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Hemophilia

Factor First!

OK, did I get your attention? Hopefully I did, because giving replacement factor to children with hemophilia presenting to the Emergency Department as soon as possible is the most important thing that you can do to positively impact outcomes. This episode of PEM Currents focuses on the different bleeding complications seen in Hemophilia and Von Willebrands and reviews basic management. There is a companion post on PEMBlog.com that has more detailed information that you should check out as well.

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I am proud to offer CME for this podcast episode through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

References

Di Michele D, Neufeld EJ. Hemophilia: a new approach to an old disease. Hematol Oncol Clin North Am. 1998;12(6):1315- 1344.

Di Michele D. Inhibitor treatment in haemophilias A and B: inhibitor diagnosis. Haemophilia. 2006;12(Suppl 6):37-42.

Labarque V, Stain AM, Blanchette V, et al. Intracranial haem- orrhage in von Willebrand disease: a report on six cases. Heamophilia. 2013;19(4):602-606.

Melchiorre D, Linari S, Innocenti M, et al. Ultrasound detects joint damage and bleeding in haemophilic arthropathy: a proposal of a score. Haemophilia. 2011;17(1):112-117.

Nagel K, Pai MK, Paes BA, et al. Diagnosis and treatment of intracranial hemorrhage in children with hemophilia. Blood Coagul Fibrinolysis. 2013;24(1):23-27. 

Oren H, Yaprak I, Irken G. Factor VIII inhibitors in patients with hemophilia A. Acta Haematologica. 1999;102(1):42-46.

Schwartz et al. Hemophilia And Von Willebrand Disease In Children: Emergency Department Evaluation And Management. EB Medicine, 2015.

Witmer C, Presley R, Kulkarni J, et al. Associations between intracranial haemorrhage and prescribed prophylaxis in a large cohort of haemophilia patients in the United States. Br J Haematol. 2010;152(2):211-216. 

Witmer CM, Raffini LJ, Manno CS. Utility of computed tomography of the head following head trauma in boys wth haemophilia. Haemophilia. 2007;13(5):560-566. 

Categories
Infectious Diseases

Talking with patients and families about the flu

I recently had the pleasure of sitting down with the always delightful Dr. Patricia Chambers to talk about influenza. In our conversation we reviewed how to discuss testing or not for the flu, as well as why antivirals are not always indicated. I firmly believe that perhaps the most important thing that we do in the Pediatric Emergency Department is communicating with patients and their families. Ultimately, they must understand why we do what we do (or don’t do). Patricia is an expert in this realm and I hope that you will learn as much as I did by listening to this episode of PEM Currents: The Pediatric Emergency Medicine Podcast.

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References

Grohskopf et al. et al. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2019–20 Influenza Season. CDC recommendations and Reports. August 23, 2019. https://www.cdc.gov/mmwr/volumes/68/rr/rr6803a1.htm?s_cid=rr6803a1_w. Accessed December 18, 2019.

Categories
Prehospital

Disaster Preparedness

This episode of PEM Currents: The Pediatric Emergency Medicine Podcast is all about disaster medicine. I interviewed Brent Kaziny, Disaster Medicine and Preparedness expert who was in training during Hurricane Katrina and lead efforts in Houston during Hurricane Harvey. Brent shares practical tips on how you can get involved and how you can learn what resources your institution has.

You can contact Brent via his email at bxkaziny@texaschildrens.org

PEMBlog.com

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References

AAP Children and Disasters Webpage

EMSC EIIC Webpage

Link to AAP Family Readiness Kit

Pediatric Disaster Preparedness MOC Part IV Initiative

Categories
Orthopedics

Foot Fractures

Don’t toe the line when it comes to your education. Step up, don’t be a heel, and listen to this episode of PEM Currents: The Pediatric Emergency Medicine Podcast focusing on fractures of the feet and toes. Learn all about metatarsal fractures, including the Jones fracture, Lisfranc injuries, why you should worry about a fracture of the talar neck, and more in this seventh and final epode of the Fracture Season.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

Follow me on Twitter @PEMTweets

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Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Inokuchi et al. Calcaneal fractures in children. J Pediatr Orthop. 1998;18(4):469. 

Lim et al. Pediatric Forefoot Fractures: Assessment of Fracture Patterns and Predictors of Complicated Outcome. Pediatr Emerg Care. 2018;34(4):233.

Mahan et al. Likelihood of surgery in isolated pediatric fifth metatarsal fractures. J Pediatr Orthop. 2015 Apr;35(3):296-302. 

Categories
Orthopedics

Femur Fractures

The fifth episode of the Fracture Season of PEM Currents, the Pediatric Emergency Medicine podcast focuses on fractures of the tibia and fibula, including the ankle. This episode also features a review of the neurovascular assessment of the lower extremity.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

Follow me on Twitter @PEMTweets

Check out my facebook page

Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Bauer JM et al. Toddler’s Fractures: Time to Weight-bear With Regard to Immobilization Type and Radiographic Monitoring. J Pediatr Orthop. 2017. 

