(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 16-year-old boy who presented with lightheadedness and palpitations during basketball warm-ups.
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10-year-old girl who was hit in the eye with a softball, causing her to fall to the ground. She has periorbital… Continue Reading →
The ABCDEFG of tox-caused bradycardia Alpha-2 agonists (e.g. clonidine) Beta-blocker Calcium channel blocker Digitalis ETOH Fentanyl and other opiates Gardening (pesticides with organophosphates)
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an adolescent who had a syncopal episode at school. It occurred 10 minutes after P.E. class had finished, when she was in… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 14 year old boy who presents with shortness of breath and chest pain while playing basketball. He has noticed it for… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an 18 year old male who presents with palpitations. Electrocardiogram reveals atrial fibrillation with a rapid ventricular response rate at 145.
Hypertensive urgencies and emergencies can be missed in kids when physicians are used to the elevated BP’s of adults with essential hypertension. Hypertension in children is defined relative to the 95th percentile for age & sex. BP > 90th percentile is elevated;… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 4 month old infant with fever, nasal congestion, and cough for 2 days. The baby is a previously well ex-full term… Continue Reading →
Everyone knows it’s nearly impossible to memorize all the formulas and doses relative to pediatric emergency medicine. That’s why 2 pediatric emergency medicine physicians created http://pocketpem.com/ when they were PEM fellows. Log on for a plethora of PEM info; maybe even bookmark… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 15yo patient with past psychiatric history who takes escitalopram (Lexapro) and quetiapine (Seroquel) for nausea and vomiting. You give the patient… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 2 year old who is slowly improving from a bout of acute gastroenteritis manifested by fever, vomiting, diarrhea, and abdominal pain… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 5yo girl comes in for chest pain for 6 hours and is noted to have a heart rate of 250 that is not varying…. Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →
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Improve success of vagal maneuvers for patients in simple SVT by adding the “REVERT” maneuver: the patient performs valsalva maneuver in a semi-recumbent position, then the practitioner immediately puts the patient into a supine position with legs passively raised at… Continue Reading →
It’s July, so good time to review the basics. For pediatric resuscitations of any type, the mnemonic ABCDEFG is great – Airway, Breathing, Circulation, Don’t Ever Forget Glucose. Children have lower reserves and become hypoglycemic more easily than adults when… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10 year old recently moved to the U.S. from Mexico with left sided chest pain for one day, and a fever… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 2yo child is brought in after having taken some of Grandma’s “heart medicine.” Because the pills are kept in an unlabeled box and not… Continue Reading →
A quick rule of thumb for estimating whether the QTc is normal is to look for it to be half the preceding RR interval (see figure below from ECG Interpretation). However, note that this rule of thumb is not accurate… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 17 year old boy comes is brought in to the ED at 2am for severe retrosternal chest pain that awoke him from sleep. He… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 2 year old child recently brought from a third world country with PMH of an unrepaired hole in the heart and mild cyanosis is… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A previously healthy 5 year old boy with PMH of ADHD presents with 9 days of lethargy, fever, vomiting, diarrhea, and weight loss. He recently… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are evaluating the electrocardiogram of a 2 year old boy. The patient presented for fever and the ECG was inadvertently ordered on him instead… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 6 week old ex-30 4/7 weeks twin A male infant was seen at an outside clinic because his parents felt that his heart was… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) An 8 year old boy presents after taking 3-4 of grandma’s pills about an hour prior. It is unknown what Grandma takes, but she has… Continue Reading →
A 14yo boy presents with fever and chest pain for 2 days. The chest pain is pleuritic and worse with leaning back. On examination, lung sounds are clear bilaterally, heart is regular with no murmurs, but a friction rub is… Continue Reading →
A 12yo boy with very high risk ALL, recent chemotherapy 4 days prior, presents to the ED with fever and lethargy. Temperature is 39C, HR 180, RR 24, BP 80/50. The patient is lethargic, has no nuchal rigidity, lungs are… Continue Reading →
17yo boy with long legs and arms, h/o scoliosis and mild pectus excavatum, hyperextensibility of the thumbs, presents with sudden onset ripping quality chest pain and feeling lightheaded. On exam, patient is anxious appearing, afebrile, HR 105, BP 98/45, RR… Continue Reading →
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