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em@3am

EM@3AM: Kawasaki Disease

A 3-year-old male presents to the ED with one week of daily fevers >102°F associated with four days of rash on the trunk. His parents have been managing his fevers with acetaminophen and ibuprofen, but became worried today when they noticed redness and swelling of the tongue in addition to swelling in the hands and feet. Vital signs demonstrate a rectal temperature 39.5°C, BP 92/60, HR 130, RR 35, and SpO2 of 98%. Physical exam demonstrates an ill appearing child with bilateral conjunctival injection; erythematous tongue with dry, fissured lips; right sided cervical lymphadenopathy; an erythematous maculopapular rash on the chest, abdomen, and back; and nonpitting edema of the hands and feet. What is the most likely diagnosis?

PEM Currents

PEM Currents – Agitation in Children – Episode 2: Non-Pharmacologic Management

Agitated should always be treated with dignity and respect. This entails utilizing the least invasive non-pharmacologic means of assisting them, before moving to physical or chemical restraints. This podcast episode is all about age-appropriate non pharmacologic management strategies for agitated children. It is also episode 2 in a 5 episode series focused on agitation in children and adolescents.