Sorry that there's not been a new post this week - our third son was born and he requires some attention. Babies can be so selfish. Anyway, more great content coming soon - including: An in depth post on procalcitonin A podcast interview with Todd Florin, one of the Pediatric Emergency Medicine faculty at Cincinnati Children's Hospital Medical Center on [...]
So you've gone ahead and diagnosed supra ventricular tachycardia. While getting ready to place an IV and draw up adenosine somebody (a seasoned RN perhaps) suggests that you try vagal maneuvers. Perhaps you're feeling pessimistic that day, and wondering if they ever work. And, which one should you choose anyway? Let's answer both questions. How should vagal maneuvers be performed [...]
It's cold out and people are trying to warm themselves up by any means necessary. In the Emergency Department that means you may end up seeing some burns. It is important not only to assess these burns, but also determine what percentage of the body surface area is superficial versus partial AND full thickness. Wait a second... Aren't we supposed [...]
It goes without saying that a clinical prediction rule, and for that matter an associated online tool (one of which in particular we'll get to in a minute) is only as good as your initial clinical judgment and as practical as the environment in which you work. These types of rules also need to be grounded in solid methodology with [...]
If you're a regular reader of the blog you know that I've posted on migraines before. For instance, you can check out the "Why We Do What We Do" on antiemetics (prochlorperazine and metoclopramide). Other excellent Pediatric Emergency Medicine educators have posted on the topic recently as well - see Sean Fox's recent post on PedEMMorsels. I wanted to take [...]
Courtesy of Steven Chan, one of the excellent Pediatric Emergency Medicine fellows at CCHMC, are some highlights from a toxicology talk given to the residents on the ED rotation. Activated charcoal is part of decontamination, but it doesn't work well for drugs like Iron, and it should never be given to the obtunded patient. Remember to remove the clothes of the [...]
Over the past several weeks I posted brief reviews of the Top Ten Articles Presented at the 2014 AAP NCE in San Diego. You can check out links to all of the individual posts here, along with the main take home point for each article. [...]
If you had a Mount Rushmore of Emergency Department drugs fentanyl would make a pretty solid case for its inclusion. This synthetic opioid is roughly 100x more potent than morphine. The onset is rapid - two to three minutes. This is in contrast to morphine, which can take up to 20 minutes. The duration of action is relatively short - [...]
In conjunction with the PEMFellows.com Blog I've authored a post on what it means to be a Residency Rotation Director, a role that I inhabit at Cincinnati Children's Hospital Medical Center. At the risk of getting analogical, there are many hats in the haberdashery of a Clinical Educator. Many institutions specify that faculty do more than provide clinical care. Though [...]
And so it is with great lament and crocodile tears that we have reached the end of my series on the top ten articles presented at the recent AAP NCE in San Diego. It took me a bit of time to get there, but I think that the journey was worth it. Look for a compilation post in the near future. Links PubMed Pediatrics [...]
