Variation in Emergency Department Diagnostic Testing and Disposition Outcomes in Pneumonia Florin et al. Pediatrics August, 2013 This study is a retrospective cohort of children aged 2 months to 18 years seen in the ED with a diagnosis of community acquired pneumonia. The data came from 36 hospitals via a large database (Pediatric Health Information System). Outcomes included: Diagnostic testing [...]
I recently had a discussion with a group of colleagues after we saw our third nursemaid's of the night. They wanted to know whether or not I thought that one maneuver was better than the other. I explained that I had been taught flexion supination, but changed my ways after reading the following article. And yes, I realize that it [...]
I'm reviewing ACLS in preparation for recertification, and aside from it being a great review of stuff I'd pushed to the nether-regions of my mind, because well, adults... it reminded me that many of my pediatric colleagues see adults when they least expect it. An adult with chest pain may or may not have an MI. Reflexively that will lead [...]
Really straightforward one this week. I just wanted to share an interesting article from BMJ Quality & Safety. It turns out that just about 1 in 4 errors in ORs were caused by machines. In a review of multiple studies the authors noted that "failures of equipment/technology accounted for a median 23.5% (IQR 15.0%–34.1%) of total errors." Each procedure saw [...]
The latest edition of PEM Currents, the pediatric emergency medicine focused podcast is now available. This time the focus is on ketamine, which I learned is also called cat valium. You can check it out on iTunes via the following link. PEM Currents on iTunes Or listen right here via the magic of cloud based internet streaming! [...]
The Scenario It is gastro season. There is vomiting and diarrhea everywhere. Just after seeing your fifth patient with the aforementioned symptoms a colleague asks you about a patient that they recently saw with, you guessed it, vomiting and diarrhea. They noted that the patient only had mild dehydration and did a great job taking adequate oral fluids after some [...]
Seriously, I can never manage to remember the differences between Monteggia and Galeazzi fractures - especially when it shows up on standardized tests. So, this edition of Fracture Fridays focuses on differentiating the two. Essentially, when one forearm bone breaks and is displaced, angulated and foreshortened something happens to the other one - usually a fracture - but sometimes a [...]
A 3 year old male was jumping in his bed. He jumped one time too many and landed on his dresser, hitting his chin and biting his tongue in the process. He then ran downstairs and bloodied the carpet. Mom grabbed a towel sopped up some mouth blood, then scooped him up and threw him to the ED. On exam [...]
Check out the 2nd episode of PEM Currents featuring the dulcet tones of Ted Brenkert's voice. This episode is the companion piece to the recent Briefs on summer penile syndrome and it clocks in under 5 minutes! Enjoy it during your commute to work. Check it out on iTunes here
A 3 year old previously presents to the ED with the chief complaint of "purple donut coming out of his butt" - seriously. It happened after he was going to the potty. The parents are understandably freaked out, and the child initially appeared mildly uncomfortable - but now is acting normally. His past history is unremarkable aside from constipation. He strains to have [...]
