Check out this brief lecture I recently gave on altered mental status. It reviews terminology, diagnosis and management and is designed as a broad overview to one of the most challenging issues to evaluate in the Pediatric Emergency Department.
Next up from the top ten articles presented at the recent AAP NCE in San Diego is a retrospective observational analysis from Freedman et al. on the increasing use of ondansetron and its effects on clinic outcomes in children. Certainly many of you have written for ondansetron. I have written about ondansetron; including a Why We Do What We Do focusing on the evidence behind [...]
I recently made some updates to my 8-part Bronchiolitis! series - specifically in the albuterol and racemic epinephrine posts. You can check out the entire series via the links below. I also highly recommend you read the AAP's Clinical Practice Guideline on bronchiolitis as well. The full pdf is FREE and available here Here are all eight posts in the [...]
Have you read my post on the exam based approach to the patient with a sore throat? Cool, you should also be using the Centor Criteria to help decide who needs to be tested for strep. These criteria can be used to assess the likelihood of bacterial infection in patients with a sore throat. It was studied in adult patients, [...]
First of all, the proper and effective treatment of a cutaneous abscess is ALWAYS incision and drainage. With that out of the way, let us address the more controversial question. Should a child be prescribed antibiotics after I&D? We'll look at the evidence as it stands then address the main question in a scenario-based approach. Certainly MRSA is the main [...]
The Differential Diagnosis for sore throat is quite long, though it is usually infectious. I will approach the approach that you should consider using when you approach the patient with a sore throat. I hope I don't face reproach for the gratuitous approach laden approach. Does the patient have respiratory distress? If the answer is yes to this one stop everything [...]
This edition of PEM Currents, the Pediatric Emergency Medicine podcast, reviews the safety and comparative efficacy of acetaminophen and ibuprofen. If you work in a Pediatric Emergency Department you'll certainly have broken a sweat over this hot debate time and time again. The main goal of this podcast is to help you discuss these medications more effectively with your patients and their [...]
This edition of PEMCurrents echoes the recent post here on the PEMBlog and reviews the use of ondansetron in acute gastroenteritis. Specifically highlighting the reduction in risk of further episodes of emesis, need for intravenous fluids and immediate admission to the hospital. No matter how you like to learn I aim to please. Check out the podcast via: iTunes Or, via the [...]
Uncomplicated urinary tract infections (your garden variety cystitis) is a common ED diagnosis. For most patients there is a wide variety of potentially effective treatment options. The purpose of this post is to caution you against the use of fluoroquinolones (like ciprofloxacin) to treat uncomplicated UTIs in children. Why is this the case? Well, fluoroquinolones are known to be one [...]
You may have noticed that many editions of PEM Currents align themselves closely with posts on the blog. This is by design! I want to make sure that I share the content in as many formats as possible in order to reach the widest audience. It goes without saying that recognizing osteomyelitis can be challenging. Treating it doesn’t have to be [...]
