Pediatric EM Morsels

JULY 19, 2024

Since tonsillectomy is one of the most common pediatric surgeries in the US (~500,000 per year) and the rate of post-tonsillectomy hemorrhage is about 1-5% , it is a good idea that we all are familiar with how to manage this issue! If bleeding, the only lab that is needed in the Emergency Department is a type and cross.

Airway Management 290

Airway Management Pediatrics Wellness Operations 290

EB Medicine

NOVEMBER 1, 2023

In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the November 2023 Pediatric Emergency Medicine Practice article, Pediatric Diabetes: Management of Acute Complications in the Emergency Department and some of the highlights from the other EB Medicine articles published in November.

Pediatrics 94

Pediatrics Point-of-Care Testing Urgent Care Emergency Department 94

Taming the SRU

DECEMBER 17, 2024

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. This has been particularly validated in pediatric literature; however, this can be applicable to the adult patient population within the right circumstances i.e Am J Emerg Med 2016;34(4):7136.

Dehydration 84

Dehydration Fluid Resuscitation Administration Resuscitation 84

ALiEM

NOVEMBER 17, 2023

A 4-year-old female with no significant past medical history is brought to the Emergency Department by her grandmother for concern for two days of progressive vaginal bleeding. Urethral prolapse is a rare condition occurring in prepubertal female pediatric patients. Laboratory Data Hemoglobin : 12.2

Pediatrics 100

Pediatrics Emergency Department Academics OB/GYN 100

Pediatric EM Morsels

JUNE 7, 2024

Lucky for us, in 2020 there were some updates made to the NIH Asthma Management Guidelines and we’re going to discuss which ones can help us in the Emergency Department! You’re probably asking yourself… is this really important for us in the Emergency Department to know? Front Pediatr. No more SABA ! 2018.00170.

Pediatrics 208

Pediatrics Emergency Department Wellness EMS 208

Pediatric EM Morsels

JUNE 2, 2023

Today we are talking about a rare disease called FPIES (food protein induced enterocolitis syndrome) and how you might encounter these patients in the Pediatric Emergency Department. Food protein-induced enterocolitis syndrome in a tertiary pediatric center: safety of guideline-conforming food challenges.

Dehydration 193

Dehydration Shock Pediatrics Emergency Department 193

Pediatric EM Morsels

MARCH 15, 2024

We encounter seizures commonly in the Emergency Department. Being comfortable evaluating and managing pediatric seizures also requires a lot of humility. World J Pediatr. The post Gelastic Seizures: No Laughing Matter appeared first on Pediatric EM Morsels. Vitamin B6 Deficiency ). 2023 Nov 8. Epub ahead of print.

Seizures 260

Seizures Pediatrics Psychiatric Emergency Department 260

ALiEM

AUGUST 9, 2023

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric lung ultrasound. Take the ALiEMU PEM POCUS: Pediatric Lung Ultrasound Quiz Module Goals List indications for performing a pediatric lung point-of-care ultrasound (POCUS). He was admitted to the pediatric intensive care unit. Balk et al.,

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Pediatric EM Morsels

NOVEMBER 17, 2023

A single cadaveric study from the 1950s showed that the pediatric subglottic space approximated a circular funnel with the narrowest portion at the cricoid level This study included only 15 children aged 4 months–14 years But why was this a problem? Front Pediatr. Acad Emerg Med. Acad Emerg Med. West J Emerg Med.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

ACEP Now

NOVEMBER 7, 2024

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. A 2020 study in the journal Pediatrics found that close to three in every five patients who sought mental health treatment at EDs were boarded. West J Emerg Med.

Psychiatric 59

Psychiatric Pediatrics Hospitals Emergency Department 59

Pediatric EM Morsels

AUGUST 23, 2024

Concussions are commonly encountered in the Emergency Department. The post Return to Learn / Return to Sport after Concussion appeared first on Pediatric EM Morsels. We have previously discussed an approach to the question of when a patient “ can return to sport.” Br J Sports Med. 2023 Jun;57(11):695-711.

Seizures 281

Seizures Pediatrics Academics Emergency Department 281

PEMBlog

MARCH 4, 2025

In this episode we dive into the resurgence of Mycoplasma pneumoniae an atypical bacterial cause of community-acquired pneumonia thats making waves in pediatric emergency medicine. Pediatr Emerg Care. For PEMCurrents, the Pediatric Emergency Medicine Podcast, this has been Brad Sobolewski. UpToDate , 1 Nov.

