POTD: Neonatal Resuscitation
Maimonides Emergency Medicine » Pediatrics
by Sabena Vaswani
1y ago
We’ll be going over a few high yield topics pertaining to NALS today.  It’s 7:30 AM, and you’ve just unwrapped your BEC sandwich and taken your first sip of coffee. You’re settling into the morning getting ready for your 12 hour peds shift… until the phone rings, and you get a note:  “Mother 38w delivered her baby at home 30 minutes ago. Baby is having labored breathing, and is bradycardic. EMS will be here in 2 minutes.” Take a deep breath. First, remember the basics. If you’re in a facility that has Peds/NICU, call them immediately. Call respiratory. Call pharmacy. Call Hector. Use ..read more
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Pediatric Fever
Maimonides Emergency Medicine » Pediatrics
by Eric Quinn
1y ago
Infant < 28 days: Do everything & give empiric Abx (Ceftazidime, Acyclovir (HSV) & Ampicillin) ^ CBC, BMP, Blood Cx (1 set), UA, Urine Cx, LP, RVP* ^There are new guidelines regarding patients who are between 3-4 weeks of age where LP may be deferred. There is a lot of controversy still regarding its adoption. 28 days to 2 months / 1st set of vaccines: Do everything however LP & Abx dependent on PECARN Rule for Low Risk Fever CBC, BMP, Blood Cx (1 set), UA, Urine Cx, RVP*, Pro-Calcitonin PECARN Rule for Low Risk Fever: LP if any of the following is positive: Pro-Cal > 0.5, A ..read more
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POTD: Hair Tourniquet
Maimonides Emergency Medicine » Pediatrics
by Catherine De Guzman
1y ago
This POTD is inspired by a case I saw from the periphery while in the Peds ED. I'll be discussing hair tourniquets! Toe-tourniquet syndrome, also called Hair-thread tourniquet syndrome (HTTS), is a rare and commonly misdiagnosed condition caused by hair or fiber wrapped around digits (fingers and toes), penis, or even clitoris. It usually affects infant and children. Prompt diagnosis is needed as ischemia can result. This is a diagnosis often missed because the presentation is so vague. Often the only complaint is a crying and inconsolable infant. This is why the physical exam is so important ..read more
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POTD: The Ingested Coin
Maimonides Emergency Medicine » Pediatrics
by Sean Dhanraj
1y ago
This POTD is inspired by a common occurrence in the pediatric ED and a question that routinely shows up on board questions. History: Mom and Dad are spring cleaning the apartment when 1 year old Freddy Boy starts having sporadic episodes of gagging or choking, and has vomited once. Parents report an episode where he looked like he was breathing faster and almost looked like he was struggling to catch his breath, which has since resolved. Mom and Dad panic and bring F.B. to your ED. Physical exam reveals a happy looking kid, vitals WNL, and a benign exam. Nothing in the back of the throat. Norm ..read more
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EMS Protocol of the Week - Pediatric Asthma/Wheezing
Maimonides Emergency Medicine » Pediatrics
by Adam Ranginwala
1y ago
Last week, we went over the REMAC protocol for asthma, but in a cliffhanger not seen sinceAvengers: Infinity War, we were all left wondering what NYC EMS does with asthmatic/wheezing kids. Well worry not, faithful readers, because this week we’re taking a look at Protocol 554 – Pediatric Asthma/Wheezing! There are a bunch of pediatric-specific protocols (remember that for the NYC REMAC, pediatric means up to 15 years of age), each with certain differences from its adult counterpart. Some differences are subtle, some not, so it’s worthwhile to at least have some awareness that these peds protoc ..read more
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POTD: Retropharyngeal Abscess
Maimonides Emergency Medicine » Pediatrics
by Adam Ranginwala
1y ago
Retropharyngeal Abscess What is it? Polymicrobial abscess in space between posterior pharyngeal wall and prevertebral fascia Adults: Usually due to direct extension of local infection (ex. ludwig's angina, pharyngitis, dental abscess etc.) Peds: Usually due to suppurative changes in local lymph nodes from an infection in the head or neck Can also be caused from trauma- falling with pencil in mouth Presentation: Patients may prefer to lay down to prevent abscess from collapsing the airway. If your suspicion is high enough, don't sit these patients up! Patients will complain most ..read more
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Paraphimosis and Phimosis
Maimonides Emergency Medicine » Pediatrics
by Sneha Shah
1y ago
What is it? Paraphimosis: the penile foreskin becomes retracted around the coronal sulcus (= the circumference at the base of the glans penis), leading to vascular congestion and glans edema Phimosis: the foreskin is retracted over the glans This is only an emergency if it is causing acute urinary retentionKeep in mind most uncircumcised infants have normal phimosis Why do we care?  If left untreated, paraphimosis can lead to some awful complications, such as necrosis or gangrene of the glans penis which can then necessitate a partial amputation of the penis  For phimosis causing uri ..read more
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POTD. Pediatric Grand Round. Pediatric Fevers
Maimonides Emergency Medicine » Pediatrics
by Elliot Warman
1y ago
Today’s Pediatric grand rounds was given by Dr. Prashant Mahajan, MH, MPH, MBA.  Professor and Vice-chair of the department of Emergency Medicine; Professor of Pediatric Medicine, Division Chief of Pediatric Emergency Medicine, Professor of Pediatrics at the University of Michigan For those that don’t know him- He’s really smart and has done a ton of research on febrile infants and he's proposing a new model to rule out serious bacterial infections in infants <60 days old.  TL:DR Serious Bacterial Infection (SBI) can be ruled out febrile infants from 29-60 days old ..read more
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POTD: Foreign Body of the Nose
Maimonides Emergency Medicine » Pediatrics
by Allison Kornblatt
1y ago
Foreign body of the Nose •        Most common age range: 2-5 yo •        Most common FB: beads, beans, peanuts, toy parts •        Beware of: button batteries and two magnets, as always. •        Can lead to septal perforation/necrosis of tissue. •        Be suspicious of nasal FB when you see unilateral discharge, often malodorous •        Complications: infection, aspiration, epistaxi ..read more
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POTD: Foreign bodies, Ears!
Maimonides Emergency Medicine » Pediatrics
by Allison Kornblatt
1y ago
This is a two part series for POTD. Foreign bodies: Ears and Nose! Today, Ears! Quick Anatomy review to help locate that FB: •        Anatomy –       medial 2/3 is fixed in temporal bone –where many FBs are lodged and/or where trauma •        Ask yourself: is it graspable or non-graspable? –       Graspable: 64% success rate, 14% complication rate –       Non-graspable: 45% success rate, 70% complication rate •   &nbs ..read more
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