Intranasal dexmedetomidine is a versatile and safe sedative, offering “cooperative” sedation ideal for non-painful procedures. Its effects start within 7 to 15 minutes and last up to 30 minutes. Minimal side effects make it preferable to benzodiazepines. Doses of 1-2 mcg/kg are effective for minimal sedation, especially in imaging and minor laceration repairs.
Dog bites are unfortunately common in the Emergency Department. Remembering which ones to suture for cosmetic concerns while assuring we reduce the risk of infections is important. Also, most should get antibiotics. Which one? Dogmentin! (It's a portmanteau of Dog and Augmentin)...
If you are a pediatric resident in a large hospital you may end of replacing more dislodged G-tubes than performing lumbar punctures. Seriously. Learn about the procedure in this post.
Is there any evidence to suggest that J-Tip can replace or supplement injected lidocaine for local anesthesia during infant LP? Read on!
Peritonsillar Abscesses are the most common deep neck infection in adolescents and young adults. You will see them in grade schoolers as well. Learn about the diagnosis and management, including making the choice between needle aspiration versus wielding a scalpel for incision and drainage.
Tongue lacerations are surprisingly common in the Emergency Department. Fortunately most of them don't require any specific interventions. You just let them go and they heal on their own. Really. But if you do have to repair I offer advice in this brief podcast episode.
The Pediatric Education and Advocacy Kit (PEAK) Pain podcast series consists of 5 episodes that all focus on different aspects of assessing, managing, and supporting the pediatric patient in pain. This series was coproduced by the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) and features episodes from 5 of the leading podcasters in Pediatric Emergency Medicine.
Laceration repair is one of the quintessential procedures that children undergo in Emergency Departments. Minimizing pain and anxiety for children is a much better idea than just holding them down and getting it done. This episode will teach you all about local anesthetics, when to use anxiolytics and procedural sedations s well as the considerable value of nonpharmacologic intervention - including Child Life Specialists.
Becky Platt and the folks from Don't Forget the Bubbles bring you a tremendous (yet succinct) blog post on removing foreign bodies from the external ear canal. Detailed are techniques such as the parent's kiss, tissue adhesive, irrigation and more! The best part? They've included videos!
What’s the best maneuver for reducing a dislocated shoulder? My guess is as good as yours. There are multiple maneuvers that work - and work well for anterior (AKA anterior-inferior) dislocations. This episode reviews how to manage shoulder dislocations in the Pediatric population.