“She won’t walk“, or “He just looks like he’s limping“.
So many things can be going on — how do we tackle this chief complaint?
You’re dreading a big work-up. You almost want to tell the kid: please, STOP LIMPING…
PEM Playbook – Please Stop Limping Read More »
Do we recognize shock early enough?
How do we prioritize our interventions?
Are we making our patient better or worse?
PEM Playbook – Approach to Shock Read More »
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 – Altered Mental Status in Children Read More »
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 – Big Labs, Little People: Troponin, BNP, D-Dimer, and Lactate Read More »
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.
PEM Playbook – Adventures in RSI Read More »
You have all of the skills you need to care for an acutely ill infant. Learn a few pearls to make this a smoother endeavor.
PEM Playbook – The Undifferentiated Sick Infant Read More »
Intranasal medications, if understood and employed properly, are a great choice to avoid an IV or as a bridge until IV access is obtained.
Learn the strengths and limits of intranasal fentanyl, midazolam, ketamine, and dexmedetomidine.
PEM Playbook – Intranasal Medications and You Read More »