Pediatric EM Morsels

DECEMBER 20, 2024

Keep in mind, there can be extrapulmonary manifestations as well! Joint pain Hemolytic anemia due to the presence of IgM antibodies on RBCs causing autoimmune hemolysis Rarely neurological complications such as meningoencephalitis, seizures , transverse myelitis , GBS , and cerebellar ataxia. UpToDate , 1 Nov.

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CDC Seizures Pediatrics EMS 130

The Skeptics' Guide to EM

DECEMBER 15, 2018

Acetaminophen and febrile seizure recurrences during the same fever episode. Pediatrics. He specialises in Paediatric Emergency Medicine and is a passionate […] The post SGEM#239: Febrile Seizure Recurrence – With or Without You Acetaminophen? Acetaminophen and febrile seizure recurrences during the same fever episode.

Seizures 52

Seizures Pediatrics Emergency Department Outcomes 52

Pediatric EM Morsels

OCTOBER 6, 2023

Recently, a pediatric patient presented to the ED who just returned from abroad with a gastroenteritis presentation. In the US 95% of vaccine-eligible pediatric patients who travel are unvaccinated (McAteer 2021) Drug resistance has been developing over time. In addition to my passion for PEM, I also share a passion for global health.

Pediatrics 161

Pediatrics CDC Seizures Documentation/Coding 161

PEMBlog

SEPTEMBER 13, 2023

Team members and families eagerly await your intervention to halt the seizure and understand its underlying cause. This harm can manifest through the discomfort of blood draws and urine catheterizations, as well as the radiation exposure involved in head CT scans. This includes scarring abnormalities, bleeds, and tumors.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

Pediatric EM Morsels

AUGUST 18, 2023

Jackson 2016) A systematic review of safety data for over 16000 pediatric patients did show MAEs were the most frequently reported event. 451 pediatric patients were included. From 2001 to 2009, in a pediatric hospital gram negative culture showed a drop in sensitivity to ciprofloxacin from 96% to 93%.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

Don't Forget the Bubbles

JUNE 30, 2023

As in CRASH-2, TXA did not show a significant increase in thrombotic events or seizures. Well, one study in Kornelson’s systematic review and meta-analysis is interesting. But the evidence is a bit contrary – the systematic review and meta-analysis found no increased risk of seizures in the 14 included studies.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

Don't Forget the Bubbles

NOVEMBER 11, 2024

Therapeutic hypothermia is thought to decrease the brain’s metabolic demand, reduce inflammation and cell death, and reduce the risk of seizures. In contrast, Kochanek reviewed each meta-analysis, as well as the RCT and secondary analyses, separately to assess overall results and potential moderators of effect. Doi:10.4266/acc.2022.01291

Hyperthermia / Hypothermia 116

Hyperthermia / Hypothermia Outcomes Pediatrics Resuscitation 116

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Get up-to-date in the understanding and management of pediatric status epilepticus. Definition of status epilepticus:Continuous seizure activity of 5 minutes or greater – OR – Recurrent activity without recovery between intervals. This definition includes clinically apparent seizures as well as those seen only on EEG.)

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Pediatric EM Morsels

APRIL 7, 2023

There are many conditions that we would like to think belong only to the “ adult patient problem DDx; ” however, as we have discussed several times previously, pediatric patients can experience many “adult conditions” (see, Aortic Dissection , Kidney Stones , and Cholecystitis ). Expert Rev Hematol. doi: 10.1586/ehm.13.25.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

Taming the SRU

AUGUST 25, 2023

wrist in extension clavicle tibial pediatric forearm Most likely injuries to need an x-ray? bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

EMDocs

DECEMBER 6, 2024

Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). McGraw Hill; 2019.

Poisoning 76

Poisoning Fluid Resuscitation Seizures Resuscitation 76

Taming the SRU

JANUARY 12, 2024

pediatric small groups WITH our cchmc colleagues Dermatologic emergencies Children can present with a wide range of rashes, many of which are benign, however identifying concerning rashes is very important.

