If you recall from my previous post we were considering when to get a head CT on a pediatric patient with a closed head injury, and specifically how to approach this with the family. In general I find that its best to be honest and discuss the criteria outlined in the Kuppermann article (you know the one). It investigated risk of [...]
I ended up seeing three patients, all of whom presented by smacking their heads on hard surfaces. I've changed their names and ages to protect the innocent, and to avoid the wrath of Hungry Hungry HIPAA. 10 year old after a bike accident The first patient was a school aged male whose bike failed him, and whose helmet was hanging [...]
Tonsillectomy is one of the most common procedures performed in children. Post op hemorrhage is either primary (within 24 hours) or secondary/delayed ≥24 hours. Primary hemorrhage is more rare and is seen in 0.2-2% of cases. Secondary hemorrhage is a bit more common, especially in the Emergency Department as kids have been home for several days. rates vary, but estimates settle [...]
This excellent article comes courtesy of Cincinnati Children's Hospital Medical Center senior resident Landon Krantz, MD - who performed a thorough literature review and wrote a concise, informative review of the titular technique. Subcutaneous abscesses are a common presenting problem in pediatric emergency rooms, and incision and drainage remains the gold standard of treatment. A new technique that is picking [...]
This episode of PEM Currents tackles a bread and butter issue in Pediatric Emergency Medicine, the newborn with fever. I discuss management, specifically how it differs for babies under 28 days of age as well as when to get labs and how to interpret them. I also reference procalcitonin, and touch on its emerging role. Read more here. You can [...]
Allow me to propose a new holiday - July 1st is now Medical New Year's Day. Yes, it's true that many training programs start before July 1st with orientation - or even clinical work as is the case where I work, but nevertheless, July is a time for new beginnings, whether for new interns, fellows or medical students. With this changing [...]
The next video in the Art of Medicine series focuses on how to talk with parents about simple febrile seizures. These can be incredibly scary, but fortunately the prognosis is almost uniformly great. Let me know what other topics you'd like to see in this series.
This post will just scratch the surface in its exploration of the diagnosis and management of corneal abrasions. What is the best technique for getting the fluorescin into the eye? First of all, please don't jab the patient's eye with the fluorescin strip itself. You can actually cause a corneal abrasion that way. In the past I would drip the [...]
This post was written by Meredith Posner Shuch, a senior resident at Cincinnati Children's Hospital Medical Center as a component of the Emergency Department Procedure Elective. Digital nerve blocks provide anesthesia for many procedures in the ED, including finger lacerations, paronychia drainage, finger reductions, and nail bed repairs [1]. Most of us are familiar with the traditional digital nerve block [...]
This past Friday night I was honored to accept the Division Teaching Award for Emergency Medicine on behalf of my colleagues. Every year the residents at Cincinnati Children's Hospital Medical Center vote and single out one division for excellence in teaching. It has been an absolute pleasure working with the graduating residents over these past few years. I will miss their [...]
