PEMBlog

MARCH 12, 2024

New this year at the AAP NCE we will be hosting a brand new session that will highlight the talents of some of the very best educators in PEM. Faculty in the first ten years following training will be eligible to submit their very best presentation in any format on any topic Four finalists will present live at the NCE and compete for the title belt.

Pediatrics 52

Pediatrics 52

PEMBlog

FEBRUARY 22, 2024

Newborn infants need intramuscular injections of Vitamin K in order to produce critical clotting factors. If they don’t get it they can have potentially life threatening bleeding. This is a podcast episode that reviews Vitamin K Deficient Bleeding AKA Hemorrhagic disease of the newborn. @PEMTweets on… sigh “X” (Twitter) My Instagram My Mastodon account @bradsobo Listen [link] Subscribe References American Academy of Pediatrics, Committee on Fetus and Newborn.

Pediatrics 73

Pediatrics Anaphylaxis Administration Wellness 73

PEMBlog

FEBRUARY 9, 2024

Just look at the rash – then scroll down to reveal the diagnosis. That’s it. This child was placed on Amoxicillin for acute otitis media and this rash developed after 9 days of treatment. The child has fever and swollen feet as well. It’s Serum Sickness Like Reaction! This is a delayed allergic reaction to an antibiotic. Another name would be Urticaria Multiforme with systemic symptoms and joint involvement.

Allergic Reactions 52

Allergic Reactions Hospitals Wellness 52

PEMBlog

FEBRUARY 8, 2024

Just look at the rash – then scroll down to reveal the diagnosis. That’s it. This is a baby with swollen, erythematous skin of the chest wall. It’s Neonatal Mastitis! This is a skin and soft tissue infection of the breast tissue in a newborn. The treatment is directed towards S. aureus and you should never squeeze or incise this tissue in the ED.

Pediatrics 52

Pediatrics Wellness 52

PEMBlog

FEBRUARY 7, 2024

Just look at the rash – then scroll down to reveal the diagnosis. That’s it. And oh yeah, she did spend time in a hot tub during a recent trip. The nodules on the platter surface of the feet are painful. She is systemically well appearing. It’s Pseudomonas Hot-Foot Syndrome! This malady is characterized by the acute onset in children of exquisitely tender plantar nodules and a benign, self-limited course.

Wellness 98

Wellness 98

PEMBlog

FEBRUARY 6, 2024

Just look at the rash – then scroll down to reveal the diagnosis. That’s it. Nothing fancy. It’s Enterovirus! This rash is from enterovirus. It often looks dramatic like this in teenagers – and it can be painful. Notice the scabbed lesions that are present on the palms. It’s like hand, foot and mouth – but this is the adolescent presentation.

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PEMBlog

FEBRUARY 5, 2024

Just look at the rash – then scroll down to see the answer. That’s it. Nothing fancy. It’s Herpetic Whitlow! Herpetic Whitlow is a condition that often is seen in thumb suckers and is due to herpes simplex virus. The lesions are painful, and should not be confused with abscesses. Attempting an I&D can only make it worse. This may be an isolated finding or part of a primary outbreak with rash elsewhere, fever, and other systemic symptoms.

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PEMBlog

JANUARY 17, 2024

This episode will help you recognize cellulitis and even differentiate it from erysipelas which is totally a different thing. You’ll also learn about treatment, whether or not a blood culture is necessary, and a whole lot more. @PEMTweets on… sigh “X” (Twitter) My Instagram My Mastodon account @bradsobo Listen [link] Subscribe References Chen AE, Carroll KC, Diener-West M, Ross T, Ordun J, Goldstein MA, Kulkarni G, Cantey JB, Siberry GK.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

PEMBlog

JANUARY 3, 2024

This is an amazingly well-done infographic/video I found on Reddit of all places. I am working on finding out the source author – stay tuned.

Wellness 52

Wellness 52

PEMBlog

DECEMBER 14, 2023

Laryngomalacia, is the most common cause of infant stridor. Early diagnosis is crucial as it can impact a child’s growth and development. Most infants get better on their own, but those with severe symptoms need surgical interventions like supraglottoplasty. Learn all about diagnosis and management of this common problem in this brief podcast episode.

Wellness 52

Wellness Pediatrics 52

PEMBlog

DECEMBER 7, 2023

The Case A middle-school aged boy presents with a slightly pruritic rash that started along the side of his chest, but then soon spread to encompass several dozen similar lesions across his torso, especially his back. he has had no other symptoms, including fever or upper respiratory complaints. There are no new food, personal care product, or animal exposures.

