anthony Crocco on Pediatric Pain Management.

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New Resource - Bottom Line Recommendations for Procedural Sedation

June 2015- TREKK's bottom line recommendations for procedural sedation are now available on trekk.ca. Created by content advisors Dr. Lisa Evered & Dr. Maala Bhatt, this two page summary outlines key facts and recommendations for procedural sedation in children.

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Podcast: Emergency Medicine Cases and The Neonatal Lazy Feeder

June 2015 - Join Dr. Anthony Crocco as he discusses an approach to the neonatal lazy feeder and why we should abandon the use of codeine in pediatrics as well as in breastfeeding mothers on this episode of Emergency Medicine Cases - Best Case Ever.

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DKA Podcast on Emergency Medicine Cases

May 1st 2015 - Join TREKK content advisors Drs. Sarah Reid and Sarah Curtis as they discuss the treatment and management of pediatric diabetic ketoacidosis in the emergency department with Dr. Anton Helman and Emergency Medicine Cases.

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Dr. Marilyn Li Pediatric Emergency Medicine Leadership Award

June 2015 - Dr. Terry Klassen is this year's recipient of the inaugural Dr. Marilyn Li Pediatric Emergency Medicine Leadership Award from the Canadian Association of Emergency Physicians. Congratulations Dr. Klassen!

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CMAJ: Ultrasound or near-infrared vascular imaging to guide peripheral intravenous catheterization in children

May 2015: This months Canadian Medical Association Journal features TREKK meningitis content advisor Dr. Sarah Curtis and TREKK Director Dr. Terry Klassen and their study on ultrasound or near-infrared vascular imaging to guide peripheral intravenous catheterization in children.

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New! Multisystem Trauma Bottom Line Recommendations

April 7th, 2015 - bottom line recommendations for multisystem trauma are now available on trekk.ca

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Canadian Children Need Improved Pain Management in Emergency Departments

Young patients across the country are being undertreated for pain, according to a study by University of Alberta pediatrics researcher Dr. Samina Ali.

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Emergency Medicine Cases Bronchiolitis Podcast

February 2015- Check out the latest pediatric podcast on the treatment and management of bronchiolitis from Emergency Medicine Cases as well as a bonus mini-podcast with Dr. Amy Plint.

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French Bottom Line Recommendations

March 25th, 2015 - Bottom line recommendations for DKA, bronchiolitis and concussion are now available in French!

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New bottom line recommendations for concussion on trekk.ca

January 20, 2015 - Check out our newest bottom line recommendations for treating and managing pediatric concussion.

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Alberta Provincial Pediatric EnTeric Infection TEam - APPETITE

November 2014 - Led by Dr. Stephen Freedman, the APPETITE research team is receiving $5M from Alberta Innovates- Health Solutions to study severe intestinal infections.

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TREKK Talk - Pediatric Gastroenteritis with Dr. Stephen Freedman

Join TREKK content advisor Dr. Stephen Freedman, as he discusses the management and treatment of pediatric gastroenteritis in the emergency department.

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