Pediatric EM Morsels

APRIL 5, 2024

Silva-Ramos 2021) Majority of cases arise from travel to South Africa. (Silva-Ramos 2021) Majority of cases arise from travel to South Africa. (Frean 2019) The classic triad described is fever, eschar and rash. Silva-Ramos 2021) Fever and a characteristic eschar (tache noir) are seen 90% of the time.

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Pediatric EM Morsels

AUGUST 4, 2023

England, 2021) The third portion of the duodenum courses between the SMA and the aorta, which can lead to external compression of the duodenum. England, 2021) In SMA syndrome the angle is decreased to < 22 o and the normal distance <8 mm. England, 2021) This condition is often attributed to rapid weight loss.

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EMDocs

NOVEMBER 13, 2024

Commonly a monomicrobial infection with gram-negative bacteria like E. Paracentesis is a safe procedure with a low complication rate (< 1%). For the remaining fluid inject 1 mL into a purple top EDTA blood tube for cell count; send 2-3 mL for Gram stain in a red-top tube or sterile urine container. 2021 Aug;74(2):1014-1048.

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Pediatric EM Morsels

MAY 5, 2023

Vegan Diets in Children: Basics Vegan Diets avoid/prohibit consumption of any animal products Exclusion of meat, eggs, honey, dairy products, etc This is often adopted due to heightened concern of animal maltreatment, but also for religious reasons or health benefits Roughly 2-5% of Western nation populations follow a vegan based diet (Sutter, 2021) (..)

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ALiEM

MARCH 7, 2024

Ultrasound probes from left to right: linear (nenoates), phased array (infants/younger children), and curvilinear (older children/adolescents) Pro tips for performing renal/bladder POCUS on a child [1] Addressing potential anxiety leads to a more efficient and comfortable examination. Estimated volume = 39.2

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ALiEM

MAY 19, 2023

The SB tube was created in 1950 in order to help tamponade variceal bleeds [1]. Apply traction to the tube by tying a roller bandage to the end of it and then the other end to a 1 L bag of IV fluids. Pearl 1: Check the units of pressure being used. The conversion rate is: 1 cmH2O = 0.74 1950 May;131(5):781-9.

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This Podcast Will Kill You

OCTOBER 1, 2024

Medical journal of Australia , 190 (9). Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-α-1, 3-galactose. Ronmark, E. The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1, 3-galactose.

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Pediatric EM Morsels

NOVEMBER 17, 2023

2021 Jun;31(6):713-719. Epub 2021 Apr 11. Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. 1994 Jul;125(1):57-62. 2019 Sep;74(9):1186-1190. 2016 Feb;30(1):3-11. Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments.

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REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. NEJM 1994. [2] Richards JE et al.

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Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm. Following more detailed questioning — it turned out the patient had started taking 9 different herbal remedies to ease lethargy and unspecific neurological symptoms. For clarity in Figure-1 — I've reproduced the initial ECG in today's case.

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REBEL EM

SEPTEMBER 27, 2023

Dosing: 1-2 mEq/kg bolus If there is a response, initiate an infusion: 150 mEq in 1L of D5W at maintenance Severely poisoned patients, may require multiple boluses of sodium-bicarbonate until the QRS narrows. Mohan 2021 ) Recall that the subsequently alkalemia will shift potassium intracellular. 1985 Aug 22;313(8):474-9.

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Dr. Smith's ECG Blog

DECEMBER 19, 2023

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. Challenge QUESTION: The relative change in T-QRS-D is not the only thing that changes during period of time that passed between recording of the 2 ECGs shown in Figure-1.

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EMDocs

NOVEMBER 6, 2024

2004;141(1):17-21. What are important clinical features differentiating strychnine and tetanus toxicity to aid with diagnosis? How does the clinical management of strychnine and tetanus differ? Site of action of strychnine and tetanus. red X = target of strychnine = target of tetanus Adapted from: Stephan J. Neurotransmitter.

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This Podcast Will Kill You

JULY 23, 2024

Official journal of the American College of Gastroenterology| ACG , 118 (1), pp.59-76. Annals of internal medicine , 172 (1), pp.ITC1-ITC16. ” BMC medicine 17 (2019): 1-20. . ” BMC medicine 17 (2019): 1-20. Gastroenterology , 160 (1), pp.63-75. ” Internal and emergency medicine 9 (2014): 249-256.

