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Medical Music Mondays: Target Sign – PEMBlog
The target sign is the pathognomonic thing seen on ultrasound in diagnosing intussusception. Also, air contrast enemas basically involve using a medical grade bike pump to reduce the stuck intestines... which is cool. Lyrics telescoping further than I ever thought we'd go intermittent painful crying episodes ileum and colon currant jelly poop intestine slowly dying turning into goop Intussusception ultrasound target sign air contrast enema after treatment you'll
Medical Music Mondays: Dex, Dex, Dex, Go! – PEMBlog
Does it take a catchy post-grunge alt rock song to remind you that all patient with croup should get a dose of dexamethasone before disposition? Does it? No? OK, well, um, the evidence is great that dex reduces the rate of return visits to Emergency Departments and Doctor's offices. So there's that. Lyrics Dex! Dex! Dex! Go! Dex!
Medical Music Mondays: 3 LPs and 1 DJ – PEMBlog
There are several things you can do to increase your likelihood of success when performing a lumbar puncture in children. Local anesthesia! Early stylet removal! Needle bevel to the hips! Lyrics Three LPs and one DJ Spinal tap procedure learn the right way Yo, roll the kid side lying tight Or upright holder if that seems right! Early sty let removal, that’s
Medical Music Mondays: Measles on the Dance Floor – PEMBlog
Measles is dancing yet again and I think we all know why. With an attack rate of 90%+ if you are not vaccinated you are at risk. Lyrics Fever’s high, eyes are red, runny nose, stuck in bed. inside cheeks, tiny spots — Koplik's calling all the shots. Rash spreads fast, head to toe—measles, no, don’t say it's so! Too
The Mycoplasma Comeback: Why This Atypical Pneumonia is Back – A PEMCurrents Podcast – PEMBlog
In this episode we dive into the resurgence of Mycoplasma pneumoniae—an atypical bacterial cause of community-acquired pneumonia that’s making waves in pediatric emergency medicine. We’ll cover its clinical presentation, epidemiology, diagnostic approach, and management, including why standard beta-lactam antibiotics won’t work. Plus, we’ll discuss whether M. pneumoniae even needs to be treated in the first place!
Medical Music Mondays: MRSA Melody – PEMBlog
MRSA is the main cause of cutaneous abscesses. You treat them with incision and drainage. remember the lidocaine field block, and break up those locations with a hemostat. Packing isn't necessary for most abscesses. Lyrics You know that what they say is true An abscess is infecting you MRSA deep within your skin Drain it with an incision Come on baby
Medical Music Mondays: Convulsive Syncope – PEMBlog
At least 40% of the time when someone faints they have some abnormal movements. These aren't seizures! Convulsive syncope is what we call it when someone faints and jerks a bit. Lyrics Sunday morn and her heads all light Stayed up late the previous night Takes a step to the bathroom Staggers and then blacks out It was a fainting spell! Then
Medical Music Mondays: Welcome to the K-Hole – PEMBlog
Ketamine is an amazing drug for procedural sedation in the Emergency Department. Kids also look wild when they're on it - some people call that look the "K-Hole." Imagine a creepy industrial metal song about that... go ahead... I'll wait. Lyrics Welcome to the K hole Now you're deep inside Not responding to stimuli But your eyes are open wide We
Medical Music Mondays: Beneath the Surface – PEMBlog
Cellulitis is like an infection of the icing - if you imagine the skin as a piece of cake that it. Treat with cephalexin - red, hot, swollen, and tender - and sometimes fever and systemic symptoms. I could've wrote a song about erysipelas but it doesn't rhyme with anything. Lyrics Fast spreading and red I hope I'm
Medical Music Mondays: Back in a SCFE – PEMBlog
Maybe this is true for you too, but I always remembered what the X-Ray findings for Slipped Capital Femoral Epiphysis are by imagine a scoop of ice cream falling off a cone. Just search for an image online. You'll see what I mean. Also this needs Orthopedic intervention within 24 hours. Lyrics The ice cream fell off
Medical Music Mondays: Slappin’ Bee Melody – PEMBlog
Slapped cheek rash? It's Parvovirus B19 causing erythema infectiosum, aka fifth disease. the characteristic rash shows up after the fever, malaise, aches and GI symptoms. Also, remember it can cause fetal anemia, non-immune fetal hydrops and fetal death if a pregnant person is infected. Also bees don't carry it. Lyrics Erythema infectiosum Fever, aches, malaise it’s true Initial constitutional
Navigating the Quademic: Clinical Differentiation of Influenza, RSV, COVID-19, and Norovirus in Pediatric Emergency Care – PEMBlog
The concurrent circulation of influenza, respiratory syncytial virus (RSV), COVID-19, and norovirus during peak viral seasons presents a diagnostic challenge in pediatric emergency settings. Differentiating these pathogens based on clinical presentation is crucial for targeted management, minimizing unnecessary diagnostic tests, and optimizing healthcare resources. This article delineates the salient clinical features, associated complications,
