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PEM Playbook

PEM Playbook – Altered Mental Status in Children

Altered mental status in children can be subtle. Look for age-specific behaviors that range from irritability to anger to sleepiness to decreased interaction. In the altered child, anchoring bias is your biggest enemy. Keep your mind open to the possibilities, and be ready to change it, when new information becomes available. For altered adults, use AEIOU TIPS (Alcohol-Epilepsy-Insulin-Overdose-Uremia-Trauma-Infection-Psychosis-Stroke).

PEM Playbook

PEM Playbook – Big Labs, Little People: Troponin, BNP, D-Dimer, and Lactate

It’s a busy shift. Today no one seems to have a chief complaint. Someone sends a troponin on a child. Good, bad, or ugly, how are you going to interpret the result? And while we’re at it – what labs do I need to be careful with in children – sometimes the normal ranges of common labs can have our heads spinning! Read on for bread-and-butter pediatric blood work and further, to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids?

PEM Playbook

PEM Playbook – Adventures in RSI

Pediatric airway management is a skill that integrates the three types of knowledge as described by the ancient Greeks: Episteme — theoretical knowledge Techne — technical knowledge Phronesis — practical wisdom — also called prudence. Here we’ll invoke each type of knowledge and understanding as we go beyond the anatomical issues in pediatric airway management – to the advanced decision-making aspect of RSI and the what-to-do-when the rubber-hits-the road.