Infectious Diseases 126

Infectious Diseases 126

PEMBlog

DECEMBER 1, 2023

This concise and informative video was developed at Cincinnati Children’s and features some of my colleagues. It discusses how to deal with fever, including treating it with antipyretics and what to look out for. I have a feeling it would be very helpful on your next shift if you shared it with a family that you are discharging home.

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PEMBlog

NOVEMBER 30, 2023

This excellent video was developed at Cincinnati Children’s and features some of my colleagues. It provides a step by step overview on how to deal with cough and congestion, including a really well done section on nasal suctioning with saline. It would be perfect to share with a family with a child with a URI or bronchiolitis.

Wellness 59

Wellness 59

PEMBlog

NOVEMBER 29, 2023

This incredible and informative video was developed at Cincinnati Children’s and features some of my colleagues. It provides a tremendous overview on how to do oral rehydration therapy in a step by step fashion and it is definitely something that I think you can share with your patients on your next shift.

Infectious Diseases 52

Infectious Diseases 52

PEMBlog

NOVEMBER 17, 2023

The case A self-proclaimed dance team superstar presents after injuring her foot at a regional competition. She tried to finish the routine after landing awkwardly. But was having difficulty bearing weight. She applied ice overnight and despite ibuprofen is still in pain, and presents to the ED the next day.On her exam the neruovascular exam is normal, and she has pain along the proximal edge of the 5th metatarsal.

Fractures 96

Fractures 96

PEMBlog

OCTOBER 26, 2023

Background Meckel diverticulum is a congenital abnormality of the small intestine and is the most common cause of significant lower gastrointestinal bleeding in children. It arises from incomplete involution of the vitelline duct during embryonic development, typically occurring by the 7th week of gestation. It is characterized by a blind-ending true diverticulum that contains all the layers found in the ileum.

Radiology 65

Radiology Radiology Administration Shock 65

PEMBlog

OCTOBER 19, 2023

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the fourth of the four cases. This case was submitted by… A previously healthy 19-month-old male presented with lethargy and abdominal distention from an urgent care.

Urgent Care 52

Urgent Care Pediatrics Poisoning Wellness 52

PEMBlog

OCTOBER 17, 2023

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the second of the four cases. This case was submitted by… A 6-year-old previously healthy female was brought to your emergency department with extremity pain. 4 days earlier, she developed r

Urgent Care 69

Urgent Care Burns Pediatrics Emergency Department 69

PEMBlog

OCTOBER 18, 2023

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the first of the four cases. This case was submitted by… A four-day-old, full-term, exclusively breastfed male with benign prenatal and antenatal courses, presented with one day of decreased

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

PEMBlog

OCTOBER 16, 2023

EmergiQuiz is an annual case-based presentation sponsored by the AAP Section on Emergency Medicine that challenges the audience to think through the differential diagnosis for four amazing cases. Traditionally these cases are presented live at the AAP National Conference and Exhibition. Since 2020 the AAP Section on Emergency Medicine has also been sponsoring the publication of online cases on EmergiQuiz.com.

Wellness 52

Wellness 52

PEMBlog

OCTOBER 16, 2023

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the first of the four cases. This case was submitted by… A 12-year-old female was brought to your emergency department by her mother for 1 month of diffuse abdominal and back pain.

Ultrasounds 69

Ultrasounds Emergency Department Pediatrics 69

PEMBlog

OCTOBER 12, 2023

After 6 wonderful years I have passed the duties of hosting PEMPix on to Maneesha Agarwal. She will do an amazing job presenting the 10 finalists at the Section on Emergency Medicine sessions at the AAP National Conference and Exhibition in Washington, DC on Saturday, October 21st from 12-1PM. As is tradition we will also be sharing 4 online cases in advance of the conference on PEMBlog.com.

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PEMBlog

OCTOBER 11, 2023

Traumatic bladder rupture is a rare yet serious injury observed in children who have experienced blunt trauma. Signs include lower abdominal pain, ecchymosis across the abdomen, bloody urine, and the presence of free fluid on abdominal imaging following a high-energy impact. The bladder is a hollow organ and therefore is relatively protected when empty, which makes rupture uncommon.

Fractures 98

Fractures Pediatrics 98

PEMBlog

OCTOBER 9, 2023

EmergiQuiz is an annual case-based presentation sponsored by the AAP Section on Emergency Medicine that challenges the audience to think through the differential diagnosis for four amazing cases. Traditionally these cases are presented live at the AAP National Conference and Exhibition. Since 2020 the AAP Section on Emergency Medicine has also been sponsoring the publication of online cases on EmergiQuiz.com.

