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 [...]
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 [...]
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 [...]
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 [...]
Minor TBI and vomiting alone? Should we be worried?
Next up from the top ten articles presented at the recent AAP NCE in San Diego is a secondary analysis from the PECARN head injury study published in Lancet in 2009. I'm sure that most have you have seen a child who hit their head with vomiting [...]
What are you waiting for? Send that kid with intussusception home
Back into the fray once more we go - or should I say back into the colon goes the ileum... Yes, the third article in the top 10 from the 2014 AAP NCE focuses on intussusception. Back when I was an intern™ after a child [...]