Infusion dead space is the internal volume of a catheter and tubing through which a fluid must pass before reaching a patient's intravenous space. It is a factor in time to delivery for intravenous administration and can be significant, depending on the volume and rate of infusion. A 10-kg infant was simulated, receiving an epinephrine infusion with a concentration of 20 mcg/mL at a rate of 0.1 mcg/kg/min, which equals 3 mL/h. Commonly used pediatric intravenous equipment was selected. The tubing was flushed with a dyed solution. The setup was connected to 24-and 22-gauge catheters, with and without extension tubing. Each configuration was tested by allowing the intravenous solution to drip onto chromatography paper until color could be seen. The time from the start of the infusion to the visualization of dye was recorded 10 times for each configuration. The average time was 88 seconds for a 24-gauge catheter and 439 seconds with extension tubing added. For the 22-gauge catheter, the average time was 98 seconds and 431 seconds with extension tubing. Though often considered inconsequential, infusion dead space can cause significant delays in drug administration, especially in small patients and with slow, concentrated infusions. When appropriate, clinicians should consider bolus administration of critical medication before starting an infusion.

excluded. Each article was classified by journal type, study design (prospective noninterventional, retrospective, randomized control trial, study specific methods), results (positive or negative/equivocal), age/type of subjects (pediatric only, pediatric and adult, medical providers), major topic (based on headings from Fleisher and Ludwig's Textbook of Pediatric Emergency Medicine) and subtopic (based on the primary outcome measure). Publishing trends were determined by date of publication (stratified to the 2004-2008 or 2009-2013 time period).Results: A total of 464 PEM articles were analyzed; 38% from pediatric journals, 34% EM, 5% GM, 3% PEM. When stratified by date of publication, 202 articles were published 2004-2008 and 262 in 2009-2013. The majority of included articles were described as randomized controlled trials (47%), with positive findings (70%), including only pediatric patients (68%), with a major topic classified as trauma (35%). The most common subtopics for all included articles were pain management, asthma, sedation, bronchiolitis, resuscitation, simulation, and ultrasound. The total number of included articles published increased between the two publication time periods for all journal types with the exception of GM (P ¼ .04). There was an increase in the total number of included articles between the two publication time periods for all study designs except for randomized controlled trial (P ¼ .01). There were no differences determined between the two publication time periods when stratified by results, age/ type of subjects, and major topic.Conclusion: We have identified trends in the publication of PEM articles between 2004 and 2013. By identifying these trends, we hope to encourage researchers to focus on performing studies in the field of PEM where deficiencies lie, to promote collaboration between EM departments and PEM divisions, both nationally and internationally, and to educate health care professionals who care for ill and injured infants and children as to where published, evidence-based PEM studies can be found in the literature.