recent articles

practice updates

Lactate Level in Kids

We see that, like in adults, an elevated lactate can help identify those patients who are potentially sicker than others, although not perfectly. It is only helpful if it alerts you to severe illness presenting subtly or helps direct your resuscitation efforts… which, again, require the astute clinician to determine. Thanks to Sean M. Fox, MD (@PedEMMorsels) for this gem with significant clinical relevance.

practice updates

Acute Chest Syndrome

Often, the dreaded complications that we are taught to look for don’t present to us in the Emergency Department, but develop and evolve during the hospitalization that began with the patient seeing us in the ED. Our skill can help the child in distress, but our vigilance can detect the evolving Acute Chest Syndrome and perhaps even prevent it. Thanks to Sean M. Fox, MD (@PedEMMorsels) for this gem with significant clinical relevance.

Peds EM Morsels

Options to Intravenous Fluids

IO Placement: "Should be done without hesitation in a child who lacks easily obtainable IV access and signs of poor perfusion"
Placing an IV in a sick pediatric patient can be a real challenge. Fortunately, there are options! Thanks to Sean M. Fox, MD (@PedEMMorsels) for this gem with significant clinical relevance.

Peds EM Morsels

Delayed Diagnosis of Kawasaki Disease

"Set an alarm that gets your attention anytime someone presents with 'fever for 5 days'"
Sean M. Fox, MD (@PedEMMorsels) with some excellent tips on recognizing factors putting your pediatric patients at risk for delayed diagnosis of Kawasaki Disease, including the more challenging to diagnose "incomplete" form of the disease.

Peds EM Morsels

Rapid MRI for VP Shunt Evaluation

"Patients with hydrocephalus will have nearly 4 scans per year during childhood"

For evaluation of VP shunts in children, the cost and study duration a rapid MRI is closer to CT than you might think (and without the ionizing radiation!). Best of all, the evidence comes from studies performed with populations chiefly less than 5 years of age. In this article, Sean M. Fox, MD makes a strong argument about why rapid MRIs should be a part of your institution's protocol.