Check out this brief lecture I recently gave on altered mental status. It reviews terminology, diagnosis and management and is designed as a broad overview to one of the most challenging issues to evaluate in the Pediatric Emergency Department.
Next up from the top ten articles presented at the recent AAP NCE in San Diego is a retrospective observational analysis from Freedman et al. on the increasing use of ondansetron and its effects on clinic outcomes in children. Certainly many of you have written for ondansetron. I have written about ondansetron; including a Why We Do What We Do focusing on the evidence behind [...]
Adapted from Muir et al, Diabetes Care, 2004 here is a protocol/schema that can guide in the assessment of cerebral edema in DKA. Recall that the symptoms of cerebral edema vary, and it can be especially difficult to diagnose as findings will occur ahead of CT/MRi changes. One-half to 1% of patients in DKA have cerebral edema, the mortality of [...]
I recently made some updates to my 8-part Bronchiolitis! series - specifically in the albuterol and racemic epinephrine posts. You can check out the entire series via the links below. I also highly recommend you read the AAP's Clinical Practice Guideline on bronchiolitis as well. The full pdf is FREE and available here Here are all eight posts in the [...]
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 as their only symptom. The authors compared children with isolated vomiting versus those with vomiting [...]
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 was reduced with air contrast enema they were subsequently admitted for 24 hours to the [...]
There are numerous techniques that we can use to improve our likelihood of success in performing a lumbar puncture. There is one that has a bit of nuance to it that I thought would be an excellent theme for my latest Why We Do What We Do post. So, without further ado, let's talk about early stylet removal. I'm also [...]
We do some hand-on practice from time to time during our Pediatric Emergency Medicine education sessions. Today we discussed and practiced using the EZ-IO for interosseous needle insertion. For those of you who weren't able to be in chilly Cincinnati, OH here's a video that we put together a little while back.
Let's move on to the next in the series of top ten articles presented at the 2014 AAP NCE in San Diego. Again, I'll review the article and briefly and highlight how you can use the results in the ED. By now, most of us have acknowledged that ultrasound is a fantastic imaging modality for the diagnosis of acute appendicitis. It is not, however the [...]
When I said I would go into the top ten articles presented at the recent AAP NCE in San Diego I meant it. I plan to tackle each article and briefly review the results and try to drive home how this can impact your practice. First up, a steroid alternative for prednisone die-hards. I've you've been a PEMBlog reader for [...]
