In adults calculating the ankle-brachial index (ABI) is a relatively simple way to confirm the clinical suspicion of lower extremity arterial occlusive disease. In pediatric lower extremity limb injury patients where vascular compromise is a concern (think bad fractures, lawnmower calamities) it may also be a helpful test. [...]

By |2016-12-14T12:56:46-05:00May 19th, 2015|Procedures, Surgery, Trauma|

Absolute and relative contraindications for ketamine use in the Pediatric Emergency Department

Another informative post by Lauren Riney, one of the excellent Pediatric Emergency Medicine Fellows at Cincinnati Children's Hospital Medical Center.   When is ketamine ABSOLUTELY contraindicated? Age younger than 3 months (primarily for risk of airway complications) Schizophrenia (studies show this condition may be exacerbated with ketamine administration) The list of relative [...]

By |2016-12-14T12:56:47-05:00March 19th, 2015|Procedures|

Baby belly button bumps

Umbilical granulomas are often an incidental finding on physical exam, but can be the reason a patient presents to the ED. These fleshy pink masses represent incomplete epithelialization of tissue that persists after the cord separates. It has the honor of being the #1 belly [...]

By |2016-12-14T12:56:52-05:00June 27th, 2014|Procedures|


There are multiple topical anesthetics that we use in the ED. The common theme is that all of these drugs with -caine cause sodium channel inhibition in nerves, which blocks axonal transmission leading to the typical numbness and and localized weakness. I admit that it can [...]

By |2016-12-14T12:56:52-05:00June 24th, 2014|Procedures|
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