Pediatrics 94

Pediatrics Military CDC Hospitals 94

The Skeptics' Guide to EM

JUNE 1, 2024

2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC. Cochrane Database Syst Rev.

Pediatrics 88

Pediatrics EMS Emergency Department Research 88

Don't Forget the Bubbles

AUGUST 30, 2023

The parents of 9-month-old Josie bring her into the Emergency Department with coryzal symptoms and difficulty breathing. A secondary analysis of a nationwide study of Emergency Department attendance in America from 2006 to 2008 found that CXRs increase the average length of stay by 27 minutes. Am J Emerg Med.

Emergency Department 131

Emergency Department Pediatrics Infectious Diseases Research 131

ALiEM

JUNE 10, 2024

Similarly, the Pediatric Emergency Care Applied Research Network (PECARN) has developed robust tools for assessing blunt head trauma in children. However, until now, there has been a gap in guidance for clinicians managing pediatric patients at risk for cervical spine injuries. Case Scenario: What would you do?

Pediatrics 126

Pediatrics Emergency Department Research Fractures 126

EB Medicine

OCTOBER 21, 2024

In this episode, Sam Ashoo, MD and T.R.

Pediatrics 59

Pediatrics Elder Abuse Risk Management Emergency Department 59

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Int J Pediatr Otorhinolaryngol. Anesthetic management of the pediatric bleeding tonsil. and youre three hours from the nearest tertiary care center. Her vital signs are normal, except for a heart rate of 115 bpm.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

Don't Forget the Bubbles

SEPTEMBER 20, 2023

Do not obtain abdominal radiographs for suspected constipation The parents of 4-year-old Matthew bring him into the Emergency Department with abdominal pain. Functional constipation and nonspecific, generalized abdominal pain are common presenting complaints for children in emergency departments. 2020;12(3):e7283.

Pediatrics 133

Pediatrics Emergency Department Radiology Radiology 133

EMDocs

MARCH 1, 2025

1: High-Dose Inhaled Steroids for Acute Asthma Spoon Feed Nebulized high-dose inhaled corticosteroid plus a short acting beta-agonist reduced emergency department length of stay in adult asthma exacerbation. Acad Emerg Med. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: 2025 Jan 13. doi: 10.1111/acem.15084.

Emergency Department 69

Emergency Department Pediatrics Research 69

PEMBlog

SEPTEMBER 20, 2023

The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Kelly Levasseur, DO Children’s Hospital of Michigan Detroit, MI, USA docklevasseur@gmail.com Jennifer Thull-Freedman, MD Alberta Children’s Hospital Calgary, Alberta, Canada Jennifer.Thull-Freedman@albertahealthservices.ca

Pediatrics 123

Pediatrics Emergency Department Hospitals Ultrasounds 123

Don't Forget the Bubbles

SEPTEMBER 6, 2023

14-year-old Katy presents to the paediatric Emergency Department (ED), alone, complaining of suicidal ideation. A comparative analysis of pediatric mental health-related emergency department utilization in Montréal, Canada, before and during the COVID-19 pandemic. Hosp Pediatr. Pediatrics.

Psychiatric 119

Psychiatric Sexual Assault Emergency Department Pediatrics 119

ALiEM

MARCH 7, 2024

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric renal and bladder ultrasonography. Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1).

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

EB Medicine

APRIL 17, 2024

In this episode, Sam Ashoo, MD interviews Ashley A. Foster, MD, Bijan Ketabchi, MD, MPH and Jennifer A. Foster, MD, Bijan Ketabchi, MD, MPH and Jennifer A.

Emergency Department 106

Emergency Department Pediatrics 106

ALiEM

AUGUST 30, 2024

A 5-year-old female presented to the emergency department (ED) with a one-year history of gradually increasing anterior neck swelling. Case Question: What is in the differential diagnosis of a pediatric patient with an anterior neck mass? Pediatric neck masses. Pediatr Rev. Free T4 : 0.5 (ref doi: 10.1542/pir.34-3-115.

