PEMBlog

NOVEMBER 11, 2024

Hypertrophic pyloric stenosis is such a down home diagnosis. You bring your baby home and then their weight goes down. Also the ultrasound measurements are a muscle wall greater than 3mm thick and a channel length greater than 14mm. 3 and 14 – 3.14, pi. Get it? Did you read this far? Lyrics [verse] Across the room The vomit goes It’s on the wall And my clothes Have a slice of pie – it’s on the menu Projectile emesis – does that offend you?

Ultrasounds 52

Ultrasounds 52

PEMBlog

NOVEMBER 4, 2024

Did you know that post tonsillectomy bleeding occurs approximately 3 to 5% of the time, most often at days 5 to 7 after the surgery? Of course you did. Unstable children with active bleeding may need a trip to the OR. Otherwise ENT can help determine management. Lyrics Nasty strep or OSA Take those tonsils out today Remove adenoids just in case Now there’s blood all over the place Post T&A bleeds frequently now you call ENT If active bleed resuscitate maybe operate on this date If not

Operations 52

Operations Resuscitation 52

PEMBlog

OCTOBER 31, 2024

Introduction Acute gastroenteritis affects millions of children in the U.S. every year, leading to emergency department visits and hospitalizations. Probiotics, particularly Lactobacillus rhamnosus GG (LGG), have been commonly used as a treatment, but evidence supporting their effectiveness has been limited. A new study conducted by the Pediatric Emergency Care Applied Research Network (PECARN) aimed to determine whether LGG could reduce the severity of gastroenteritis in children.

Outcomes 105

Outcomes Pediatrics Emergency Department Research 105

PEMBlog

OCTOBER 28, 2024

Night terrors are super scary. And the kid doesn’t even remember them! They’re more like sleep walking than nightmares and parents are often worried that it’s a seizure or something more serious. Lyrics [verse] Woke up late at night flailing and crying Couldn’t wake him up though the parents were trying Oh why the unstoppable fussing and screamin’ Could it be a seizure or possession by a demon?

Seizures 52

Seizures 52

PEMBlog

OCTOBER 21, 2024

Pinworms! Ahhhhh! They itch at night and they’re scary. Fortunately they are easy to treat and eradicate. They’re still gross. Lyrics [Intro] Pinworms makin me itch Pinworms son of a… WOAH! [Verse] Nocturnal anal pruritus Emergence of the white worm Even steadfast parents Are beginning to squirm But fret not and don’t cry There’s a treatment for you Pyrantel pamoate and repeat in two weeks That’s what we’ll do!

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

OCTOBER 18, 2024

Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. The condition affects multiple organ systems—muscular, cardiac, and respiratory—leading to a myriad of clinical complications. When patients with DMD present in the Emergency Department (ED), an understanding of the nuanced aspects of their care is essential for optimal management.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

PEMBlog

OCTOBER 14, 2024

Did you know that pancreatitis is mostly caused by viruses in kids? They don’t drink alcohol or get gallstones like grown ups. Also, scorpion bites apparently cause it. But that’s silly and only something you see in board review books. Anyway, this would be a better Broadway musical than most retreads of 1980s & 90s movies. Lyrics [Verse] Pancreatitis calls out my name The pain the intensity, I cannot explain My mom said I ate too many wings My dad told me to focus on more pleasa

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PEMBlog

OCTOBER 7, 2024

Children with Hemophilia who present to the ED need to get a dose of Factor First! Don’t delay and give their home factor if they have it. Lyrics Factor First! Factor First! Bleeding hemophiliac What’s the plan of attack? Factor first! Factor first! Factor VIII or Factor IX Use home factor everytime Factor first! Factor first! IV access nice and quick Hopefully one needle stick Factor first!

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PEMBlog

OCTOBER 2, 2024

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , I explore the complexities of gastroesophageal reflux (GER) and gastritis in children and adolescents. I’ll make the important distinction between gastritis – which is diagnosed only via endoscopy – and dyspepsia, the term best used to describe the symptoms many patients experience.

