PEMBlog

FEBRUARY 10, 2025

Ketamine is an amazing drug for procedural sedation in the Emergency Department. Kids also look wild when they’re on it – some people call that look the “K-Hole.” Imagine a creepy industrial metal song about that… go ahead… I’ll wait. Lyrics Welcome to the K hole Now you’re deep inside Not responding to stimuli But your eyes are open wide We can reduce your fracture straight no pain without a wait side effects include emesis laryngospasm, agitation

Fractures 52

Fractures Emergency Department 52

PEMBlog

FEBRUARY 3, 2025

Maybe this is true for you too, but I always remembered what the X-Ray findings for Slipped Capital Femoral Epiphysis are by imagine a scoop of ice cream falling off a cone. Just search for an image online. You’ll see what I mean. Also this needs Orthopedic intervention within 24 hours. Lyrics [Verse] The ice cream fell off the cone today A year of leg pain, now my left hip gave way Orthopedic surgery is booked for tomorrow Never seen hip X-Rays bring one kid such sorrow [Chorus] I got me

52

52

PEMBlog

JANUARY 27, 2025

Slapped cheek rash? It’s Parvovirus B19 causing erythema infectiosum, aka fifth disease. the characteristic rash shows up after the fever, malaise, aches and GI symptoms. Also, remember it can cause fetal anemia, non-immune fetal hydrops and fetal death if a pregnant person is infected. Also bees don’t carry it. Lyrics Erythema infectiosum Fever, aches, malaise its true Initial constitutional symptoms Sometimes puke and diarrhea too Once viremia time is gone Those cheeks are rosy red

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

JANUARY 21, 2025

The concurrent circulation of influenza, respiratory syncytial virus (RSV), COVID-19, and norovirus during peak viral seasons presents a diagnostic challenge in pediatric emergency settings. Differentiating these pathogens based on clinical presentation is crucial for targeted management, minimizing unnecessary diagnostic tests, and optimizing healthcare resources.

Rapid Diagnostic Testing 52

Rapid Diagnostic Testing Pediatrics Dehydration Outcomes 52

PEMBlog

JANUARY 20, 2025

Migraines are terrible. In the Emergency Department the “Migraine Cocktail” successfully treats 90+ percent of patients. Prochlorperazine and Toradol to the rescue! Also, it’s hard to make an AI Radiohead inspired song. Lyrics throbbing headache on one side floating zig zags eye to eye lights and sounds irritate Nausea, triptan? is it too late [Chorus] headache worsens treatment time Prochlorperazine plus toradol and you’ll be fine sip a cocktail through your vein preferr

Emergency Department 52

Emergency Department 52

PEMBlog

JANUARY 16, 2025

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , we explore the complex and often underrecognized issue of inhalant misuse. From the early days of glue sniffing to the recent rise of nitrous oxide misuse, fueled by brands like Galaxy Gas and viral trends on TikTok and Instagram, inhalant misuse has evolved into a growing concern among adolescents.

Pediatrics 52

Pediatrics Poisoning Wellness Burns 52

PEMBlog

JANUARY 14, 2025

Here in early 2025 we are seeing a norovirus outbreak in the United States. That’s a lot of vomiting and diarrhea. I wanted to share my podcast episode on norovirus that is only 7 minutes and 13 seconds long! If you listen at 1.5x speed – I know there are those of you out there – that’s only 4 minutes and 49 seconds. If you listen at 2x you’re a sicko… You can find PEM Currents: The Pediatric Emergency Medicine Podcast wherever you listen and subscribe to podc

Pediatrics 52

Pediatrics Infectious Diseases 52

PEMBlog

JANUARY 13, 2025

Appendicitis! Rock Opera! McBurney’s point! Epic! Lyrics [Chorus] So Appy to see you Said the Surgeon to the doc Take out that appendix while I’m on the clock [Verse] Pain was vague then moved last night In the quadrant lower right Vomit and some hopping pain A fever now, can you explain? McBurney’s point and rebound Next step is an ultrasound Call the surgeon, call them quick Appendicitis made him sick [Chorus} So Appy to see you Said the Surgeon to the doc Take out that appen

Ultrasounds 52

Ultrasounds 52

PEMBlog

JANUARY 6, 2025

Sexually transmitted infections are extremely popular. This is a bad thing. We should test for them in patients with and without symptoms and have a treatment plan as well. Also ska is fine. Not great. Fine… Lyrics Drippy, drip, and painful pee Are you thinking STD? Chlamydia and GC Trichomonas certainly Dont forget syphilis the great pretender Remember this!

