Epinephrine is the most important drug in the management of anaphylaxis. It is so important because it saves lives! This is no hyperbole. This edition of the Why we do what we do series focuses on the evidence behind the use of IM Epi in Anaphylaxis. What are the indications? You should rapidly administer IM Epi for anyone with anaphylaxis. [...]
The latest video in the PEMBlog shorts series tackles the titular question. Just how often are certain signs and symptoms present in patients with anaphylaxis?
Sorry for the lack of updates - I've been on vacation this week. But I'll be back next week with new content all focusing on Anaphylaxis. Until then enjoy the dog days of summer (in the Northern Hemisphere at least).
Undoubtedly you will see a child with a "near drowning" if you work in the ED during the summer. Most children are fine, even those that received some back blows, mouth to mouth or some semblance of bystander rescue maneuvers. Asymptomatic children (no respiratory symptoms) can be safely discharged home. Those that are having difficulty breathing or other symptoms should [...]
I've recently shared posts on Loop abscess and drainage as well as on the utility and need for packing abscesses. I've concluded, for the time being, that it is likely appropriate to pack abscesses greater than 5cm. But, is there something other than stuffing a bunch of gauze in there that would do the trick as well? The answer, as [...]
When I was first taught how to drain an abscess I was taught to pack most with ¼ inch gauze. Initially it was iodoform gauze, later just plain old ribbon gauze. As with many things I felt like it worked and had no impetus to change. Recently, I began to reconsider based on a review of the literature and experience at [...]
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 [...]
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 [...]
Tonsillectomy is one of the most common procedures performed in children. Post op hemorrhage is either primary (within 24 hours) or secondary/delayed ≥24 hours. Primary hemorrhage is more rare and is seen in 0.2-2% of cases. Secondary hemorrhage is a bit more common, especially in the Emergency Department as kids have been home for several days. rates vary, but estimates settle [...]
This excellent article comes courtesy of Cincinnati Children's Hospital Medical Center senior resident Landon Krantz, MD - who performed a thorough literature review and wrote a concise, informative review of the titular technique. Subcutaneous abscesses are a common presenting problem in pediatric emergency rooms, and incision and drainage remains the gold standard of treatment. A new technique that is picking [...]
