Category: Pediatrics
Keywords: Ferbrile Seizures, Bacteremia, Fever (PubMed Search)
Posted: 2/15/2008 by Sean Fox, MD
(Updated: 8/14/2024)
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Febrile Seizures
Category: Pediatrics
Keywords: Neonatal Conjunctivitis, Chlamydia, Gonorrhea, Red Eye (PubMed Search)
Posted: 2/2/2008 by Sean Fox, MD
(Emailed: 2/8/2008)
(Updated: 8/14/2024)
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Neonate with Red Eye
Category: Pediatrics
Keywords: Laceration, Dermabond, cyanocrylate (PubMed Search)
Posted: 2/1/2008 by Sean Fox, MD
(Updated: 8/14/2024)
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Tissue adhesives:
Cyanocrylate Tissue Adhesive is an excellent product to use when repairing linear lacerations.
A few things to remember:
The wound needs to be irrigated as you would any other wound prior to closure.
Gravity works. Consider where the product may drip to before you apply it (Eyes, Ears, Nose, etc).
Use Surgi-Lube (or other petroleum product) to create a barrier to limit the flow of the cyanocrylate.
For long lacerations, you may use steri-strips to help approximate edges before applying the tissue adhesive.
What to do if the glue gets out of control and drips onto the eyelids... may also apply to Krazy-Glue:
Use copious irrigation and then Mineral Oil (not acetone or alcohol - which won't go well in the eyes).
Often there will be an associated corneal abrasion... treat it as other corneal abrasion.
Category: Pediatrics
Keywords: Back Pain, Leukemia, Lymphoma, Neuroblastoma (PubMed Search)
Posted: 1/24/2008 by Sean Fox, MD
(Emailed: 1/25/2008)
(Updated: 8/14/2024)
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Pediatric Back Pain
Category: Pediatrics
Keywords: Ketamine, RSI, TBI (PubMed Search)
Posted: 1/18/2008 by Sean Fox, MD
(Updated: 8/14/2024)
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Ketamine and RSI for pts p TBI
Category: Pediatrics
Keywords: ITP, Leukemia, Steroids, IVIG, Anti-Rh(d), Bone Marrow Aspiration (PubMed Search)
Posted: 1/11/2008 by Sean Fox, MD
(Updated: 8/14/2024)
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Pediatric ITP – Bone Marrow Aspiration
Category: Pediatrics
Keywords: RSV, Apnea, Congenital Heart Disease, Chronic Lung Disease, Prematurity, Rapid testing (PubMed Search)
Posted: 1/4/2008 by Sean Fox, MD
(Updated: 8/14/2024)
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Bronchiolitis: Use of RSV rapid testing
Purcell K, Fergie J. Concominant serious bacterial infections in 2396 infans and children hospitalized with respiratory syncytial virus lower respiratory tract infections. Arch pediatr adolesce med. 2002; 156: 322-324.
Category: Pediatrics
Keywords: Childhood Cancers, Leukemia, Lymphoma, pallor, fatigue (PubMed Search)
Posted: 12/28/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Pediatric Leukemia/Lymphoma Presentation in the ED
Jaffe D, Fleisher G, Grosflam J. Detection of cancer in the pediatric emergency department. Pediatr Emerg Care. 1985 Mar;1(1):11-5.
Category: Pediatrics
Keywords: Limp, Antalgic Gait, Trendelenburg Gait, Septic Arthritis, Legg-Calve-Perthes Disease, SCFE (PubMed Search)
Posted: 12/21/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Child with a Limp
Grossman, Emblad, Plantz. Orthopedic Emergencies in Pediatric Emergency Medicine Board Review. 2nd Edition. 2006. p305.
Category: Pediatrics
Keywords: Child Abuse, Fractures (PubMed Search)
Posted: 12/14/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Child Abuse
Category: Pediatrics
Keywords: Neonatal Respiratory Distress Syndrome, RDS, Cold Stress, Surfactant (PubMed Search)
Posted: 12/7/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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The Premature Infant Delivered in Your Department
An ode to my final NICU Call… just because you don’t work in a Pediatric ED, doesn’t mean you won’t encounter premature infants.