Wellness 52

Wellness Infectious Diseases 52

PEMBlog

DECEMBER 30, 2024

Guess who’s back? Back again. Epi Pen. Jab a friend. Give that EpiPen even if you think it might possibly be anaphylaxis! Lyrics His palms are sweaty, knees weak, arms are heavy, He’s allergic, it’s anaphylaxis already. He’s chokin’, his throat’s closin’, hives all over, IgE mediated, peanut exposure Mucosa swollen, he’s gaspin’ for breath, Heart poundin’ like a drum, he’s scared to death. multi system reaction, puking and wheezin

Anaphylaxis 52

Anaphylaxis 52

PEMBlog

DECEMBER 23, 2024

The Emergency Department never closes – not even on Christmas Day. This song reminds us all that the ED is always open, and that we are there for our patients during the holidays. But we still miss our families… Lyrics When Ive got to work on Christmas Ill tell you what Ill do I will treat all sorts of problems Cough and cold and strep and flu Ill unwrap a diagnosis With a test or three I will splint a buckle fracture like I trim a tree If your child is sick on Christmas We will neve

Fractures 52

Fractures Emergency Department 52

PEMBlog

DECEMBER 16, 2024

Urgent Cares are awesome places to receive effective efficient care. they can also be busy. Maybe a female power-pop-punk-alternative band can help celebrate the achievements of our Urgent Care clinicians. Lyrics We just told you that its just a virus Even though diagnosis did not inspire us It doesnt mean that your childs not ill Or the diagnosis needed no skill Its okay that we just reassure And tell you simply what you have in store Youre doing a great job with oral hydration And saline aided

Urgent Care 52

Urgent Care Dehydration Operations 52

PEMBlog

DECEMBER 9, 2024

Pertussis AKA whooping cough is on the rise due to declining vaccination rates. The initial catarrhal phase has mild symptoms but is super contagious. Then you cough like forever. Lyrics [Chorus] cough cough cough hack Whoop! uh huh uh huh uh huh cough cough cough hack Whoop! uh huh uh huh uh huh cough cough cough hack [Verse] Pertussis made a comeback rapid spread, why the setback?

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

DECEMBER 4, 2024

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , we explore pertussis, also known as whooping cough – a disease that remains a public health challenge despite widespread vaccination efforts. We will review the clinical presentation, diagnostic strategies, management protocols, infection control practices, and vaccination updates.

Pediatrics 52

Pediatrics PPE Wellness Infectious Diseases 52

PEMBlog

DECEMBER 2, 2024

The Rome IV criteria are how you diagnose constipation. Also X-Rays don’t help. And “The Red Hot Chili Poopers” would be a great name for a tribute band. Lyrics Can’t poop, no stool in about three weeks Walk slow cause now I think my butt leaks I strain and try but I can’t go – no My bowel transit rate is so slow Bristol One is all that I can do I hurts so much when I try to go poo [chorus] Constipation!

52

52

PEMBlog

NOVEMBER 25, 2024

The Kocher criteria can help you rule out a septic hip. Transient Synovitis is a much better diagnosis. It used to be called Toxic Synovitis, but that name was too scary so it got changed. Lyrics In a kid with hip pain I’ve got to explain The Kocher criteria And using your brain Cannot bear weight A fever complaint White count 12K ESR 40 today I’ve they’ve got all four The hips septic for sure But if they have none Then show them the door Note: CRP of >2.5 can replace ESR>40, but it was

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

NOVEMBER 21, 2024

I am excited to share the recording of the AAP Section on Emergency Medicine Fall Virtual Education Session , originally held on Tuesday, November 19, 2024 focused on delivering timely and actionable feedback, along with strategies to develop and implement sustainable feedback programs. PEM educators shared their experiences and provided practical strategies to strengthen evaluation processes and initiatives in this multidisciplinary, interactive session.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department 52

PEMBlog

NOVEMBER 18, 2024

You don’t need to send comprehensive viral tests in the majority of children with cough and congestion. Just make a clinical diagnosis dang it! Lyrics Adeno, rhino, entero too swabbing a nose just for something to do RSV, HSV, EBV, no! Save all that money and let the kid go Influenza, COVID, why not some more? Big viral panels? Show them the door!

Infectious Diseases 52

Infectious Diseases 52

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

52

52

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!

52

52

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?

52

52

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

52

52

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