Remaining vigilant for the child with a subtle presentation of a severe illness is part of our job in the Ped ED; however, sometimes, the illness is not subtle and the child requires critical actions (ex, Damage Control Resuscitation, Mechanical Ventilation, Optimize Chest Compressions) . Often, it is best to consider these critical actions prior to needing to do them so there is no delay. One such, potentially life-saving, critical action is Extracorporeal Membrane Oxygenation (ECMO). Recently there was a nice review of Pediatric ECMO [Gehrmann, 2015] that deserves further contemplation. Below are some highlights from that article:

“Rash” seems to be a ubiquitous complaint some days in the Ped ED. Knowing that the skin is the largest organ, it seems only appropriate that we should take these complaints seriously. Unfortunately, often I feel a little inadequate when trying to decipher the code of the Pediatric Rash.

Children like to pretend to be grown-ups. Unfortunately, sometimes they develop grown-up problems (Cholelithiasis, Kidney Stones, and Hypertension). Additionally, often kids will complain of symptoms that warrant great concern in adults, but often engender apathy when considered in children. Chest Pain is a great example of one of these complaints.

Neonatal HSV is a rare condition, but one that results in devastating Morbidity and Mortality; therefore, it is imperative that we keep it on our radar and stay vigilant for it!

Is there a way to help define a group of kids who are at Low Risk for Intra Abdominal Trauma?

While the goal is often to prevent intubation, occasionally, the only option is to use Mechanical Ventilation for your patient with Severe Asthma. The question, then, is how to make the best of a bad situation.

This is another great reason to discuss not throwing antibiotics at every kid with an ear.

Before you jump to the conclusion that this is merely “Colic” in the 2 month old, let us quickly highlight some entities that should be at the top of your DDx when evaluating the inconsolable child