Welcome back to the Osteo series - Whereas part one focused mainly on etiology, part 2 delves into making the diagnosis with a good history and physical. I should really say that your history and physical helps increase your index of suspicion - since osteo can be quite elusive especially in the early stages. Harkening back to part one, it [...]
Thus begins the PEMBlog series on Osteomyelitis. In each edition I'll tackle a different question - ranging from diagnosis to therapy and hopefully review most of the finer points. There is no better place to begin than at the start. Osteo as it will now be known (because I don't feel like typing the myelitis part) is a bacterial infection [...]
If you were unable to attend the conference in Philadelphia this weekend, or you are interested in the use of technology in education check out a (slightly) abridged version of my talk that I recorded especially for the PEMBlog. In it I review: The web has evolved into a constant flow of information. The job of medical educators is to [...]
This edition of PEM Currents focuses on the use of antiemetics to treat status migrainosus in the Pediatric ED. Prochlorperazine and Metoclopramide are safe and effective agents with a low incidence of self limited side effects that when given in combination with ketorolac result in over 90% of patient being headache free at 3 hours. You can get it from [...]
Hematemesis in the newborn period can be alarming for parents and doctors. In this edition of Briefs we are going to look specifically at bloody emesis only in the neonatal period - age less than 4 weeks. Obviously the initial questions should focus on the quantity and character of the vomiting. Was it spontaneous? After feeds? Streaks of red versus [...]
Here is a summary of some of the high points from an excellent review on child abuse and patterns of injury. If you want to see more like this in real time you can always follow me on twitter @PEMTweets. [View the story "Summary of child abuse lecture live tweet" on Storify]
Here is a summary of clinical prediction models in pediatric community acquired pneumonia and the signs and symptoms most suggestive of pneumonia. The take home point is that there is such a wide variability that you should only test/treat if your clinical suspicion is high. All four of these articles are worth a look. Lynch et al. - Pediatrics 2004 [...]
Check out the Storify summary of today's pneumonia lecture [View the story "February 21st pneumonia live tweet" on Storify]
Perforation is more likely in younger kids because: 1. The appendix has a thinner wall 2. Younger children can’t communicate as well, resulting in prolonged symptoms before diagnosis 3. The level of suspicion for appendicitis is lower in younger age groups Pro-Tip: In addition, appendicitis can progress to peritonitis quicker in infants, because they have a less well developed omentum, [...]
Physicians aren’t great at differentiating bacterial versus viral conjunctivitis. Especially in kids this leads to the provision of antibiotics regardless of etiology. This post will discuss antibiotics agents and therapeutic considerations - including return to school/daycare. Whether you are a network anchor or 4 year old preschooler conjunctivitis will lead to some pretty disruptive symptoms. Neonatal conjunctivitis is another issue [...]
