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Briefs: You spin me right round…

Recently I have seen a few preschoolers with true vertigo – one even told me that it felt like he just “spinned on a baseball bat.” For those of you without a clear mental image of what he meant check...

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Briefs: Red flags for deep space upper airway infections

You are seeing a 2 year old boy with a high fever who is irritable and refuses to look up. His parents think he has a sore throat. You are appropriately worried about a retropharyngeal...

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Briefs: Seeing red

A mom brings her six year old son into the ED with concerns of fever and rash. She is concerned that he caught his sister’s pneumonia – and that he is super uncomfortable because of his sunburn. On...

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Briefs: Let’s be blunt (about abdominal trauma)

Though readily available, and the reference standard for diagnosing intraabdominal injuries (IAI) the radiation exposure from a CT is not benign – especially in children. Ultrasound in trauma (FAST) is...

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Briefs: Don’t hold your breath

A reasonably terrified mom brings her 17 month old boy into the ED after an apparent seizure. She states that her older daughter took a piece of candy away from the toddler, and then her son started to...

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Briefs: All bark and no stridor

In many ways the management of sicker patients with suspected croup is more straightforward. Give them steroids early, let the patient protect their own airway and use inhaled racemic epinephrine. But...

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Briefs: Pavor nocturnus!

A 5 year old boy presents to the ED with his parents at 1:15AM. The parents report that they went to their son’s room when they heard him screaming. It started all of a sudden, and aside form his...

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Briefs: Back pain in the pediatric ED

Keeping it short and simple this week folks. Here is a presentation on back pain in the pediatric ED. Just scroll vertically through the slides. You can even download it if you want. Spoiler alert! I...

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Briefs: HSP, belly pain and steroids

You see a kid that you’re pretty sure has Henoch Schonlein Purpura (HSP). OK, you’re certain ’cause they have the rash and EVERYTHING. They aren’t hypertensive, and their urine is normal. They have...

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Briefs: Sitting in the nosebleed section

A surprisingly common complaint that I deal with in the pediatric ED is epistaxis. While I find that many cases come down to worried parents who haven’t applied appropriate measures to get the bleeding...

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Briefs: Special K is not just for breakfast

Simultaneously in your ED you encounter; A 2 year old male with a complex facial laceration A 9 year old female gymnast you decided to do a back handspring, and in the process fractured her right...

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Briefs: NPO for sedation

This is a follow-up of last week’s Briefs on ketamine. How long do you really need to keep a patient NPO prior to moderae/procedural sedation in the ED? Let’s look at this issue form a few different...

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Briefs: It’s a private matter…

A 3 year old male presents with the chief complaint of “privates swollen.” He was previously well until today, and after itching in his underpants in the morning mom checked and saw that her son had...

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Briefs: Baby you’re a firework!

The grammatical (in)correctness of the title aside, the 4th of July is marked by the use of fireworks by amateurs across the US. Fortunately the number of injuries had declined in recent years – until...

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Briefs: Purple doughnuts…

A 3 year old previously presents to the ED with the chief complaint of “purple donut coming out of his butt” – seriously. It happened after he was going to the potty. The parents are understandably...

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Briefs: Tongue laceration repair

A 3 year old male was jumping in his bed. He jumped one time too many and landed on his dresser, hitting his chin and biting his tongue in the process. He then ran downstairs and bloodied the carpet....

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Briefs: Baby come back?

The Scenario It is gastro season. There is vomiting and diarrhea everywhere. Just after seeing your fifth patient with the aforementioned symptoms a colleague asks you about a patient that they...

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Briefs: Aspirin and Nitroglycerin for (almost) everyone

I’m reviewing ACLS in preparation for recertification, and aside from it being a great review of stuff I’d pushed to the nether-regions of my mind, because well, adults… it reminded me that many of my...

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Briefs: Shunts gone bad!

This edition of Briefs focuses on CSF shunt malfunctions and infections. It is such a big (and important) topic in the pediatric ED that I thought it share all of what I’ve learned via a presentation....

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Briefs: Pumping Iron

Kids accidentally ingest medicines. In the Peds ED we are rightfully worried about opiates, BP meds, acetaminophen, and diabetes drugs (among many others) but we shouldn’t overlook the potential...

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