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’.

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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.

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Tags foot fractures

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’.

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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.

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Orthopedics Podcast

Tibia and Fibula Fractures

Post author By bradsobo
Post date September 13, 2019
No Comments on Tibia and Fibula Fractures

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’.

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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.

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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’.

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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.

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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’.

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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.

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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’.

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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

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Orthopedics

Forearm and Wrist Fractures

Post author By bradsobo
Post date August 16, 2019
2 Comments on 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’.

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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.

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Tags buckle fracture, forearm fractures, greenstick fracture, radius fractures, torus fracture, ulna fracture

Cardiology

SVT

Post author By bradsobo
Post date June 4, 2019
2 Comments on SVT

Three of my favorite letters in the Pediatric Emergency Department are S, V and T. This episode of PEM Currents, the Pediatric Emergency Medicine Podcast focus on the diagnosis and management of paroxysmal supraventricular tachycardia in the ED. I discuss preparation, vagal maneuvers, cardioversion, disposition and more!

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References

Appelboam, et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. The Lancet, 2015.

Friedman. Intraosseous adenosine for the termination of supraventricular tachycardia in an infant. Annals of EM, 1996

Garson et al. Supraventricular tachycardia in children: Clinical features, response to treatment, and long-term follow-up in 217 patients. The Journal of Pediatrics, 1981.

Getschman SJ et al. Intraosseous adenosine. As effective as peripheral or central venous administration? Arch Pediatr Adolesc Med. 1994 Jun;148(6):616-9.

Goodman et al. Intraosseous infusion is unreliable for adenosine delivery in the treatment of supraventricular tachycardia. Peds Emerg Care, 2012.

Hayes, Tricks of the Trade: Combine Adenosine with the Flush. Academic Life in Emergency Medicine, 2012. Accessed June 3, 2019.

Müller et al. “Vagal maneuvers” and adenosine for termination of atrioventricular reentrant tachycardia. The American Journal of Cardiology, 1994.

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Tags supra ventricular tachycardia, svt

Uncategorized

Measles

Post author By bradsobo
Post date May 14, 2019
No Comments on Measles

I never thought that this particular disease would make a comeback in the United States. But here we are. Measles. As of May 2019 there have been cases reported in over 20 states. Declining vaccine rates and international travel to areas with local measles epidemics have led to a sharp rise in the number of cases in the US. The goal of this epode of PEM Currents is to discuss the diagnosis, treatment and prevention of measles, as well as how you can recognize it and appropriately diagnose and report cases.

You should definitely check out the following resources – since measles is a visual illness with a memorable rash (not that most of us have actually seen it). as well as learn about local hospital and health department procedures for treating, isolating and reporting confirmed and suspected cases.

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References

CDC – Measles (Rubeola) – Main Page

CDC – Photos of People With Measles

CDC – Measles Cases and Outbreaks

AAP – RedBook Measles

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gastroenterology

Constipation

Constipation is an incredibly common problem in the Pediatric Emergency Department and amongst children who visit the Emergency Department with complaints of abdominal pain. This episode of PEM Currents, the Pediatric Emergency Medicine podcast features an interview with Danny Mallon, a Gastroenterologist from Cincinnati Children’s @dannymallon24 who is an expert in managing pediatric constipation. Our discussion focused on diagnosis in the Emergency Department, management and why you don’t need an X-Ray to make there diagnosis.

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