Many of us have seen a patient in the ED with a "stiff neck." Though parental concerns range from fears of meningitis (because they Googled...) to injuries, many cases are simply torticollis. Let's dive in - gently... What is it? AKA wry neck, torticollis refers to a condition whereby the neck is twisted laterally. The head is tilted to one [...]
There are many ways to repair a wound. Please use this table as a reference to help guide selection of materials and a guide for removal. *Consider use of Fast Absorbing Gut (5-0/6-0) on Ear, Eyelid, Eyebrow, Nose, Lip and Face if anticipated difficulty with suture removal (Note: follow up still required for wound evaluation) NOTE: If cartilage involved, strongly [...]
First of all, let's make one thing perfectly clear. ALTE is not a diagnosis, rather it is a chief complaint - an event that occurred because of something else preceding it. Most are insignificant in the long term health of the child, but the prevalence is 0.5 to 1%, which makes them common enough to merit a thorough history and [...]
Kids accidentally ingest medicines. In the Peds ED we are rightfully worried about opiates, BP meds, acetaminophen, and diabetes drugs (among many others) but we shouldn't overlook the potential dangers that come with iron ingestion. Let's take a look shall we? Why do humans need iron? Iron is a part of lots and lots of proteins and enzymes especially hemoglobin, [...]
This edition of Briefs focuses on CSF shunt malfunctions and infections. It is such a big (and important) topic in the pediatric ED that I thought it share all of what I've learned via a presentation. Enjoy!
I'm reviewing ACLS in preparation for recertification, and aside from it being a great review of stuff I'd pushed to the nether-regions of my mind, because well, adults... it reminded me that many of my pediatric colleagues see adults when they least expect it. An adult with chest pain may or may not have an MI. Reflexively that will lead [...]
The Scenario It is gastro season. There is vomiting and diarrhea everywhere. Just after seeing your fifth patient with the aforementioned symptoms a colleague asks you about a patient that they recently saw with, you guessed it, vomiting and diarrhea. They noted that the patient only had mild dehydration and did a great job taking adequate oral fluids after some [...]
A 3 year old male was jumping in his bed. He jumped one time too many and landed on his dresser, hitting his chin and biting his tongue in the process. He then ran downstairs and bloodied the carpet. Mom grabbed a towel sopped up some mouth blood, then scooped him up and threw him to the ED. On exam [...]
A 3 year old previously presents to the ED with the chief complaint of "purple donut coming out of his butt" - seriously. It happened after he was going to the potty. The parents are understandably freaked out, and the child initially appeared mildly uncomfortable - but now is acting normally. His past history is unremarkable aside from constipation. He strains to have [...]
The grammatical (in)correctness of the title aside, the 4th of July is marked by the use of fireworks by amateurs across the US. Fortunately the number of injuries had declined in recent years - until a spike was seen in 2011, when according to the National Fire Protection Association (NFPA) 9,600 fireworks-related injuries were treated in U.S. hospital emergency rooms. One quarter [...]
