The case A self-proclaimed dance team superstar presents after injuring her foot at a regional competition. She tried to finish the routine after landing awkwardly. But was having difficulty bearing weight. She applied ice overnight and despite ibuprofen is still in pain, and presents to the ED the next day.On her exam the neruovascular exam is normal, and she has pain along [...]
In many ways the management of sicker patients with suspected croup is more straightforward. Give them steroids early, let the patient protect their own airway and use inhaled racemic epinephrine. But what about the larger majority of kids that you might see in the ED (usually between 10PM and 4AM) who now have a barky cough and that's it. Sure, [...]
You may have noticed that there's no Fracture Fridays this week - well that's because I'm at PAS learning stuff, and preparing for my workshop from 8:30 to 11:30AM on Tuesday 5/7/13 at the Washington, DC Convention Center - Room 101. The focus is on the use of technology in education for millenial learners. You can learn more about me [...]
A reasonably terrified mom brings her 17 month old boy into the ED after an apparent seizure. She states that her older daughter took a piece of candy away from the toddler, and then her son started to cry, and then "turned blue" and fell to the ground. He had not eaten any candy yet, and did not appear to be [...]
Here is a (relatively recent) presentation that I gave for a group of Emergency Medicine residents on management of headaches in the the pediatric ED. The following questions were addressed: [list type="check"] Which patients need a head CT? When should I be worried about a tumor? How do I make a migraine headache better? [/list] The following question was not addressed: [...]
Sepsis is such a gigantic topic that one lousy post won't do it justice, so just like the bronchiolitis series from this winter I'll be posting a series on pediatric sepsis. Look for posts on management of shock, antibiotics, labs and more. Coming soon to a PEMBlog near you!
The case A 16 year old self-proclaimed track star was running the 400 meter sprint when he felt a pop at the bottom of his left buttock. He stopped running. He became mad. his mom became worried. He became your patient. This has never happened to him before because he states that he always stretches - a lot. On exam [...]
Though readily available, and the reference standard for diagnosing intraabdominal injuries (IAI) the radiation exposure from a CT is not benign - especially in children. Ultrasound in trauma (FAST) is a valuable tool - but moreso in adults as children may have physiologic free fluid and injuries that will not require surgery as compared to grown ups with similar findings. [...]
The case A 15 year old skateboarder totally screws up a rail grind. After posting his wipeout to YouTube his friends call his mom, who notices that he has been unable to walk on his ankle - probably because of how ridiculously swollen it is. A gnarly swollen ankle You get an XRay, because that's what you do... [...]
A mom brings her six year old son into the ED with concerns of fever and rash. She is concerned that he caught his sister's pneumonia - and that he is super uncomfortable because of his sunburn. On exam he looks OK, and has a fever of 38.7 C. His vitals, aside from a HR of 110 BPM are not [...]