Pediatrics 52

Pediatrics Emergency Department Ultrasounds Wellness 52

PEMBlog

SEPTEMBER 30, 2024

Cannabis Hyperemesis Syndrome can make habitual smokers miserable! They will got some relief from hot showers – but many need fluids, ondansetron, topical capsaicin, and even Haldol. Lyrics [Chorus] Don’t fear the reefer? Cannabis hyper-emesis syndrome says you do Intractable vomiting, many hot showers What, oh what, will we do? [Verse] You didn’t think this would happen You just decided to smoke Now you’re puking your guts up Is this some sick kind of joke?

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PEMBlog

SEPTEMBER 26, 2024

EmergiQuiz is an annual case-based presentation sponsored by the AAP Section on Emergency Medicine that challenges the audience to think through the differential diagnosis for four amazing cases. Traditionally these cases are presented live at the AAP National Conference and Exhibition. Since 2020 the AAP Section on Emergency Medicine has also been sponsoring the publication of online cases on EmergiQuiz.com.

Wellness 52

Wellness 52

PEMBlog

SEPTEMBER 26, 2024

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the last of the four cases. This case was submitted by Dr.

Fractures 59

Fractures Pediatrics Wellness 59

PEMBlog

SEPTEMBER 25, 2024

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the third of the four cases. This case was submitted by Dr.

Pediatrics 52

Pediatrics Wellness 52

PEMBlog

SEPTEMBER 24, 2024

EmergiQuiz is an annual case-based presentation sponsored by the AAP Section on Emergency Medicine that challenges the audience to think through the differential diagnosis for four amazing cases. Traditionally these cases are presented live at the AAP National Conference and Exhibition. Since 2020 the AAP Section on Emergency Medicine has also been sponsoring the publication of online cases on EmergiQuiz.com.

Wellness 59

Wellness 59

PEMBlog

SEPTEMBER 24, 2024

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the second of the four cases. This case was submitted by Dr.

Pediatrics 52

Pediatrics Ultrasounds Hospitals Wellness 52

PEMBlog

SEPTEMBER 23, 2024

What if the Fab Four from Liverpool sang about Henoch-Schönlein purpura – AKA IgA vasculitis. Wouldn’t that be neat? Probably not. Anyway. Listen to this song, it’s fun. Lyrics H-S-P Palpable purpura and swelling of the knee protein in the pee hypertension is a thing that you might see If the urine and B-P are okay You can send them home to be seen on another day[chorus] H-S-P I-G-A vasculitis of the kidney know the rash, catch some pee, get a BP Lyrics [Verse] HSP Palpable pur

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PEMBlog

SEPTEMBER 23, 2024

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the first of the four cases. This case was submitted by Dr.

Pediatrics 59

Pediatrics Radiology Radiology Research 59

PEMBlog

SEPTEMBER 16, 2024

Acquired torticollis is a self limited spasm of the neck muscles – often he sternocleidomastoid – that responds well to ibuprofen, heat, and gentle massage and stretching exercises. I thought you’d appreciate the “wry” sense of humor in the album cover… You’d think I’d write a song about asthma and a child that’s a “Weezer?

Wellness 52

Wellness 52

PEMBlog

SEPTEMBER 9, 2024

Dewdrops on a rose petal describes the classic appearance of the lesions in varicella infections. Chicken pox is preventable by vaccines you know… Lyrics [Chorus] Dewdrops on a rose petal Vaccines test your mettle it’s chicken pox you silly fox! [Verse] prodrome fever, body hurts then the rash arrives in spurts Varicella’s itchy lesions most on trunk for some reason scabbing over, different stages once all crusted, not contagious [Chorus] Dewdrops on a rose petal Vaccines test

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

SEPTEMBER 2, 2024

In honor of the return of football season I decided to post this tune… Concussions are nothing to mess around about – and sometimes you don’t know you have one until a bit later. So a conservative plan involves resting until symptoms improve and following up with your doctor. No one knows if listening to “bro country” worsens symptoms.

