Community Acquired Pneumonia

Fever, tachypnea and rales – it must be a community acquired pneumonia… right? Learn more about the diagnosis and management of this common problem in the Pediatric Emergency Department.

Essential Reading

Bradley JS, Byington CL, Shah SS, Alverson B, Carter ER, Harrison C, Kaplan SL, Mace SE, McCracken GH Jr, Moore MR, St Peter SD, Stockwell JA, Swanson JT; Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Executive summary: the management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011 Oct;53(7):617-30. PMID: 21890766.

CSF Shunt Complications

Ventricular CSF shunts are very common – many kids have them. The most common complications are malfunction and infection. This episode of PEM Currents reviews the basics and how you can assess for complications in CSF shunts in kids.

PEMBlog.com

Boyle, Kimia, Nigrovic. Validating a Clinical Prediction Rule for Ventricular Shunt Malfunction. Pediatric Emergency Care, 2017.

Riva-Cambrin et al. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study. Journal of Neurosurgery: Pediatrics. Apr 2016, Vol. 17, No. 4 , Pages 382-390.

Vocal Cord Dysfunction

Vocal cord dysfunction, AKA paradoxical vocal fold motion is more common than you might think. Patients often present to the Emergency Department in respiratory distress and “wheezing.” Learn about the diagnosis itself, different phenotypes and what treatment options are out there.

References

Christopher KL, Wood RP 2nd, Eckert RC, Blager FB, Raney RA, Souhrada JF. Vocal-cord dysfunction presenting as asthma. N Engl J Med.1983;308 :1566– 1570

Doshi D, Weinberger M. Long-term outcome of vocal cord dysfunction. Ann Allergy Asthma Immunol.2006;96 :794– 799

Weinberger M, Abu-Hasan M. Pseudo-asthma: when cough, wheezing, and dyspnea are not asthma. Pediatrics. 2007 Oct;120(4):855-64.

 

Management of Elevated ICP

Get ahead of your peers and listen to this episode of PEM Currents, the Pediatric Emergency Medicine podcast where you’ll learn all about the management of acutely elevated intracranial pressure. You’ll learn about common maneuvers such as optimizing the ABCs, Keeping the head elevated and midline as well as thermoregulation. I also discuss osmotic therapies and make the case for one agent versus another.

As always you can check out more great educational content at PEMBlog.com

Breath Holding Spells

Don’t hold you breath while listening to this podcast – because you’d be doing so for longer than 20 seconds – and you will have apnea. Do however, listen to learn more about cyanotic and pallid breath holding spells so that you can be prepared to diagnose and manage them in the Emergency Department.

Check out more great educational content at PEMBlog.com

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Serum sickness

What does the combination of erythema multiforme, fever and swollen joints equal? If you answered a visit to the Emergency Department you’re only partially correct. Serum sickness like reaction is a delayed type hypersensitivity reaction that often occurs 7-10 days after starting a course of antibiotics. Learn how you can recognize it and differentiate it form more serious illness like Stevens Johnson Syndrome in this episode of PEM Currents, the Pediatric Emergency Medicine Podcast.

Kidney Stones

It’s an epidemic! OK, so not quite, but we are seeing a rise in the number of kidney stones recently and we’re not quite sure why. This episode of PEMCurrents will focus on diagnosis and treatment of stones and answer such questions as; Which pain medicine should I order first? and which is the better imaging test, ultrasound or CT?

Hemorrhagic Ovarian Cysts

Check out the latest episode of PEM Currents the Pediatric Emergency Medicine podcast where I talk about hemorrhagic (AKA ruptured) ovarian cysts. I delve into diagnosis and management and suggest strategies for obtaining a diagnostic ultrasound.

Check out more great educational content on PEMBlog.com

Interview with Ben Kerrey about Pediatric Rapid Sequence Intubation

Ben Kerrey is a rising star in Pediatric Emergency Medicine and is the point man for an ongoing initiative at Cincinnati Children’s centered around improving safety and limiting complications during rapid sequence intubation. I recently sat down with Ben to talk about the state of RSI in pediatric patients, the difference between a checklist and a a true cognitive aid, the role of residents during RSI and more.

You can check out several related articles right here – all provided by Dr. Kerrey.