Medical Music Mondays: Migraine Cocktail – PEMBlog
Migraines are terrible. In the Emergency Department the "Migraine Cocktail" successfully treats 90+ percent of patients. Prochlorperazine and Toradol to the rescue! Also, it's hard to make an AI Radiohead inspired song. Lyrics throbbing headache on one side floating zig zags eye to eye lights and sounds irritate Nausea, triptan? is it too late headache worsens treatment time Prochlorperazine plus toradol and you'll be fine sip
A Podcast on Inhalant Misuse: From Glue to Galaxy Gas – PEMBlog
In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, we explore the complex and often underrecognized issue of inhalant misuse. From the early days of glue sniffing to the recent rise of nitrous oxide misuse, fueled by brands like Galaxy Gas and viral trends on TikTok and Instagram, inhalant misuse has evolved
In case you missed it: A podcast on norovirus – PEMBlog
Here in early 2025 we are seeing a norovirus outbreak in the United States. That's a lot of vomiting and diarrhea. I wanted to share my podcast episode on norovirus that is only 7 minutes and 13 seconds long! If you listen at 1.5x speed - I know there are those of you
Medical Music Mondays: So Appy to See You – PEMBlog
Appendicitis! Rock Opera! McBurney's point! Epic! Lyrics So Appy to see you Said the Surgeon to the doc Take out that appendix while I'm on the clock Pain was vague then moved last night In the quadrant lower right Vomit and some hopping pain A fever now, can you explain? McBurney's point and rebound Next step is an ultrasound Call the surgeon, call them quick Appendicitis
Medical Music Mondays: STI Guy – PEMBlog
Sexually transmitted infections are extremely popular. This is a bad thing. We should test for them in patients with and without symptoms and have a treatment plan as well. Also ska is fine. Not great. Fine... Lyrics Drippy, drip, and painful pee Are you thinking STD? Chlamydia and GC Trichomonas certainly Don’t forget syphilis the great pretender Remember this! Please, please test for HIV And
Medical Music Mondays: Anaphylax Attack – PEMBlog
Guess who's back? Back again. Epi Pen. Jab a friend. Give that EpiPen even if you think it might possibly be anaphylaxis! Lyrics His palms are sweaty, knees weak, arms are heavy, He's allergic, it's anaphylaxis already. He's chokin', his throat's closin', hives all over, IgE mediated, peanut exposure Mucosa swollen, he's gaspin' for breath, Heart poundin' like a drum, he's scared
Medical Music Mondays: We’re Here for You This Christmas – PEMBlog
The Emergency Department never closes - not even on Christmas Day. This song reminds us all that the ED is always open, and that we are there for our patients during the holidays. But we still miss our families... Lyrics When I’ve got to work on Christmas I’ll tell you what I’ll do I will treat all sorts of
Medical Music Mondays: Sorry About the Wait (Urgent Care) – PEMBlog
Urgent Cares are awesome places to receive effective efficient care. they can also be busy. Maybe a female power-pop-punk-alternative band can help celebrate the achievements of our Urgent Care clinicians. Lyrics We just told you that it’s just a virus Even though diagnosis did not inspire us It doesn’t mean that your child’s not ill Or the diagnosis needed no
Medical Music Mondays: Whoop! 100 Days – PEMBlog
Pertussis AKA whooping cough is on the rise due to declining vaccination rates. The initial catarrhal phase has mild symptoms but is super contagious. Then you cough like forever. Lyrics cough cough cough hack Whoop! uh huh uh huh uh huh cough cough cough hack Whoop! uh huh uh huh uh huh cough cough cough hack Pertussis made a comeback rapid spread, why
Whoop! There It Is: A Pertinent Pediatric Pertussis Podcast – PEMBlog
In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, we explore pertussis, also known as whooping cough - a disease that remains a public health challenge despite widespread vaccination efforts. We will review the clinical presentation, diagnostic strategies, management protocols, infection control practices, and vaccination updates. This episode also covers what healthcare
Medical Music Mondays: Constipation Nation – PEMBlog
The Rome IV criteria are how you diagnose constipation. Also X-Rays don't help. And "The Red Hot Chili Poopers" would be a great name for a tribute band. Lyrics Can't poop, no stool in about three weeks Walk slow cause now I think my butt leaks I strain and try but I can't go - no My bowel transit rate
Medical Music Mondays: Hip Pain Blues – PEMBlog
The Kocher criteria can help you rule out a septic hip. Transient Synovitis is a much better diagnosis. It used to be called Toxic Synovitis, but that name was too scary so it got changed. Lyrics In a kid with hip pain I’ve got to explain The Kocher criteria And using your brain Cannot bear weight A fever complaint White count 12K ESR 40
A fabulous virtual education session on delivering and receiving feedback from the AAP Section on Emergency Medicine – PEMBlog
I am excited to share the recording of the AAP Section on Emergency Medicine Fall Virtual Education Session, originally held on Tuesday, November 19, 2024 focused on delivering timely and actionable feedback, along with strategies to develop and implement sustainable feedback programs. PEM educators shared their experiences and provided practical strategies
