Blog

In honor of a rosh review question that I got wrong, lets review Lyme disease!   Lyme disease is caused by the spirochete Boriella burgdorferi, transmitted to humans through tick bites from ixodes ticks. Location: US, endemic in NE coast, midatlantic region, and north central states. Transmission: transmission of the spirochete occurs during feeding whichRead more

NGT INSERTION

Your patient has an SBO and has repeated bilious emesis on the side. The surgery team is in the OR and they ask if you can place the nasogastric tube (NGT). Lets review proper NGT placement and some new techniques that can facilitate placement.     SUPPLIES cup of water with a straw emesis basinRead more

No, that’s not an olive. That’s Pyloric Stenosis!

Inspired by what appears to have been a very interesting day in the Peds ED, lets review a rare but interesting pediatric entity: PYLORIC STENOSIS Background: MC in Males (5:1) & firstborn children (30%) Usually begin between 3-6 wks of age, rarely after 12 wks Clinical Presentation: Nonbilious emesis. Early, patient will be hungry andRead more

Ouch that monkey bit me!

At the request of a colleague who recently treated a patient bitten by a monkey, I am going to write about treatment and prophylaxis for animal bites. First, a little BIT (get it?) about monkey bites. These are relatively rare in the US, primarily occurring in India or research labs. They have a high rateRead more

Don’t put that peanut in your nose, honey!

Here is a pearl about nasal foreign bodies:   The nose is the MC site of fb insertion, seen mostly in children <5 years. Most of the time, the risk of aspiration and complications are low. However, if the fb is a button battery or a set of paired disc magnets, the risks can beRead more

It’s Freezing!

You are at elmhurst in the cardiac room. It is FREEZING outside. The triage nurse tells you there is a frequent flier in triage, EMS found him sleeping on the street with +AOB. He is confused and moaning to sternal rub. They cannot get an oral temp and they cannot find the rectal probe, butRead more

pediatric blood transfusion

So you’re in peds and your patient is anemic. You need to transfuse, but you are confused. How much blood do you give? How fast do you give it? How much: The volume of blood to be transfused may vary depending on the clinical scenario. The transfusion volume is usually 10 to 15 mL/kg. InfantsRead more

Spontaneous Pneumomediastinum

Your patient is a 24 yo M with chest pain.  It is pleuritic. He has normal vitals and you’re not too concerned. You get a CXR and you see the result in this post. He has pneumomediastinum! What is that? What do I Do now? Spontaneous pneumomediastinum is rare, occurring in approximately 1 in 30,000Read more