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practice updates

Hypertensive Crisis in Kids

I think that we’d all agree that 144/89 is not a normal blood pressure, but it is one that those of us who have the pleasure of caring for adults will look at with almost a sense of comfort – because it isn’t 70/30 or 210/120. Unfortunately, however, this sense of reassurance cannot be had when dealing with children. Depending on the patient’s sex, age, and height, 144/89 may not only represent hypertension but may be associated with hypertensive crisis in kids!

practice updates

Atropine Not Needed for RSI

We have covered several other pediatric EM myths and misconceptions previously: Cuffed ETT are ok, a doughnut is not a good shape for LP Positioning, the 500:1 rule should not be used, Oral Rehydration is faster than IV, and you can/should give morphine to kids you are worried have appendicitis. Recently, I was reminded of another myth that continues to have a foothold: Atropine and RSI.

practice updates

Post-Tonsillectomy Hemorrhage

We know that all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources. We also know that the easiest, and often most efficacious, way to halt bleeding is to put some manual pressure on the source of bleeding. Well, that isn’t always so easy to accomplish. How do you put your finger on a bleeding tonsil?

practice updates

Pediatric Back Pain

Pediatric patient with back pain? Those of us who take care of adults also know all too well the complaint of Back Pain and are comfortable looking for the Red Flags of serious etiologies of that complaint. Back pain in the pediatric ED is definitely not as prevalent as the adult ED, but actually warrants some additional concern. Thanks to Sean M. Fox, MD (@PedEMMorsels) for this great post!

practice updates

Osteomyelitis in Kids

Another tasty Ped EM Morsel to complement last week's adult osteomyelitis post by Ben Cooper. Thanks to Sean M. Fox, MD (@PedEMMorsels) for this great post!

practice updates

Intranasal Analgesia

Being flexible and creative are important traits to have while working the ED. It is also vital to always keep the end result in mind. Pain control is always an important endpoint for us to constantly consider. While most of us would say that we strive alleviate our patients’ pain, there is evidence that we are not great at it. Thanks to Sean M. Fox, MD (@PedEMMorsels) for this great post!