Medical Music Mondays: Shiny Happy Virus – PEMBlog
You don't need to send comprehensive viral tests in the majority of children with cough and congestion. Just make a clinical diagnosis dang it! Lyrics Adeno, rhino, entero too swabbing a nose just for something to do RSV, HSV, EBV, no! Save all that money and let the kid go Influenza, COVID, why not some more? Big viral panels? Show them the
Medical Music Mondays: Palpable Olive Season – PEMBlog
Hypertrophic pyloric stenosis is such a down home diagnosis. You bring your baby home and then their weight goes down. Also the ultrasound measurements are a muscle wall greater than 3mm thick and a channel length greater than 14mm. 3 and 14 - 3.14, pi. Get it? Did you read this far? Lyrics Across the room The
Medical Music Mondays: Bleeding Tonsil Funk – PEMBlog
Did you know that post tonsillectomy bleeding occurs approximately 3 to 5% of the time, most often at days 5 to 7 after the surgery? Of course you did. Unstable children with active bleeding may need a trip to the OR. Otherwise ENT can help determine management. Lyrics Nasty strep or OSA Take those tonsils out today Remove adenoids
Probiotics don’t improve outcomes in children with acute gastroenteritis – PEMBlog
Introduction Acute gastroenteritis affects millions of children in the U.S. every year, leading to emergency department visits and hospitalizations. Probiotics, particularly Lactobacillus rhamnosus GG (LGG), have been commonly used as a treatment, but evidence supporting their effectiveness has been limited. A new study conducted by the Pediatric Emergency Care Applied
Medical Music Mondays: Terror of the Night – PEMBlog
Night terrors are super scary. And the kid doesn't even remember them! They're more like sleep walking than nightmares and parents are often worried that it's a seizure or something more serious. Lyrics Woke up late at night flailing and crying Couldn't wake him up though the parents were trying Oh why the unstoppable fussing and screamin' Could it be
Medical Music Mondays: The Pinworm Shuffle – PEMBlog
Pinworms! Ahhhhh! They itch at night and they're scary. Fortunately they are easy to treat and eradicate. They're still gross. Lyrics Pinworms makin me itch Pinworms son of a... WOAH! Nocturnal anal pruritus Emergence of the white worm Even steadfast parents Are beginning to squirm But fret not and don't cry There's a treatment for you Pyrantel pamoate and repeat in two weeks That's what we'll do!
Caring for Patients with Duchenne Muscular Dystrophy in the Emergency Department: A Problem-Based Approach – PEMBlog
Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. The condition affects multiple organ systems—muscular, cardiac, and respiratory—leading to a myriad of clinical complications. When patients with DMD present in the Emergency Department (ED), an understanding of the nuanced aspects of their care is
Medical Music Mondays: Lipase High! – PEMBlog
Did you know that pancreatitis is mostly caused by viruses in kids? They don't drink alcohol or get gallstones like grown ups. Also, scorpion bites apparently cause it. But that's silly and only something you see in board review books. Anyway, this would be a better Broadway musical than most retreads of 1980s & 90s
Medical Music Mondays: Factor First! – PEMBlog
Children with Hemophilia who present to the ED need to get a dose of Factor First! Don't delay and give their home factor if they have it. Lyrics Factor First! Factor First! Bleeding hemophiliac What's the plan of attack? Factor first! Factor first! Factor VIII or Factor IX Use home factor everytime Factor first! Factor first! IV access nice and quick Hopefully one needle stick Factor first! Factor first! Hematology call
Scope This! A Podcast on Gastroesophageal Reflux and Gastritis – PEMBlog
In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, I explore the complexities of gastroesophageal reflux (GER) and gastritis in children and adolescents. I'll make the important distinction between gastritis - which is diagnosed only via endoscopy - and dyspepsia, the term best used to describe the symptoms many patients experience.
Medical Music Mondays: Fear the Reefer (Cannabis Hyperemesis) – PEMBlog
Cannabis Hyperemesis Syndrome can make habitual smokers miserable! They will got some relief from hot showers - but many need fluids, ondansetron, topical capsaicin, and even Haldol. Lyrics Don't fear the reefer? Cannabis hyper-emesis syndrome says you do Intractable vomiting, many hot showers What, oh what, will we do? You didn't think this would happen You just decided to smoke Now you're puking
EmergiQuiz 2024 Online Case Diagnoses Revealed – PEMBlog
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
PEMPix 2024 Online Case #4: Frozen Ever After – PEMBlog
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 last of the four cases.
PEMPix 2024 Online Case #3: It’s a Small World – PEMBlog
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 third of the four cases.
EmergiQuiz 2024 Online Case Presentations – PEMBlog
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