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Description
Trips and tricks for taking care of children in the Emergency Department
44 Episodes
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Contrary to what F. Scott Fitzgerald may have written, i think there are second acts in American life. While PEM education has been my passion for the last 7 years, I have made the hard decision to transition away from Academic Emergency medicine. So enjoy this short and sweet goodbye as I express my gratitude for all the people who made this podcast go over the last 3 years.
Stealing a bit from Bill Shakespeare, this is a daily and possibly the most important question we grapple with on a daily basis. But unlike, the Melancholy Dane the question we struggle with is the incredible diagnostic power or a CT vs. the possible downsides. This podcast aims to look at the CT question through the old standard- the lens of risks and benefits and hopefully will give you a framework for how to think about this famous question.
Y'all asked, I answered! Thanks to an email from across the boarder in Quebec.- I've tried to put together my thoughts on those pesky dots- i.e. what to do the next time you see a kid with petechia.
The dog days of summer are winding down, but there is still plenty of time to soak up some sun and spend some time in the water. But even a day at the beach can quickly turn tragic, as drowning (aka submersions injuries) can happen suddenly. Hopefully this review will give you some pointers about how to monitor, resuscitate and prognosticate the next time you get a pediatric submersion injury.
If you like the PEM content and lame dad jokes then here is your chance to see it in person! I have entered ACEPs drop the mic new speaker competition. Voting is open to all ACEP members and can be accessed here: https://ecme.acep.org/diweb/gateway/init/1/f/catalog*2Fitem*2Feid*2F900028So if you like what you hear and see (in this case) take some time and vote Joe. Hope to see y'all in Philly in October.
There have been several reports over the last few years of increasing pediatric Group A Strep (Strep Pyogenes) infections. While most these are localized infections the mortality of invasive Strep will keep even the most seasoned doctor up at night. Hope you enjoy this quick primer on Strep its presentations and treatment.
How many times in pediatrics do we say "it's just a virus" and "testing wont change our management". For the most part this is true, but how do we navigate this in a post covid world and are there scenarios where knowing what virus it is may actually help?
We have all had the anxious feeling of a lump in the throat. But what if our anxious lump comes from seeing a pediatric patient with an actual lump. Hopefully this podcast will help demystify those pesky three letter neck infections and give you a framework to get to the right diagnosis and treatment.
PECARN head trauma guidelines are as close as it comes to dogma in pediatric emergency medicine. We all know and love them, but what about certain populations where the rules don't apply. Tune in, and we review some of the latest and greatest literature for those situations that PECARN doesn't cover.
At first, Lyme disease can seem daunting- there are myriad clinical syndromes and patients can even be minimally symptomatic or asymptomatic. In areas with high prevalence of the causative agent, Borrelia Burgdorferi, which is found in deer ticks, providers are typically accustomed to recognizing the symptoms particularly in the warmer months. However, with climate change, a more interconnected world, and long incubation periods- Lyme may be coming to an area near you! As such, providers in all areas should be familiar with some of the more common syndromes, which diagnostic tests are available, and how to appropriately treat and disposition patients from the emergency department. The aim of this podcast is not to make you Lyme expert but give you key points for diagnostic dilemmas.
Thanks to people who get concussions for a living, like boxers or NFL players, we know a lot more about the long-term effects of hits to the head than we did 30 years ago. Given this explosion of research and tons of good, bad, and ugly information available to patients and families, what are the best evidence-based recommendations for the next time you see a pediatric patient who has a concussion.
We have all had the experience of something going “down the wrong pipe” or having the wrong thing down the right pipe. Any way you slice it, things end up in the GI tract or bronchial tree that shouldn’t be there. Try not to get choked up as we cover how to figure out what went where and, more importantly, what to do about it.
Taking care of three kids in cardiac arrest in the span of one month has been rough, to say the least. The very nature of the disease makes a good outcome unlikely, which can be emotionally devastating and can cause us to question our careers. So what do we do when a pediatric cardiac case comes through the door? How can we stay organized and do our very best, which, at the end of the day, is all we are capable of?
Needles in haystacks can poke and zebras can bite. Pediatric stroke is one of those occurrences so rare that diagnosis can be delayed simply because we don’t think of it. Tune in as we put our minds to the pediatric brain, cogitate about how this disease can present, and how we can be ready to recognize and manage it.
Nothing underscores the adage “Don’t just do something- stand there” like a simple febrile seizure. The terror level in parents is often mega high and the temptation may be to go quickly to IVs and CTs. But if the kid is well and back to baseline, one approach is a chair, 5 minutes and the FAQs- it might just save you an invasive work up.
There is no getting around it: rashes are rough. Different pathologies can have the same sympotoms; the same pathologies can look completely different on different skin tones. I realized that if I'm to have any street cred as a PEM physician, I need to either memorize the Atlas of Dermatology or come up with another approach for the ED. After making it through a few pages of the Atlas, I gave up and created Joe's Three Step Approach to Rashes.
For the most part young and healthy kids have young and healthy kidneys. However, for a small subset there is either acute or chronic renal disease. In this episode I spill the beans on some common presentations and not so obvious complications.
The management of BRUE is based partly on historic etymology and partly on medicine. This episode will walk through the history of the events now known as BRUEs, which are as old as time, and focus on how the name change encapsulates the management. What is and what is not a BRUE? If it is a BRUE what do we do? All this and a quick sample from George Carlin!
Kudos to AAP for trying to tackle one of the toughest questions in PEM: what do we do with the febrile neonate? The PEM community is fired up to get its hot little hands on consensus guidelines about which neonates are low risk for an invasive bacterial infection. Tune in to this special, mid-hiatus episode of PEM GEMS as we explore the recommendations or, for a medium-length dive, check out the accompanying review on EMdocs.net.
Full disclosure: I am not a toxicologist, but I do know a thing or two about pediatric ingestions. Witnessed ingestions are easy: call poison control and spend as much time as you want reviewing pharmacology and biochemistry. But what about the unwitnessed ingestion, or the altered and sick kid? Its important to keep Tox on the differential- also remember the medications where one pill can kill or make very ill.
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