Wellness 52

Wellness 52

PEMBlog

SEPTEMBER 29, 2023

Did you know that there are comprehensive respiratory viral panels that will test for dozens of viruses all at once? Did you know that these tests are very expensive, and that they rarely alter management? Did you know that Choosing Wisely recommends that we do not routinely obtain them for respiratory viral illnesses? Of course you did, but that doesn’t mean you shouldn’t watch this entertaining video that I made with Dr.

Pediatrics 52

Pediatrics Infectious Diseases 52

PEMBlog

SEPTEMBER 27, 2023

This is a blog post designed to disseminate the important work of Choosing Wisely , an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not. The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Olivia Ostrow, MD Hospital for Sick Children Toronto, Ontario,

Pediatrics 52

Pediatrics Hospitals Emergency Department Infectious Diseases 52

PEMBlog

SEPTEMBER 22, 2023

For most children with children with constipation an abdominal X-Ray will not assist in making the diagnosis or quantifying the exact stool burden. @WilltheThrill2 made a special video that helps to answer the question. And yes, he’s my son. Enjoy!

Pediatrics 52

Pediatrics Radiology Radiology 52

PEMBlog

SEPTEMBER 20, 2023

This is a blog post designed to disseminate the important work of Choosing Wisely , an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not. The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Kelly Levasseur, DO Children’s Hospital of Michigan Detr

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Pediatrics Emergency Department Hospitals Ultrasounds 123

PEMBlog

SEPTEMBER 15, 2023

Did you know that lab tests and CT scans are not recommended for most children who fully recover after a simple febrile seizure or a first-time, unprovoked generalized seizure? Choosing Wisely recommends that doctors and all medical providers have detailed conversations with patients and their families about why labs and CT scans are unlikely to give new information or provide any additional reassurance.

Seizures 52

Seizures Pediatrics 52

PEMBlog

SEPTEMBER 13, 2023

This is a blog post designed to disseminate the important work of Choosing Wisely , an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not. The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Paul Mullan, MD Children’s Hospital of the King’s Daughters No

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

PEMBlog

SEPTEMBER 8, 2023

Did you know that screening laboratory tests in the medical clearance process of pediatric patients who require inpatient psychiatric admission are not recommended unless clinically indicated? This video discusses why we don’t need labs for most children and adolescents who are being admitted to an inpatient mental health facility via an admittedly silly (but representative) conversation.

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Psychiatric Pediatrics 98

PEMBlog

SEPTEMBER 6, 2023

This is a blog post designed to disseminate the important work of Choosing Wisely , an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not. The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Shabnam Jain, MD, MPH Emory University/Children’s Healthcare o

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Psychiatric Pediatrics Emergency Department EKG/ECG 52

PEMBlog

AUGUST 28, 2023

Staring this week, and continuing for the next five, we will be releasing new content supporting the key Pediatric Emergency Medicine recommendations of Choosing Wisely. I have partnered with world experts on the subject matter, and we’ve been developing this series over the past several months. There will be episodes of PEM Currents: The Pediatric Emergency Medicine Podcast, blog posts here on PEMBlog, articles from Don’t Forget the Bubbles , videos, and more!

Pediatrics 52

Pediatrics Seizures Psychiatric 52

PEMBlog

AUGUST 30, 2023

This is a blog post and a podcast episode designed to disseminate the important work of Choosing Wisely , an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not. The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Michele Nypaver, MD University of Michig

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Pediatrics Best Practices Hospitals Emergency Department 52

PEMBlog

SEPTEMBER 1, 2023

Did you know that chest X-Rays are not recommended for most children with respiratory problems such as bronchiolitis, asthma exacerbations, croup, or first-time wheezing. Choosing Wisely recommends that doctors and all medical providers have detailed conversations with patients and their families about why X-Rays are unlikely to give new information or provide any additional reassurance.

Pediatrics 52

Pediatrics Infectious Diseases Radiology Radiology 52

PEMBlog

SEPTEMBER 1, 2023

Repetitive Read Syndrome is affecting Radiologists across the globe. Symptoms include dictations including the same phrasing and suggesting clinical correlation repeatedly. We can help our Radiology colleagues by avoiding unnecessary chest X-ray orders for most children with respiratory problems such as bronchiolitis, asthma exacerbations, croup, or first-time wheezing.

Radiology 52

Radiology Radiology Pediatrics 52

PEMBlog

AUGUST 8, 2023

Henoch–Schönlein Purpura (HSP) is a common vasculitis seen in younger children. The classic skin finding is palpable purpura in gravity dependent areas of the body (buttocks and legs). Children can also have arthralgias, abdominal pain and intussusception, and even nephritis. Learn about the diagnosis and management of Henoch–Schönlein Purpura (HSP) in this brief podcast episode.

Pediatrics 52

Pediatrics 52