In children 10 years of age and under 90% of clavicle fractures occur in the middle third, 60 percent of which are nondisplaced. Above age 10, the majority are displaced (as is the case in adults). Immobilization with sling and swathe for 3-4 weeks is generally sufficient for most uncomplicated fractures in prepubertal children. An open fracture should be suspected [...]
I want to make sure I continue to deliver content that is valuable and timely. In support of that effort I plan to repurpose the BRIEFS to cover quick, high yield topics, and post a new one each Thursday. I'll include one article that I feel encapsulates the topic at hand and allows readers to delve deeper. [divider scroll_text=""] [frame src="http://people.duke.edu/~ema5/Golian/Slides/5/hematology5_files/Hem055.jpg" width="IMAGE_WIDTH" height="IMAGE_HEIGHT" [...]
Take a look at the following seven chest X-Rays. The accompanied history is super vague on purpose I swear. Post your answers in the comments. Enjoy! Toddler with tachypnea and upper respiratory infection School age child with fever and cough Child with sickle cell anemia and chest pain Teen that developed chest pain [...]
As a follow up to today's lectures at Cincinnati Children's here are links to both a video on bag mask ventilation and IO insertion. You never know when these skills might come in handy. Bag mask ventilation http://vimeo.com/57016752 [divider scroll_text=""] IO needle insertion using the EZ-IO http://vimeo.com/35338622
For those of you that have been following the blog over the past week you've been inundated with a series of posts on bronchiolitis - the most common lower respirator tract infection in infants - that just happens to be taking the country by storm. If you missed any part of the series you can check out the individual posts here. [...]
Alas, this is the final post in the bronchiolitis series. I hope you've enjoyed it. Parts I, II, III, IV, V, VI, and VII aren't going anywhere - so check them out if you haven't done so yet. This post will focus on the disposition of patients with bronchiolitis in the ED. Essentially, who do we feel comfortable sending home (and vice versa)? Let's take a [...]
Welcome back to the seemingly endless spew of bronchiolitis related content here on the PEM Blog. Check out editions I, II, III, IV, V, and VI if you'd like. Today we'll be focusing on additional modes of respiratory support in babies with bronchiolitis. So, without further ado let's get to it. Ask yourself the following questions before moving on. Do I use this therapy at my institution? If [...]
If you haven't read parts I, II, III, IV or V what are you waiting for? Today's post will focus on testing in bronchiolitis. And no, I won't be testing you... Let's get straight to the content. [divider scroll_text=""] Question: Do you need to get a chest X-Ray? Answer: No Consider the findings of Schuch et al in Pediatrics, 2007. [...]
Parts I through IV are in the books, so let's move onto another therapy that has been tossed around as a potential solution to bronchiolitis - Corticosteroids. In the early 'aughts many of you may have given steroids to bronchiolitics, but now you don't. Perhaps it will help if I frame things as A Tale of Three Studies. Disclaimer: Yes, I know that [...]
Parts I, II, and III are still there for those of you yet to dive in but now we turn our attention to a lesser used, but potentially valuable therapy in bronchiolitis. ED providers are already familiar with its use in the management of elevated intracranial pressure. What is it? Nebulized hypertonic (3%) saline of course. It is thought to increase [...]
