Briefs: Ultrasound Prep 101
In order to get the best possible ultrasound you'll want to have your patient ready, either with an empty stomach or a full bladder.
2017 PEMPix Online Case #2: Big Circle
Though the PEMPix presentation is scheduled for Saturday 9/16/17 at the AAP NCE in Chicago there were so many great cases this year that I decided to share three of them online prior to the conference. This is the second case "Big Circle." All three cases will also be available at PEMPix.com.
Reading facial X-Rays
Here are some thoughts on the utility of facial X-Rays and a link to a good review.
AAP 2016 Top 10 #4: Clinical judgment vs PECARN Clinical prediction rule in TBI
The 4th article in the AAP NCE top 10 of 2016 is a secondary analysis of that PECAN TBI paper everyone has been talking about.
You don’t need an X-Ray to diagnose constipation! (Re-post)
Go ahead and diagnose constipation based on your history and physical exam. Don't order an X-Ray if you don't need one. Read on for more in this PEMBlog exposé.
Is parental report of “child acting abnormally” as the only symptom worrisome for TBI?
Children with closed head injury who are reported as acting abnormally by their guardian, with no other concerning findings are low risk for clinically important TBI.
To scan or not to scan – Part two: Answers and a summary of literature
If you recall from my previous post we were considering when to get a head CT on a pediatric patient with a closed head injury, and specifically how to approach this with the family. In general I find that its best to be honest and discuss the criteria outlined in the Kuppermann article (you know the one). It investigated risk of [...]
To scan or not to scan – Three scenarios to ponder
I ended up seeing three patients, all of whom presented by smacking their heads on hard surfaces. I've changed their names and ages to protect the innocent, and to avoid the wrath of Hungry Hungry HIPAA. 10 year old after a bike accident The first patient was a school aged male whose bike failed him, and whose helmet was hanging [...]
Why we do what we do: Ultrasound for appendicitis
Why we do what we do has returned - this time focusing on the use of ultrasound in appendicitis, which has become the test de rigeur these days in most Pediatric Emergency Departments. I won't belabor the point on how important it is to correctly diagnose appendicitis. It peaks between ages 9-12, and can lead to perforation within 36-72 hours. Missed [...]
Isolated loss of consciousness and risk for clinically important traumatic brain injury
Continuing onward with the top ten articles presented at the recent AAP NCE in San Diego is yet another secondary analysis of the original PECARN study on clinically important TBI (ciTBI). This time looking at children with isolated loss of consciousness (LOC). The outcomes were ciTBI which resulted in death, neurosurgery, intubation for >24 hours, or hospitalization for ≥2 nights and a comparison [...]