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EMDocs

FEBRUARY 15, 2024

1 These plants contain tropane alkaloids such as atropine (mixture of d-hyoscyamine and l-hyoscyamine) and scopolamine which are muscarinic receptor antagonists. 2 Jimson weed ( Datura stramonium, Figure 1) is one of several anticholinergic plants that if ingested can cause anticholinergic toxicity. 3 Figure 1. 3 Figure 1.

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This Podcast Will Kill You

NOVEMBER 27, 2023

” Cambridge: Cambridge University Press 197 (1993): 9-23. Parasites & Vectors , 15 (1), pp.1-9. Global programme to eliminate lymphatic filariasis: progress report, 2021– Weekly Epidemiological Record , 97 (41), pp.513-524. The Lancet Global Health , 8 (9), pp.e1186-e1194. 2021): 879-893. 2021): 3-23.

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This Podcast Will Kill You

NOVEMBER 12, 2024

1996 Jul;10(9):1002-13. Dermato-endocrinology , 1 (3), pp.162-169. International journal of women’s dermatology , 8 (1), p.e003. Aesthetic Surgery Journal , 30 (1), pp.74-77. The Journal of clinical and aesthetic dermatology , 14 (9), p.33. Bagatin, E., Journal of neurobiology , 66 (7), pp.606-630.

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EMDocs

JULY 17, 2023

1 While less common than small bowel obstruction (SBO), obstruction of the large bowel is more likely to be a surgical emergency and is often associated with a serious underlying condition. 1 The most common causes of non-cancer-related LBO are cecal and sigmoid volvulus. Small bowel dilation may also be seen.

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This Podcast Will Kill You

JANUARY 16, 2024

Manaresi, E. Pt 9 (2008): 2280. Adeno-associated virus 2 infection in children with non-A–E hepatitis. ” Parvoviruses 1 (2006): 5-14. . “Host-specific parvovirus evolution in nature is recapitulated by in vitro adaptation to different carnivore species.” ” PLoS pathogens 10.11 (2014): e1004475.

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EMS 12-Lead

APRIL 28, 2022

Initial vital signs include: NIBP 99/58 HR 150-160 (trend) RR 10 (spontaneous, but shallow) SpO2 86 (RA) BBS CTA The initial rhythm strip is attached: Figure 1 There is a wide complex tachycardia of varying morphology, amplitude, and R-R cycle length. A prominent vertical scar, however, is noted at the sternum.

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This Podcast Will Kill You

NOVEMBER 5, 2024

1996 Jul;10(9):1002-13. Dermato-endocrinology , 1 (3), pp.162-169. International journal of women’s dermatology , 8 (1), p.e003. Aesthetic Surgery Journal , 30 (1), pp.74-77. The Journal of clinical and aesthetic dermatology , 14 (9), p.33. Bagatin, E., Journal of neurobiology , 66 (7), pp.606-630.

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Don't Forget the Bubbles

JUNE 30, 2023

He has already climbed Ben Nevis in Scotland, visited the Gobi desert (possibly from the comfort of his parents 4 x 4, but who’s judging) and has his bronze D of E nailed. She calls out her findings: A – OK B – 1 puncture mark to the anterior left chest wall, covered with a three-sided dressing. Actively oozing.

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Don't Forget the Bubbles

NOVEMBER 29, 2023

Intensive Care Research , 1 (3-4), pp.60-64. Epub 2014 Sep 9. Pappal RD, Roberts BW, Mohr NM, Ablordeppey E, Wessman BT, Drewry AM, Winkler W, Yan Y, Kollef MH, Avidan MS, Fuller BM. 2021 May;77(5):532-544. 2021 May;77(5):532-544. Epub 2021 Jan 21. 2013 Jan;31(1):222-6. Burgart, A.M. and Kanaris, C.,

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EMDocs

JUNE 27, 2024

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? 2022 Jul 5;328(1):57-68. 2020 Feb 12;10(1):2470.

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Don't Forget the Bubbles

JANUARY 17, 2024

2021 A plain abdominal X-ray shows multiple dilated loops of bo wel. 2021 These beads, once hydrated inside the body, reached considerable sizes. Around 80% of those reported pass spontaneously, with another 10-20% requiring endoscopic removal and only 1% requiring surgical intervention. BMC Pediatrics , 21 (1), Jackson, J.,

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ALiEM

OCTOBER 30, 2023

It should be no surprise that academic clinical educators are at high risk for burnout, stalled career advancement, and abandonment of academic medicine altogether [1, 2]. 2022; 11(1):45-52. 2019 Nov 27;4(Suppl 1):S130-S139. 2021; 43(10):1210-1213. PMID 32130055 Schulte EE, Alderman E, Feldman J, et al.

