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practice updates

Pediatric Protective Custody

When an emergency physician is faced with a scenario in which he or she does not believe a legal guardian is acting in a child's best interests, further investigation and possibly action is required. In cases where the child’s health or safety are in question, temporary protective custody of a minor may be needed. This post evaluates several cases concerning this topic.

practice updates

Can’t Intubate Can’t Ventilate

“Can’t Intubate Can’t Ventilate” is one of the frightening statements that causes massive surges of adrenaline in everyone. Unfortunately, most neural synapses don’t function well with that large surge of adrenaline, and it is, therefore, imperative to contemplate how to manage this scenario before it arises.

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).

practice updates

Ear, Nose, and Throat Foreign Bodies

Foreign bodies of the ear, nose and throat are commonly seen complaints in emergency department, namely the pediatric emergency department. This is a brief review of some commonly seen foreign bodies and how to remove them safely.

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?

practice updates

Cystic Fibrosis: ED Management, Pearls and Pitfalls

Cystic fibrosis (CF) is a relatively rare disease but may present to the emergency department with severe complications including intestinal and pulmonary complications. This is a brief review of CF and the management of a few complications that can be associated with CF.

practice updates

FOAMed Resource Series Part III: Pediatrics

"Kids are not just little adults." While this statement generates controversy, a sick pediatric patient in the ED can be scary. Staying up to date with the most current pediatric EM literature can be difficult, but FOAMed can help. Welcome to Part III of the FOAMed series, where we will cover pediatric EM resources.