0:01

This is the emergency medical

0:03

minute sponsored by mile

0:05

high ambulance. It

0:11

is still group season. Dr. Miller just discharged

0:13

a group patient. Did anybody take care of

0:15

that patient? Yes. What

0:17

did we do for our group patient? We're C.

0:19

McEppy. Ooh, we're C. McEppy. Okay. And

0:22

Dictiron and Motrin. Okay. Those

0:24

are good treatments. Anything else you guys sometimes do

0:26

for your group patients or recommend

0:28

to the parents for group patients? Take

0:33

them outside. Okay. I know. We

0:36

always say that, right? Yeah. Throw

0:38

them in the snow. I'm adding that

0:40

to my interventions. Okay. So

0:43

just as a reminder, group is a viral

0:45

respiratory illness that we see most commonly in

0:47

the summer. Some studies say it's up

0:49

to 5% of total pediatric

0:52

visits to emergency departments, which seems like a

0:54

lot. It primarily affects young kids,

0:56

so kind of six months to three years old. Although

0:58

it can be older all the way up to 10

1:00

years old. I myself have treated my

1:02

very own son in room nine in the middle of

1:05

the night for group here when I was working overnights.

1:08

So we do often tell parents

1:10

to throw their children in the

1:12

snow or otherwise expose them to cold.

1:14

But this, it falls into the tradition

1:16

handed down, sort of like putting mayonnaise

1:18

on burns, right? Something

1:21

that had never really been studied.

1:24

So I love this study, which was in

1:26

the Journal of Pediatrics in 2023. It

1:29

was a single pediatric emergency department in

1:32

Switzerland where the average temperature

1:34

during the fall and winter seasons

1:36

was less than 50 degrees. And

1:39

so they took all of their group patients and they

1:41

randomized them. So any child that presented

1:43

with group during the appropriate season, if

1:46

they had, there's a Wesley group score

1:48

that they scored them on. If

1:50

they had at least a score of two, they got

1:52

randomized. So on arrival, they got 0.6 milligrams

1:54

per kilogram of Decadron, which is very

1:56

similar to what we did. That's probably

1:59

the same dose. range that your patient

2:01

got. And then they were randomized

2:03

to either go outside or to

2:05

stay inside. So the average temperature

2:07

inside the ED was 70 something,

2:10

like 71, oh no, 77 degrees. That's

2:13

a very warm emergency department. And

2:16

then the average temperature outside had to be less

2:18

than 50 degrees. And the kids were wrapped in

2:20

warm blankets, taken with their parents, and they had

2:22

to stay for at least 30 minutes outside of

2:24

the ED. There was no specification

2:26

about throwing them in the snow. And then they

2:28

came back to the emergency department and they assessed

2:31

them. So they were able to find 118

2:33

children to do this. Over

2:35

the couple of years, there were more boys than

2:37

girls. And how do you think they did? They

2:40

did great. Kids who went outside did great. So

2:43

they looked at a decreased score

2:45

of greater than two on their

2:47

group scoring scale. And

2:49

for the two groups, the numbers were 49%

2:53

for the outside group reduction in their group

2:56

score, and 23% for the indoor group. The

2:59

interesting thing was these differences went away by

3:01

about 60 minutes. So they felt that

3:04

either by that time, the steroids had time to kick in,

3:06

or it was just kind of a temporary

3:08

effect of the cold air exposure. But

3:11

this is pretty solid scientific evidence that we

3:13

can make a difference by telling parents to

3:15

take their kids outside in the cold. Probably

3:17

has to be less than 50 degrees, like

3:19

in this study. So if you're looking to

3:21

publish and become famous, I would say the

3:23

next two things you can study are the

3:25

steamy showers for little kids, because no one

3:27

studied that one, or the mayonnaise for burns.

3:30

All right? So hopefully we won't have

3:32

any group kids today, but if we do, we're

3:35

prepared. We'd like to thank

3:37

our sponsor, Health One Continental Division and

3:39

Swedish Medical Center for their financial contributions

3:41

to the EMM. Donations

3:43

from them and listeners like you make

3:45

it possible for us to fulfill our

3:48

mission of producing and spreading free medical

3:50

education to the masses. If

3:52

you enjoy our show, please consider making

3:54

a one-time or reoccurring donation to

3:56

help cover our operational costs. And

3:59

keep doing that. the EMM Awesome.

4:01

Click on the link in our share notes to make a donation. Thank

4:04

you for listening.