Ted Brenkert sticks his neck out to educate you on retropharyngeal abscesses. RPAs can be an especially worrisome diagnosis in young children who will present with fever, sore throat and limitation of neck movement. Check it out here iTunes and streaming live via SoundCloud
I recommend this article to anyone who cares for children in their practice - specifically anyone who will interpret CSF results. In 2007 the Pediatric Emergency Medicine Collaborative Research Committee (PECARN) published the following article in JAMA. Link The authors noted that few children who end of being admitted to the hospital on antibiotics with CSF pleocytosis actually have bacterial meningitis [...]
A 14 year old male presents with a very sore throat and fever. The symptoms have been present for 4 days. His PMD saw him 2 days ago and performed a rapid strep test, and it was negative. Since then he has gotten worse and it is hard for him to open his mouth fully. Per his mother it sounds [...]
Variation in Emergency Department Diagnostic Testing and Disposition Outcomes in Pneumonia Florin et al. Pediatrics August, 2013 This study is a retrospective cohort of children aged 2 months to 18 years seen in the ED with a diagnosis of community acquired pneumonia. The data came from 36 hospitals via a large database (Pediatric Health Information System). Outcomes included: Diagnostic testing [...]
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 [...]
Keeping it short and simple this week folks. Here is a presentation on back pain in the pediatric ED. Just scroll vertically through the slides. You can even download it if you want. Spoiler alert! I will actually be giving this talk live tomorrow at the Cincinnati Children's resident lectures. Back Pain in the Pediatric ED
In many ways the management of sicker patients with suspected croup is more straightforward. Give them steroids early, let the patient protect their own airway and use inhaled racemic epinephrine. But what about the larger majority of kids that you might see in the ED (usually between 10PM and 4AM) who now have a barky cough and that's it. Sure, [...]
A mom brings her six year old son into the ED with concerns of fever and rash. She is concerned that he caught his sister's pneumonia - and that he is super uncomfortable because of his sunburn. On exam he looks OK, and has a fever of 38.7 C. His vitals, aside from a HR of 110 BPM are not [...]
You are seeing a 2 year old boy with a high fever who is irritable and refuses to look up. His parents think he has a sore throat. You are appropriately worried about a retropharyngeal cellulitis/abscess and obtain the following X-Ray. Widened prevertebral soft tissue space consistent with a retropharyngeal cellulitis/abscess Fortunately he is adequately protecting his airway. [...]
Recently I have seen a few preschoolers with true vertigo - one even told me that it felt like he just "spinned on a baseball bat." For those of you without a clear mental image of what he meant check out this video. Both had a history of recent URI symptoms, and ultimately we diagnosed one with acute otitis media and the [...]
