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Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage. Detecting coagulopathy in pediatric patients with post-tonsillectomy hemorrhage. Int J Pediatr Otorhinolaryngol.

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Elbow Dislocations

RebelEM

Medial epicondyle fractures in the pediatric population. 2012 Apr;20(4):223-32. 2012 Feb 1;94(3):240-5. 2012 Apr 18;2012(4):CD007908. J Emerg Med. 2018 Jun;54(6):849-854. doi: 10.1016/j.jemermed.2018.02.011. 2018.02.011. Epub 2018 Apr 19. PMID: 29681420 Gottschalk HP, Eisner E, Hosalkar HS. J Am Acad Orthop Surg.

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ToxCard: Iron

EMDocs

Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Published 2012 Jul 1.

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Morel-Lavallée Lesion in Children

Pediatric EM Morsels

Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

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EM@3AM: Stercoral Colitis

EMDocs

Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation.

EMS 94
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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

A 2012 study on paediatric patients showed that approximately 42% were intubated without medications, and 2% were intubated with paralysis only in the ED. Awake fiberoptic intubation where the patient consents, co-operative AND the airway is prepared with local anaesthesia. What are the only exceptions? DOI: 10.1097/PEC.0b013e3182713316

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Don’t Forget the Orbeez!

Don't Forget the Bubbles

The liquids were chosen to “approximate a pediatric digestive environment.” Mirza and Sheikh reported perhaps the first unfortunate case in 2012. They passed away a few days after a second operation. In 2012, one brand of SAP beads – Water Balz – was recalled by the U.S. BMC Pediatrics , 20 , pp.1-5.