PEM Currents, the Pediatric Emergency Medicine podcast returns today with an episode focusing on upper GI bleeds. Serious UGI bleeds - you know, the ones with shock, massive transfusions and more - are fortunately rare in the Pediatric Emergency Department. However, there is a growing population of patients with chronic diseases that can lead to portal hypertension, varies and other [...]
You'll see all sorts of things in the Emergency Department - sometimes the concern is related to the appearance of bodily fluids. You will, at one point or another, undoubtedly encounter parental concerns about the potential presence of blood in the diaper of a newborn. As you could imagine this is potentially scary. In the included image you will note [...]
This is not something that any of us wants to evaluate in the Emergency Department, but it is a necessary part of the job. First, look for suspicious or atypical bruises: A case control study of 95 PICU trauma patients under the age of 4 showed that: Bruises on the torso, ear, or neck for a child ≤4 years of [...]
This is the first video in the ongoing Art of Medicine series common . The goal is these videos is to share a demonstration of how I would talk to parents about common conditions encountered in the Emergency Department. I could think of no better topic than mild to moderate croup without stridor at erst. In less than 4 minutes you [...]
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. Technique Measure the systolic blood pressure at the ankle Place a blood pressure cuff [...]
The Case An 80 pound 12 year old soccer star tripped in a hole while challenging for the ball. Another player on the pitch stumbled in the same (big) hole and landed awkwardly on the first player's leg. Even the fans on the next field over heard the snap. EMS was called and an obviously uncomfortable 12 year old male [...]
Do you have 7 minutes and 22 seconds to learn more about endotracheal intubation? Of course your do! Watch this brief video I originally made for AAP's PediaLink educational portal that reviews the basic technique of direct laryngoscopy for endotracheal intubation. Edit: I am aware that in the video I flip-flopped the equations for cuffed and uncured [...]
In contrast to Emergency Departments in which the clientele are mostly grown ups, patients with chest pain in the Pediatric Emergency Department have mostly benign causes. I wanted to review some of the findings associated with benign causes of non traumatic chest pain. Tenderness to palpation of the chest wall In children tenderness of chest chest wall very much suggests [...]
This post originally appeared in a slightly different form on the excellent PEM Fellows Network Blog. Suppose that you are an attending, fellow or senior resident precepting in the ED and your shift has been going well. You supervised a first-time LP—only 2 RBCs (Chardonnay tap?)—and helped with a patellar reduction. With your fellow mojo at an all-time high the last thing [...]
In what has become an annual tradition and a way for me to avoid going to Hallmark I've made yet another anniversary video for my beautiful, amazing lovely wife Kerri.