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This Podcast Will Kill You

JANUARY 2, 2024

2002): 1-7. Nature Reviews Endocrinology , 7 (9), pp.540-557. Endocrine reviews , 43 (1), pp.61-90. Molecular and Cellular Pediatrics , 7 (1), pp.1-9. Sochett, E. Annual review of biochemistry , 78 , pp.929-958. “Aspects of the history of osteogenesis imperfecta (Vrolik’s syndrome).” 2016): 62-76.

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This Podcast Will Kill You

SEPTEMBER 10, 2024

Perantoni, E., Kaimakamis, E., JMIR Medical Informatics, 9(1), p.e22753. . “Laennec, the Man—1781–1826.” ” The Boston Medical and Surgical Journal 195.5 1926): 208-211. Lung sounds recordings: Rocha, B.M., Vogiatzis, I., Natsiavas, P., Oliveira, A., Marques, A. and Paiva, R.P., and Pang, W.,

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EMDocs

FEBRUARY 7, 2024

Despite a plateau in overall union membership of around 10% in 2023 1 , major labor actions shook the U.S. there were 31 recorded healthcare strikes in 2021, 39 recorded healthcare strikes in 2022, and 37 healthcare strikes in 2023 as of November 3rd. months between 1993 and 2021 to one strike every 1.4 2023 October 9.

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REBEL EM

JANUARY 25, 2024

What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021. The first evaluation of the patient was to be done within 1 hour of arrival to ED (Including the first POCUS). to −0.66) and −1.66 (95% CI −2.09

ED 130

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EMDocs

JANUARY 17, 2024

1) There are a limited number of antitussives on the US market which include benzonatate, codeine, dextromethorphan, diphenhydramine, and hydrocodone. 9) The safety announcement highlighted the mortality risk of exploratory ingestions in children under 10 years. What are the treatment options for a benzonatate overdose?

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Pediatric EM Morsels

AUGUST 18, 2023

Myth #1: Musculoskeletal Adverse Events (MAE) This concern is likely the most common reason fluoroquinolones are rarely used in children. Which is a risk of 1 event for 62.5 Ross 2021) Predisposing risk factors including older age , trauma to tendons or joints , and a family history of MAEs. Arthropathy was seen in 13.7%

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Don't Forget the Bubbles

JULY 22, 2024

study from 200 9. A large proportion of the trials come from Finland (3) and The UK (2) and also from Australia (1) and the US (1), but only a small number took place in the ED. Castro-Rodriguez JA, Beckhaus AA, Forno E. 2019 Aug;9(8):e028511. 2023 Sep 9 [cited 2024 Jan 30];62(suppl 67). Pediatr Pulmonol.

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Don't Forget the Bubbles

MARCH 18, 2024

The Royal Children’s Hospital in Melbourne summarises them in an easy-to-follow flow diagram (figure 1). Typical HUS has a diarrheal prodrome, usually caused by an infection with a Shiga-toxin-producing E. Blood tests Urine Stool Full blood count with blood film Urinalysis Stool MC&S Coagulation Urine MC&S E.

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ACEP Now

JANUARY 9, 2024

FIGURE 1: Abdominal X-ray showing particulate radiopaque foreign bodies involving the stool. 1 Children are particularly vulnerable. 9 Lead exerts its toxic effects by interfering with various organ functions, primarily targeting the nervous system and hematopoietic system, as well as impairing liver and kidney functions.

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EMDocs

MAY 11, 2024

CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis? Updated November 9, 2023. Epub 2019 Dec 9. On exam, the patient opens eyes to voice, has extraocular movements intact, is unable to speak, and has 0/5 strength in all extremities. Available from: [link] Guy-Evans, Olivia.

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This Podcast Will Kill You

NOVEMBER 7, 2023

New England Journal of Medicine, 355(1), pp.51-65. Nature reviews Disease primers, 1(1), pp.1-20. Craythorne, E. 2021): 1044-1049. International journal of dermatology, 49(9), pp.978-986. Public Health Research & Practice, 32(1). British Journal of Dermatology, 178(1), pp.140-147.

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