In the Pediatric ED we encounter post-LP headache (PLPHA) less frequently than our colleagues who take care of grown ups. Nonetheless, it is an important topic to review. This post focuses specifically on caffeine, though before moving on to the not-quite Starbucks sponsored portion of the post it is a good idea to review PLPHA in general: The estimated incidence [...]
Many of treat migraines in the ED. I even discussed the use of Depakote recently. I figured for installment #2 of the WWDWWD series I'd take a step back and discuss the first line IV treatment for refractory migraines in the ED. Before I do that I wanted to make sure that I elaborated on the main goals of ED [...]
I've been regularly checking out the PEM Database Online for several years now. It is a good example of a hyper-focused content aggregation site. What do I mean by content aggregation? Well, in general on a website you either create content, share content that other people have produced - or both. The PEMBlog is an example of the latter. I [...]
Certainly you will be seeing some sicker children with bronchiolitis this winter who have issues with feeding. The copious nasal congestion and increased work of breathing may preclude adequate oral intake. Some of these children will merit admission and generally we obtain IV access for hydration. But why can't we use their gut via a nasogastric tube? Logically this makes sense - [...]
As a follow up to today's live demo at our morning lectures here is a lumbar puncture focused video that I recently uploaded to Vimeo.
I encourage you all to check out the topic review that was posted yesterday on Academic Life in Emergency Medicine. It focuses on the well trodden topic of when to get a head CT in a child with a head injury and offers a great summary of the available literature while providing a good discussion of the limitations. Check it [...]
Many a migraine headache is encountered in the ED. The evidence is reasonably clear that the antiemetics (prochlorperazine/metoclopramide - Compazine/Reglan) combined with ketorolac (Toradol) will treat >90% of patients effectively. What about those that don't respond and are still in (dramatic pause) status migrainosus. The intravenous dose is 15-20 mg/kg IV (max of 1 gram). It turns out that a [...]
This week on Tech Tuesdays I am delighted to present a post from a special guest author - Dr. Jeffrey Hill from the University of Cincinnati Department of Emergency Medicine. Jeffery Hill, MD I am a second year Education Fellow in the Department of Emergency Medicine at the University of Cincinnati, a position accepted after having completed my residency training [...]
People punch things. Sometimes they break their hands. This post is about those people.
A 12 year old male was chasing his friend through the backyard when he fell striking his face on an air conditioning unit. After cringing you learn that he did not lose consciousness and has not vomited. He also has a normal mental status. His main reason for coming to the ED to see you is related to his "two [...]
