(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 2-year-old girl that had a PEG gastrostomy tube placed 1.5 years ago. The parents have noticed resistance when pushing in the… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10 month old female with profuse projectile vomiting and one episode of diarrheal stool over the last 2 hours. She is… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) Parents bring in a 3 year old child that drank a few sips of household bleach which had been stored by grandparents in an empty… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies 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!) You are seeing a 19 year old male who has had several ED visits for abdominal pain, nausea and vomiting. He insists that he does… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) A 6 year old boy presents with 2 days of nontender palpable purpura of bilateral lower extremities, accompanied by arthralgia of the left ankle. Vital… 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 week old infant with non-bilious forceful vomiting x 3 days.
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 5 day old infant born term without complications brought to the ED because the parent noted a streak of bright red… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies 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!) You are seeing a 3 year old child adopted from another country 6 months ago for abdominal pain. Since then, the child has had chronic… 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 →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 2yo patient with 6 hours of intermittent episodes of apparent abdominal pain happening every 15-20 minutes, and non-bloody non-bilious vomiting. In… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10 year old boy with abdominal pain. He was seen last night with a few hours of periumbilical abdominal pain. Work-up… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) A full term infant with no birth complications and no known risk factors for hyperbilirubinemia complications, discharged early at 36 hours of life, presents to… Continue Reading →
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With the rise in legality of cannabis products, ED (and even PED) clinicians are seeing a big rise in cannabis hyperemesis syndrome. Topical capsaicin 0.025-0.075% is a known reliever of symptoms, as outlined on AliEM here. But who stocks topical… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) What is the most common cause of lower GI tract bleeding in young infants after anal fissure?
(Click the link to comment and to vote – voting not working through email, sorry!) A 1 week old presents with multiple bouts of hematemesis. The baby was born full-term, no complication, has been breast-feeding normally, and is afebrile. The… Continue Reading →
Hyperemesis due to cannabis use is on the rise, particularly in areas with marijuana legalization. While classically it is seen in chronic, daily users, affected patients sometimes have been using cannabis for less than a year, and may be using… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) 14yo boy presents with LLQ abdominal pain and left hip pain for 5 days. He has not had any fever. He is an active baseball… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 5 month old comes in with diarrhea x 3 days, 5 times per day initially now 3 times per day, non-bloody, no fever, no… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) An 11 year old girl was sitting with lap belt only in the back seat of a minivan involved in a motor vehicle accident where… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 10 month old infant with history of constipation comes in with a 1cm dark red (but not dusky) painless mass extruding from the anus…. Continue Reading →
Your local hospital cafeteria can be a useful resource in managing your PED patients: Sugar liberally applied to the edema of a paraphimosis or rectal prolapse may help decrease swelling and improve reduction efforts A mayonnaise packet provides useful lubricant… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Several members of a family present to the cruise ship infirmary of an Alaskan cruise. They just ate a lunch consisting of tuna salad sandwiches…. Continue Reading →
A family obtained tuna from the local farmer’s market and prepared it for dinner. The children thought the fish tasted weird, peppery or metallic, but the parents did not, and told the children to stop complaining and eat dinner. Within… Continue Reading →
A 19yo man presents with his 3rd bout of unremitting nausea and vomiting. He has been admitted twice before and treated with ondansetron and IV fluids. He was noted to take frequent long showers while admitted. (Click the link to… Continue Reading →
What do you include in your GI cocktail for adolescents?
You are seeing a 5 year old with intermittent LLQ abdominal pain for a month. She is well appearing and has a benign abdominal exam. She is eating normally, not vomiting, and has no fever or diarrhea. The parents deny… Continue Reading →
You are seeing a 6 week old ex-full term infant who is breastfeeding exclusively, having 6 wet diapers per day, 4 or more soft seedy stools per day, growing well, and no fever. Baby has been jaundiced since 1st week… Continue Reading →
All of the following preclude expectant outpatient management in the case of an ingested button battery found by imaging to be in the stomach except: A. Co-ingestion of a magnet B. Child complains of abdominal pain C. Child has history… Continue Reading →
A 6yo boy is in the ED with his third episode of intussusception over the past year. Previous episodes presented with colicky abdominal pain and stool guaiac positive, and were successfully managed using barium enemas. He has been completely well… Continue Reading →
What can you do if your patient is maxed out on ondansetron but still feels nauseated? A recent study in Annals EM found a positive treatment effect of deeply inhaling from a standard isopropyl alcohol pad held 2.5 cm from the… Continue Reading →
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