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EM Cases

EM Cases: Pediatric DKA

Learn the key historical and examination pearls to help pick up this sometimes elusive diagnosis, what the value of serum ketones are in the diagnosis of DKA, how to assess the severity of DKA to guide management, how to avoid the dreaded cerebral edema that all too often complicates DKA, how to best adjust fluids and insulin during treatment, which kids can go home, which kids can go to the floor and which kids need to be transferred to a Pediatric ICU.


EM@3AM: Intussusception

A 3-year-old male presents with his mom with chief complaint of vomiting and recurrent abdominal pain. Her son will intermittently cry and refuse to eat, followed by normal activity. His appetite has been decreased. VS are normal. Physical exam reveals a patient who appears stated age, nontoxic, and playful. Your physical exam, including abdomen and GU, is normal. The mom rushes out several minutes later and notifies you that her son is crying and holding his abdomen. What’s the diagnosis, and what’s your next step in your evaluation and treatment?

Peds EM Morsels

Pediatric Difficult Airway

Airway management in the ED is a complex interplay of patient factors, clinical illness status, and provider factors that through our thorough training we become proficient at navigating. One topic that deserves specific attention is the notion of a Difficult Airway.