It's no secret that youngsters like Instagram. For the unfamiliar, it is an "online mobile photo-sharing, video-sharing and social networking service that enables its users to take pictures and videos." The Division or Radiology at Cincinnati Children's Hospital Medical Center has set up an education-focused Instagram page with a plethora of great images and cases. Add it to the list [...]
Did you know that hospital waste an incredible number of IV fluid bags every year? One of the most significant occurrences of the aforementioned waste is in DKA, where frequent changes to the dextrose concentration are needed as the acidosis is corrected with an insulin infusion. Instead of changing to a new bag each time you want to alter the [...]
I finally met Sean Fox from Carolinas Medical center this summer. He runs a fantastic PEM focused blog called Pediatric EM Morsels. The goal of the site is to present bite sized topic reviews on a diverse array of topics that are always clinically relevant. I particularly enjoy the posts where he tackles commonly held myths - check these out [...]
There are many demands in the emergency department, some of which come from patients and their families. This post in the Art of Medicine series looks at those situations in which patients/parents are requesting - nay demanding specific tests. As I noted in a previous post in this series the ED is an emotionally charged environment. Often parents are seeking an answer as [...]
Geographic tongue is a common oral finding. It is AKA benign migratory glossitis and is seen in up to 1/30 of the human population. Females have it twice as often as males. It is thought that inheritance is polygenic. There is a slightly increased risk if the patient has psoriasis. Most are asymptomatic - though it may cause mild sensitivity to spicy foods. [...]
Certainly we've all taken care of of the patient with the chief complaint "possible seizure." Upon history and examination many of us will discover that the patient had syncope. So, the purpose of this post is to examine how we differentiate between convulsions in a epileptic seizure versus those that occur when a patient faints. Read on! What actually happens [...]
Don't swoon with excitement because the latest episode of PEM Currents, the Pediatric Emergency Medicine podcast is here! The focus is on convulsive syncope - essentially patients who faint and have movements that could be construed as seizures. You'll learn how common convulsions with syncope are and what to do if you encounter them in the Emergency Department. Check it [...]
Allow me to present a common clinical scenario. The patient presents with right lower quadrant abdominal pain. Appendicitis is in the differential diagnosis. After an appropriately thorough H&P you have ascertained that it is not gastro/UTI/strep/pneumonia/constipation/porphyria/pregnancy etc., etc,. and obtain an ultrasound which shows a normal appendix but reveals the presence on enlarged mesenteric lymph nodes. from Radiopaedia.org [...]
The Case An athlete presents to the ED with an injured pinky finger. He says that he struck it on a teammate during practice and "it bent back." The pinky finger is abducted and jutting out at an extreme angle. It is making dad nauseous. The XRay shows the following: Diagnosis This is a Salter-Harris II fracture of the proximal [...]
In the ED we certainly see a significant number of head injuries. There are an estimated 1.7 million per year in the US. Fortunately most of these are not associated with intracranial bleeding. However, that certainly does not mean that there aren't important diagnoses to consider. Concussions have gained increased attention over the past decade thanks in part to a growing [...]