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PEMBlog

AUGUST 26, 2024

Ondansetron is an antiemetic that reduces vomiting episodes in many illnesses. It also helps reduce the risk of IV fluids and admission in children with acute gastroenteritis. Also, AI images are weird and why did I end up with a picture of a Bruno mars look a like sitting on the toilet? Lyrics It might seem crazy what I’m ’bout to say Vomiting and diarrhea all throughout the day Norovirus from some jerk’s kid at daycare Dehydration is now on the way Yeah, he’s got gastro Crap all da

Dehydration 52

Dehydration Infectious Diseases 52

PEMBlog

AUGUST 20, 2024

This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals.

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CPR Resuscitation Pediatrics Hospitals 52

PEMBlog

AUGUST 19, 2024

Scabies is everywhere! It’s also very treatable with permethrin topically. It’s also important to remember that patients and families feel unclean and stigmatized by this common infection – but they shouldn’t! Also “Scabies for the Babies” will be stuck in your head. I promise… Lyrics [chorus] It’s scabies for the babies Woo hoo We got scabies for the babies Do you?

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

AUGUST 14, 2024

Intranasal dexmedetomidine is one of the latest sedative options that’s gaining traction, especially for non-painful procedures. Let’s take a closer look at what makes this medication so useful, particularly when given intranasally. What is Dexmedetomidine? Dexmedetomidine, often known by its brand name Precedex, is a fascinating medication. It’s a highly selective central alpha-2 agonist that’s able to induce a state of sedation that closely mimics natural sleep.

Pediatrics 59

Pediatrics Wellness 59

PEMBlog

AUGUST 12, 2024

If the Wu Tang clan produced a track about strep throat in children it might sought like this. Also ODB could be “Oropharyngeal Disease Bacteria.” Lyrics I’m at your throat like strep erythema, fever and exudate pain when I swallow It hurts and so can relate swollen lymph nodes in the neck belly pain headache and more stuff can you treat it?

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

AUGUST 9, 2024

Recently, I had the opportunity to present a morning report to the residents and medical students at Cincinnati Children’s, focusing on the topic of febrile seizures. The session was highly engaging, with a lot of interest from the audience, as febrile seizures are a common but often frightening experience for families. During the presentation, we covered a range of topics, including the definition and incidence of febrile seizures, their causes, and how to manage and counsel families when their

Seizures 105

Seizures Emergency Department 105

PEMBlog

AUGUST 5, 2024

Time is testicle! Acute scrotal pain must be evaluated promptly in the ED. You’ll see swelling, extreme pain, sidling testis, and absent cremaster reflex. You’ve got 4 to 6 hours at most to get the patient to surgery. Time is testicle! Also yacht rock. Lyrics [Verse] Pain started suddenly Testicle twists freely Side lying swollen now Cremaster gone, holy cow!

Ultrasounds 52

Ultrasounds 52

PEMBlog

JULY 29, 2024

Dog bites are unfortunately common in the Emergency Department. Remembering which ones to suture for cosmetic concerns while assuring we reduce the risk of infections is important. Also, most should get antibiotics. Which one? Dogmentin! (It’s a portmanteau of Dog and Augmentin)… Lyrics What you’re hearin’ is true, dog bites on the rise Take a big chunk outta hands face or thighs Animal safety prevention 101 cuddly puppies can still bring us fun But if kids are bitten we

Emergency Department 52

Emergency Department Infectious Diseases 52

PEMBlog

JULY 22, 2024

Bogus man! Kids can get kidney stones too. This alt-rock homage discusses imaging, pain control, and more. Lyrics Everyone knows that kidney stones cause so much pain colicky anguish radiation to the flank and symptoms all the same toradol is the first choice along with fluids if you’re a nice doc an ultrasound can show hydronephrosis if a stone’s blocked [chorus] kidney stones can happen in children think about the pain, the pee, the ultrasound if you feel me don’t forget to c

Ultrasounds 52

Ultrasounds 52

PEMBlog

JULY 15, 2024

Ovarian Torsion causes lots of pain and vomiting. If you want to get a transabdominal ultrasound you need a full bladder. Also Motown is cool. Lyrics It’s a fallopian twist of fate Pain and vomiting won’t abate You thought it was gas And that it would pass But now you hope it’s not too late Ultrasound of the belly Transabdominal needs jelly A full bladder as well Ovary’s deep in the well Blood flow I hope we will see [Chorus] Torsed again!

