recent articles

practice updates

Acute Mastoiditis: Pearls and Pitfalls

Acute mastoiditis is a common complication of acute otitis media. Diagnosis includes clinical evidence of mastoid inflammation and may necessitate further imaging to exclude other complications. IV antibiotics and a surgical consult are required.

practice updates

Ovarian Torsion

Naturally, we have all been taught to think “outside the box” and know to consider conditions outside the abdominal cavity.. When we are thinking outside of the box, make sure we keep Ovarian Torsion on our DDx list for the young girls.

practice updates

ECMO in the Ped ED

Remaining vigilant for the child with a subtle presentation of a severe illness is part of our job in the Ped ED; however, sometimes, the illness is not subtle and the child requires critical actions (ex, Damage Control Resuscitation, Mechanical Ventilation, Optimize Chest Compressions) . Often, it is best to consider these critical actions prior to needing to do them so there is no delay. One such, potentially life-saving, critical action is Extracorporeal Membrane Oxygenation (ECMO). Recently there was a nice review of Pediatric ECMO [Gehrmann, 2015] that deserves further contemplation. Below are some highlights from that article:

practice updates

Appendicitis: Pearls and Pitfalls in Adult and Pediatric Populations

There is no individual sign or symptom that can reliably exclude appendicitis in any patient. Appendicitis should be considered one diagnosis among a large differential. Concerning cases with a negative CT should be considered for admission. Radiation should be limited in children. Treatment may include antibiotics along with surgery.

practice updates

Pediatric Chest Pain

Children like to pretend to be grown-ups. Unfortunately, sometimes they develop grown-up problems (Cholelithiasis, Kidney Stones, and Hypertension). Additionally, often kids will complain of symptoms that warrant great concern in adults, but often engender apathy when considered in children. Chest Pain is a great example of one of these complaints.

practice updates

Neonatal HSV

Neonatal HSV is a rare condition, but one that results in devastating Morbidity and Mortality; therefore, it is imperative that we keep it on our radar and stay vigilant for it!