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

Taming the SRU

FEBRUARY 23, 2024

Total RBC count (<500 RBCs in last tube), as well as clearance by the last tube (decrease in RBC count by at least 70% by the last tube), can be used to differentiate between traumatic taps and a SAH. If assessing for SAH, xanthochromia may not appear until 12 hours after onset, though may appear after 2-4 hours.

Pediatrics 74

Pediatrics Ultrasounds Fractures Wellness 74

EMDocs

NOVEMBER 6, 2023

Because venoarterial extracorporeal membrane oxygenation implementation takes time, the process should be started early in patients who are not responding well to other therapies. Flumazenil administration is associated with harm in patients who are at increased risk for seizures or dysrhythmias. COR No Benefit, LOE C-EO.

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Poisoning Hyperthermia / Hypothermia Seizures Administration 94

EMDocs

NOVEMBER 19, 2024

1 Seizures may occur due to lowered seizure threshold. 1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. 6 Seizures have been observed and are dose-dependent.

Poisoning 90

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 90

The Skeptics' Guide to EM

NOVEMBER 18, 2017

We have covered fever before on the SGEM in pediatric patients. There was the great episode on pediatric fever fear with PedEM Super Hero Anthony Crocco ( SGEM#95 ). We also did a RANThony on pediatric fever fear that you can watch on YouTube. Will treating with antipyretics prevent a febrile seizure?

Sepsis 52

Sepsis Emergency Department Seizures Pediatrics 52

RebelEM

JULY 10, 2024

Fever in sickle cell is an emergency and always requires cultures and antibiotics even if the child appears well. Red flags in patients with headaches that may suggest a brain tumor include signs of increased intracranial pressure, focal neurological signs, seizures or ataxia. Red flags in patients with. Read more

Seizures 58

Seizures Administration EMS Wellness 58

ACEP Now

OCTOBER 3, 2023

Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. In a metropolitan area, pediatric patients with severe TBI should be transported directly to a pediatric trauma center if available.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Taming the SRU

DECEMBER 17, 2024

Out of 18 patients receiving ORT, 4 failed to respond well and were escalated to IV therapy. Hospitals can purchase ORT packets for use in EDs as well as giving patients the formula to make their own at home. A number of studies have compared the effects of ORT and IV rehydration therapy in infants and children with acute GI illness.

Dehydration 52

Dehydration Fluid Resuscitation Administration Resuscitation 52

PEMBlog

MARCH 27, 2024

My special guest podcaster, Emily Groopman, is an actual Pediatric Geneticist in training and we hope that you will find this episode useful. Pediatr Rev. Pediatrics. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

Taming the SRU

FEBRUARY 5, 2024

Several definitions have been set forth for this common injury, with perhaps the most well accepted definition being introduced by the Centers for Disease Control and World Health Organization. The history should focus on both the events surrounding the traumatic event, as well as current symptomatology. JAMA Pediatr.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

The Skeptics' Guide to EM

DECEMBER 7, 2019

Pediatrics 2019 Guest Skeptic: Dr. Katie Noorbakhsh is a pediatric emergency physician at the Children’s Hospital of Pittsburgh. This is an SGEM Xtra and it was inspired by the recent publication in Pediatrics on BRUEs. […] The post SGEM Xtra: Strange BRUE first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Seizures CPR Hospitals 52

ACEP Now

JUNE 14, 2024

And the Board approved a new clinical policy, “Critical Issues in the Management of Adult Patients Presenting to the ED with Seizures,” rescinding the 2014 clinical policy with same title. There were some ACEP business decisions at the April Board meeting, as well. 17-23, 2025 in Orlando, Florida.

Sexual Assault 52

Sexual Assault Seizures Documentation/Coding EMS 52

PEMBlog

SEPTEMBER 6, 2023

However, the vast majority of pediatric patients with psychiatric complaints do not present with undifferentiated acute psychosis; rather, they are seen for behavioral concerns or suicidal ideation. Decades ago, psychiatric complaints in the pediatric ED were infrequent. Acute onset psychosis is relatively rare.