Pediatrics 64

Pediatrics Ultrasounds Academics Emergency Department 64

PEMBlog

JUNE 14, 2023

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. Leyenaar; Pediatric Mental Health Boarding. Pediatrics October 2020; 146 (4): e20201174. Zima; Follow-up After Pediatric Mental Health Emergency Visits. West J Emerg Med.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

The Skeptics' Guide to EM

JANUARY 20, 2024

JAMA Pediatr. JAMA Pediatr. Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences.

Pediatrics 75

Pediatrics Anaphylaxis Emergency Department Outcomes 75

PEMBlog

NOVEMBER 21, 2024

Michael “Fish” Fishman, MD, PEM – Fellow, Boston Children’s Utilizing Co-regulated Evaluations (CORE) to Optimize Feedback and Evaluations Explored success in implementing and maintaining a co-regulated evaluation system in the Emergency Department.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department 52

PEMBlog

JUNE 7, 2023

Other Episodes in the Agitation Series Episode 1: Differentiating organic versus psychiatric causes of agitation and altered mental status | Supplementary EMDocs article Episode 2: Non-pharmacologic management of agitated children | Supplementary EMDocs article Episode 3: Pharmacologic management of the agitated child | Supplementary EMDocs article (..)

Pediatrics 123

Pediatrics Psychiatric Emergency Department EMS 123

EB Medicine

MARCH 1, 2023

Announcements: The interactive Clinical Pathways have launched and they are available for free! — In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the February 2023 Pediatric Emergency Medicine Practice article on Pediatric Electrolyte Emergencies: Recognition and Management in the Emergency Department — History Point-of-care (..)

Pediatrics 52

Pediatrics Point-of-Care Testing Emergency Department 52

EMDocs

MAY 4, 2024

. #1: Emergent Cath Lab Activations with “Normal” Computer ECG Interpretations Spoon Feed A significant minority of code STEMI patients have an initial normal computer ECG interpretation. Consequently, emergency physicians must remain vigilant to identify signs of OMI regardless of the initial computer ECG interpretation. 14795. . #3:

Documentation/Coding 98

Documentation/Coding Stroke Emergency Department Pediatrics 98

EM Literature of Note

SEPTEMBER 13, 2024

These are each awful, of course, in their own way from a patient- and parent-oriented standpoint, but they’re also quite awful at the population level, overburdening limited pediatric and emergency department resources. RSV, in particular, is a vicious scourge of young and vulnerable infants.

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

Don't Forget the Bubbles

SEPTEMBER 13, 2023

The parents of 18-month-old Susie brought her to the Emergency Department after she had a seizure at home. Take home points References American Academy of Pediatrics, Subcommittee on Febrile Seizures. Pediatrics. J Trop Pediatr. Pediatr Rev. Pediatrics. Front Pediatr. Pediatrics.

Seizures 131

Seizures Pediatrics Emergency Department Radiology 131

Ultrasound Gel

MAY 11, 2020

This study looks at the implementation of a transcervical ultrasound protocol in a pediatric emergency department to see if it helps this population. This study looks at the implementation of a transcervical ultrasound protocol in a pediatric emergency department to see if it helps this population.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department 52

ACEP Now

OCTOBER 11, 2024

Introduction Pediatric intubations in the emergency department (ED) occur at only a tenth the frequency of adult intubations. 1 Pediatric rapid sequence intubation (RSI) in the ED is associated with a higher frequency of failed first attempts and adverse effects than in adult patients. mg/kg IV, ketamine at 1.5–2

Pediatrics 52

Pediatrics Airway Management Emergency Department Wellness 52

EB Medicine

JANUARY 3, 2023

See the summary here. In this episode, Sam Ashoo, MD, interviews Ara Festekjian, MD, one of the authors of the November 2022 Pediatric Emergency Medicine Practice article on Pediatric Septic Shock in the Emergency Department Introduction: How common is sepsis in kids and what is the mortality rate in the US?

Shock 52

Shock Pediatrics Airway Management Sepsis 52

ACEP Now

JUNE 7, 2023

The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding. Preliminary results of the survey are being released to help emergency physicians understand that current challenges are occurring nationwide.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

NOVEMBER 14, 2023

The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. While most academic EDs have lost pediatric volume, the UVA ED continues to see almost 20 percent pediatric patients. Pediatric patients go to their own zone.

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Academics Emergency Department Leadership Operations 52