Ultrasounds 52

Ultrasounds Wellness 52

PEMBlog

JULY 10, 2024

Syphilis has gone by many nicknames over the years including “The Great Pretender” and “The Great Imitator.” Emily Labudde, MD, a Pediatric Emergency Medicine fellow at Children’s Healthcare of Atlanta and recent pediatric residency graduate from Cincinnati Children’s discusses the various manifestations of this sexually transmitted infection, and how we can’t miss this very treatable, but sneaky malady.

Pediatrics 52

Pediatrics CDC Seizures Emergency Department 52

PEMBlog

JULY 8, 2024

Dude! If you could remember the rockin’ drug sequence to for anti epileptics in the Emergency Department that would be totally awesome! Wait, there’s a hair metal song with lyrics to that effect? Rad! Lyrics [Chorus] Benzo, Benzo, second line Seizures stop in record time! [Verse] Seizures longer than five minutes straight Need medication to help them abate Lorazepam’s great if you have an I V I M drugs are fine too you’ll see [Chorus] Benzo, Benzo, second line Seizures st

Seizures 52

Seizures Emergency Department 52

PEMBlog

JULY 1, 2024

Heat Stroke is a serious medical diagnosis that can be differentiated from other forms of heat illness. If only there were a calypso song to teach you the main findings… Lyrics [Chorus] Hot, So Hot, It’s Heat Stroke Got to cool them down Hot, Hot with heat stroke You must cool them down [verse] Core Temp greater than 40 or 104 Dry hot skin and sweating no more Pinpoint pupils, Trouble breathing Bizarre behavior, confusion or seizing [Chorus] Hot, So Hot, It’s Heat!

Stroke 52

Stroke 52

PEMBlog

JUNE 24, 2024

It’s a new wave of information! RSV causes bronchiolitis. OK, so it’s not new. We can make a clinical diagnosis, and X-Rays are not necessary for most children with Bronchiolitis. Lyrics Wheezing and coughing subcostal retractions Nasal secretions suctioning action RSV causes the typical cases Worried looks on parental faces Usual course with typical findings Normal oxygen sats is a silver lining It’s bronchiolitis, diagnosis so easy There’s no need for X-Rays in a baby this wheezy H

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

JUNE 17, 2024

It used to be ALTE but now it’s BRUE. Brief Resolved Unexplained Event. It is a better name after all. And it makes for better puns. Lyrics Sudden brief resolved single episode baby’s under a year old Cyanosis pallor or breathing and tone change altered responsiveness and no way to explain[chorus] something’s brewing here Brief resolved unexplained event observation’s warranted for high risk infants How these videos were produced This song and video were created using Art

Resuscitation 52

Resuscitation 52

PEMBlog

JUNE 10, 2024

Supraventricular tachycardia is really fun to convert. You go do all kinds of vagal maneuvers which are basically heart games. Then there’s the REVERT maneuver – it works great! Search for it and learn it. Or watch this video. Lyrics S V T! A heart rate so fast as fast as can be S V T! EKG super fast rate with no p waves Q R S is narrow, that’s what you will see S V T!

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EKG/ECG Resuscitation 52

PEMBlog

JUNE 5, 2024

Cervical Spine Injuries are fortunately rare in children. this episode is all about learning when to suspect them, how to immobilize the C-spine properly, and which imaging test to choose. It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging in children.

Fractures 52

Fractures Pediatrics Radiology Radiology 52