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

Taming the SRU

MARCH 14, 2023

He appears well and is triaged to an ESI 4. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. The seizure abated with rectal diazepam given by the squad. You notice a med-alert bracelet with the patient’s name and the word “SEIZURES.”

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Pediatric Emergency Playbook

APRIL 1, 2016

Read on to go from bread-and-butter pediatric blood work to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids? This is especially true in children – the majority of pediatric ambulatory visits do not require blood work to make a decision about acute care. The punchline is, use a pediatric reference.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Pediatric Emergency Playbook

MAY 1, 2017

Pediatrics. Pediatrics. Home care The neonate who is safe to go home is well appearing, and not dehydrated. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. This will tell you: home or admission. Use the Bilitool or Bhutani Nomogram (below).

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

The Pediatric Assessment Triangle is a rapid, global assessment tool using only visual and auditory clues to make determinations on three key domains: appearance, work of breathing, and circulation to the skin. Pediatr Clin N Am. You have all of the skills you need to care for an acutely ill infant. 2006; 53:69-84.

Seizures 40

Seizures Sepsis Pediatrics Shock 40

Pediatric Education

APRIL 28, 2024

“I’m happy that she is continuing to progress and the physical therapist thinks she will do very well. JAMA Pediatr. Adv Pediatr. Adv Pediatr. D’Alessandro, MD Professor of Pediatrics, University of Iowa We’ll just have to see with time. 2017;171(9):897-907. doi:10.1001/jamapediatrics.2017.1689

Seizures 40

Seizures Pediatrics Dislocations Stroke 40

Pediatric Emergency Playbook

JUNE 1, 2017

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Pediatric Education

MARCH 3, 2024

The placenta doesn’t work very well causing problems for mom and baby. The baby doesn’t grow very well so that causes a host of problems including abnormal glucoses. In my experience, small babies don’t feed as well. Eclampsia is a severe complication of pre-eclampsia that has new onset seizures.

Wellness 40

Wellness Pediatrics Seizures Stroke 40

Taming the SRU

MAY 1, 2023

Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 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. Topics covered include: The pathophysiology of GER and GERD in the pediatric population. J Pediatr Gastroenterol Nutr. J Pediatr Gastroenterol Nutr.

Pediatrics 52

Pediatrics Emergency Department Ultrasounds Wellness 52

Taming the SRU

SEPTEMBER 1, 2023

Can also extend this logic to those with TBI’s or trauma patients are inebriated Can attempt try to mitigate the risk and harm associated with iWBCT’s Future use of low-dose iWBCT Full-body MR imaging is already being used in pediatric patients Logistic regression in REACT-2 patient population identified 10 characteristics to warrant iWBCT in patients (..)

Sepsis 95

Sepsis Documentation/Coding Fractures Administration 95

Taming the SRU

APRIL 17, 2023

The majority of ingestion cases occur in pediatric patients and are often minor due to low quantities of exposure. Thankfully, some of the more common and/or dangerous plant poisonings have been well-categorized, and are summarized below. Deadly Nightshade and Jimson Weed are well known among the poisonous plants. Decontaminate.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Anaphylaxis Pediatrics 52

Advanced Emergency Nursing from AENJ

MAY 14, 2017

" Some epileptic seizures will be heralded by a loud inspiratory "cri du epilepsie" as the diaphragm contracts in spasm and by the strong negative pressure against a partially closed larynx (in the form of a Müller maneuver or "reverse Valsalva maneuver") similar to that made by a partially-obstructing laryngospasm.

Dislocations 40

Dislocations Emergency Nursing Seizures Fractures 40

Don't Forget the Bubbles

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. Some families have unexplained deaths during sporting events, an unusual number of car accidents, seizures in someone without a formal diagnosis of epilepsy. On arrival at hospital the child was well with normal observations.

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EKG/ECG Hospitals Shock Documentation/Coding 98