What do you need to remember when a premature infant is born in your ED (or the ambulance / cab / car)?
Category: Pediatrics
Keywords: Pediatric Airway, Pierre Robin Syndrome, Micrognathia, Emergent Tracheostomy, LMA (PubMed Search)
Posted: 11/30/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Pierre Robin Syndrome
Baraka, A. Laryngeal Mask Airway for Resuscitation of a Newborn with Pierre-Robin Syndrome. Anesthesiology. 83(3):646-647, September 1995.
Category: Pediatrics
Keywords: Proteinuria, Orthostatic Proteinuria, Creatinine (PubMed Search)
Posted: 11/23/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Proteinuria
Chandar J, Gomez-Martin O, del Pozo R, et al. Role of routine urinalysis in asymptomatic pediatric patients. Clin Pediatr (Phila). 2005; 44:44-48.
Hogg RJ, Portman Rj, Milliner D, Lemley KV, Eddy A, Ingelfinger J. Evaluation and management of proteinuria and nephritic syndrome in children recommendations from a pediatric nephrology panel established at the National Kidney Foundation Conference on Proteinuria, Albuminuria, Risk, Assessment, Detection, and Elimination (PARADE). Pediatrics. 2000; 105: 1242-1249.
Category: Pediatrics
Keywords: Stroke, Embolus, Retinal artery occlusion (PubMed Search)
Posted: 11/16/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Atrial Myxomas:
Majeed Al-Mateen, et al. Cerebral Embolism From Atrial Myxoma in Pediatric Patients. Pediatrics, Aug 2003; 112: e162 - e167.
Category: Pediatrics
Keywords: Rheumatic Fever, Jones Criteria, Heart Disease, Salicylates, Chorea (PubMed Search)
Posted: 11/9/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Rheumatic Fever
Category: Pediatrics
Keywords: Heart Transplantation, Rejection, Syncope, Chest Pain (PubMed Search)
Posted: 11/2/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Children s/p Heart Transplantation – Rejection
Woods, WA. Care of the Acutely Ill Pediatric Heart Transplant Recipient. Pediatric Emergency Care. 23(10):721-724, October 2007.
Category: Pediatrics
Keywords: Severe Asthma, Refractory to standard therapy, intubation, atrovent, magnesium, noninvasive ventilation, heliox, ketamine, singulair (PubMed Search)
Posted: 10/26/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Severe Asthma in Pediatrics (Using “the kitchen sink” when all else fails)
Every effort should be made to avoid intubating an asthmatic pt. Here are some possible options to consider:
Category: Pediatrics
Keywords: Sepsis, Shock, Tachycardia, Hypotension (PubMed Search)
Posted: 10/19/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Pediatric Septic Shock
Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005 Jan;6(1):2-8.
Category: Pediatrics
Keywords: Foreign Body, Button Battery, Heliox, Respiratory Distress (PubMed Search)
Posted: 10/12/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Foreign Bodies
• No object should be left in the esophagus for >24 hrs
• Unusual FB’s:
==> Very Sharp or pointed objects may perforate the GI tract and should be removed endoscopically.
==> Long objects (>6cm) or wide (>2cm) objects may not pass and should be remove endoscopically.
• Button Batteries
==> 9% of cases involve more than one battery (x-ray mouth to anus)
==> Hazards:
(1) Heavy metal leakage (Mercury) – low risk but real
(2) Electrical Discharge (Local tissue injury)
(3) Pressure Necrosis
(4) Leakage of Corrosives
==> 85% Pass without symptoms
(1) No intervention if pass the esophagus and pt is without symptoms
• Consider Heliox as a temporizing measure in children with respiratory distress, while awaiting endoscopy/bronchoscopy.
Category: Pediatrics
Keywords: Concussion, Second Impact Syndrome, Sports Medicine (PubMed Search)
Posted: 10/5/2007 by Sean Fox, MD
(Updated: 8/14/2024)
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Concussions
Colorado Medical Society School and Sports Medicine Committee. Guidelines for the management of concussion in sports. Colo Med 1990;87:4.