Blog

Reduction technique for Nursemaid’s elbow

It’s another busy afternoon in the peds ED when grandma comes in stating that her grandson broke his arm. He was jumping on the bed, and reached out to grab hold of a side rail before falling to the ground. It looks normal, but now the little guy refuses to use the arm and isRead more

52 in 52: A Clinical Predictive Tool for Intra-Abdominal Trauma in Pediatric Patients

Title: Validation of a prediction rule for the identification of children with intra-abdominal injuries after blunt torso trauma Article Citation: Holmes JF, Mao A, Awasthi S, McGahan JP, et al. Validation of a prediction rule for the identification of children with intra-abdominal injuries after blunt torso trauma. Ann Emerg Med. 2009 Oct;54(4):528-33. PMID: 19250706 WhatRead more

52 in 52: Dexamethasone in Mild Croup

Bjornson CL, Klassen TP, Williamson J, Brant R, et al; Pediatric Emergency Research Canada Network. A randomized trial of a single dose of oral dexamethasone for mild croup. N Engl J Med. 2004 Sep 23;351(13):1306-13. PMID: 15385657   What we already know: Croup, also known as acute laryngotracheobronchitis, is a disease that commonly affects the pediatricRead more

Hyperpronation for Nursemaid’s elbow reduction

“Childhood means simplicity. Look at the world with the child’s eye – it is very beautiful.” -Kailash Satyarthi   Nursemaid’s elbow is a radial head subluxation, typically caused by a “pulling” mechanism. It occurs most often in children six months to five years of age. The child will present with pain and will not useRead more

NEC, volvulus, pyloric stenosis, oh my!

This is a review of specific pediatric entities that may cause abdominal pain, bloody diarrhea, or vomiting. The following lists are not comprehensive and emergency physicians should consider a broad differential based on symptoms and presentation. The aim of this pearl is to familiarize us with these select pediatric conditions. Case courtesy of A.Prof FrankRead more

Tricky Orthopedics

That being said, let’s go through some commonly tested and easily confused orthopedic entities… Salter-Harris Classification http://orthoinfo.aaos.org/topic.cfm?topic=A00040 Type 1 – Slipped (Physis) Type 2 – Above (metaphysis) Type 3 – Lower (Epiphysis) Type 4 – Transverse all 3 Type 5 – Rammed (crush) Hand/Wrist injuries Scapholunate vs. Perilunate vs. Lunate Dislocation Mechanism for all 3:Read more

Imaging in Intussusception

Clinical Scenario: A 2-year-old female with no significant past medical history presents with vomiting and abdominal pain for 1 day. Among other entities in your differential diagnosis you are considering intussusception, however it is lower on your differential. How would you work-up this child?   Presenting Symptoms for Intussusception1 Sudden onset of intermittent, severe, crampy,Read more

Conjunctivitis In A Newborn

A mother brings her 4 day old newborn baby boy into the Peds ED for bilateral eye discharge. Mom tells you he was full-term and healthy, but she did not have prenatal care. The baby is well appearing and is eating, urinating and defecating well. A picture of his eyes are above, are you concerned? YouRead more

Broselow to the Rescue!

How do you calculate the correct ETT size for a child in a pediatric resuscitation? ETT size = (age + 16) / 4 ETT size = (age/4) + 4 ETT size = 4 + 1/4 age If you find yourself thinking about the order of operations (PEMDAS for anyone who missed elementary school math class) duringRead more

Shouldn’t I Just Give the Little Guy Some Albuterol?

You see a 20 month old with no PMH who has been wheezing and coughing for a few days.  His cousin has RAD.  Should you just give him a little albuterol and see how he does? Here’s his x-ray: What are you concerned for?Read more