Peds EM Morsels

Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. Fortunately, it is relatively rare, but the rarity can lead to some confusion when it comes to its management.

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.

“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.

“Dyspnea / tachypnea in conjunction with abdominal pain (hepatomegaly) warrants consideration of acute heart failure as much as the kid presenting in overt shock”

Sean M. Fox, MD (from the great pedemmorsels.com) discusses signs, symptoms, and mimics of heart failure in children.

“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.