Boutis K et al. Sensitivity of a clinical examination to predict need for radiography in children with ankle injuries: a prospective study. Lancet. 2001;358(9299):2118.

Sapru K et al. Management of the Toddler’s fracture with and without initial radiological evidence. Eur J Emerg Med. 2014;21(6):451.

Schuh AM wt al. Management of Toddler’s Fractures in the Pediatric Emergency Department. Pediatr Emerg Care. 2016;32(7):452. 

Categories
Orthopedics Podcast

Tibia and Fibula Fractures

The fifth episode of the Fracture Season of PEM Currents, the Pediatric Emergency Medicine podcast focuses on fractures of the tibia and fibula, including the ankle. This episode also features a review of the neurovascular assessment of the lower extremity.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

Follow me on Twitter @PEMTweets

Check out my facebook page

Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Bauer JM et al. Toddler’s Fractures: Time to Weight-bear With Regard to Immobilization Type and Radiographic Monitoring. J Pediatr Orthop. 2017. 

Boutis K et al. Sensitivity of a clinical examination to predict need for radiography in children with ankle injuries: a prospective study. Lancet. 2001;358(9299):2118.

Sapru K et al. Management of the Toddler’s fracture with and without initial radiological evidence. Eur J Emerg Med. 2014;21(6):451.

Schuh AM wt al. Management of Toddler’s Fractures in the Pediatric Emergency Department. Pediatr Emerg Care. 2016;32(7):452. 

Categories
Orthopedics

Hand Fractures

This is the 4th episode in the Fracture Season of PEM Currents. You will learn about carpal fractures – especially the dreaded scaphoid fracture, metacarpal fractures, and fractures of the phalanges.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

Follow me on Twitter @PEMTweets

Check out my facebook page

Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Abzug et al. Pediatric Phalanx Fractures. Journal of the American Academy of Orthopaedic Surgeons: November 2016 – Volume 24 – Issue 11 – p e174–e183. doi: 10.5435/JAAOS-D-16-00199

Watts. Seymour Fracture: Ortho Bullets. Accessed August 10, 2019. https://www.orthobullets.com/hand/6000/seymour-fracture

Simon et al. Emergency Orthopedics: the Extremities. 6th Edition. McGraw Hill Medical, NY. 2011.

Categories
Orthopedics

Humerus Fractures

This episode in the Fracture Season of PEM Currents, the Pediatric Emergency Medicine podcast focuses on humerus fractures. The humerus is a super duper forgiving bone in pediatrics that almost never requires reduction or surgeries if there is a mid shaft or proximal shaft fracture. Don’t forget to listen to the Forearm and Wrist Episode if you’d like to brush up on your neuromuscular assessment.

This episode is shorter – so I can’t offer CME in the same manner as the previous two. But you can still get CME for other episodes in the series. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

Follow me on Twitter @PEMTweets

Check out my facebook page

Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Kohler R, Trillaud JM. Fracture and fracture separation of the proximal humerus in children: report of 136 cases. J Pediatr Orthop 1983; 3:326.

Shrader MW. Proximal humerus and humeral shaft fractures in children. Hand Clin 2007; 23:431.

Categories
Orthopedics

Elbow Fractures

This episode in the Fracture Season of PEM Currents, the Pediatric Emergency Medicine podcast focuses on elbow fractures. Did you know that the elbow has there joints? Did you know that supracondylar fractures can happen after a fall from something other than monkey bars? Don’t forget to listen to the Forearm and Wrist Episode if you’d like to brush up on your neuromuscular assessment.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

Follow me on Twitter @PEMTweets

Check out my facebook page

Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

 Mazda K, Boggione C, Fitoussi F, Penneçot GF. Systematic pinning of displaced extension- type supracondylar fractures of the humerus in children. A prospective study of 116 consecutive patients. J Bone Joint Surg Br 2001; 83:888.

Woon, C. Supracondylar Fracture – Pediatric: Ortho Bullets. Accessed 8/5/2019. https://www.orthobullets.com/pediatrics/4007/supracondylar-fracture–pediatric

Categories
Orthopedics

Forearm and Wrist Fractures

This summer, in honor of the 7th anniversary of PEMBlog and PEM Currents I will be releasing a mini-season of fracture focused podcasts.

This episode focuses on radius and ulna fractures, including buckle, greenstick, physis and more! learn about the neurovascular assessment of the upper extremity and general management pearls for some of the most common injuries that you will see in the Pediatric Emergency Department.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

Follow me on Twitter @PEMTweets

Check out my facebook page

Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Abraham A, Handoll HH, Khan T. Interventions for treating wrist fractures in children. Cochrane Database Syst Rev 2008; :CD004576.

Drendel AL, Gorelick MH, Weisman SJ, et al. A randomized clinical trial of ibuprofen versus acetaminophen with codeine for acute pediatric arm fracture pain. Ann Emerg Med 2009; 54:553.

Douma-den Hamer D, Blanker MH, Edens MA, et al. Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis. PLoS One 2016; 11:e0155659.