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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
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.
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 #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
PEMPix 2024 Online Case #2: Flight of Passage – 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 second of the four cases.
PEMPix 2024 Online Case #1: Mission: SPACE – 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 first of the four cases.
Medical Music Mondays: HSP – PEMBlog
What if the Fab Four from Liverpool sang about Henoch-Schönlein purpura - AKA IgA vasculitis. Wouldn't that be neat? Probably not. Anyway. Listen to this song, it's fun. Lyrics H-S-P Palpable purpura and swelling of the knee protein in the pee hypertension is a thing that you might see If the urine and B-P are okay You can send them home to
Medical Music Mondays: The World Has Turned And I’m Stuck Here – PEMBlog
Acquired torticollis is a self limited spasm of the neck muscles - often he sternocleidomastoid - that responds well to ibuprofen, heat, and gentle massage and stretching exercises. I thought you'd appreciate the "wry" sense of humor in the album cover... You'd think I'd write a song about asthma and a child that's a "Weezer?" Lyrics The
Medical Music Mondays: Dewdrops on a Rose Petal – PEMBlog
Dewdrops on a rose petal describes the classic appearance of the lesions in varicella infections. Chicken pox is preventable by vaccines you know... Lyrics Dewdrops on a rose petal Vaccines test your mettle it's chicken pox you silly fox! prodrome fever, body hurts then the rash arrives in spurts Varicella's itchy lesions most on trunk for some reason scabbing over, different stages once all crusted, not
Medical Music Mondays: Blindsided – PEMBlog
In honor of the return of football season I decided to post this tune... Concussions are nothing to mess around about - and sometimes you don't know you have one until a bit later. So a conservative plan involves resting until symptoms improve and following up with your doctor. No one knows if listening to "bro
Medical Music Mondays: Keep on Dancing (The Zofran Plan) – PEMBlog
Ondansetron is an antiemetic that reduces vomiting episodes in many illnesses. It also helps reduce the risk of IV fluids and admission in children with acute gastroenteritis. Also, AI images are weird and why did I end up with a picture of a Bruno mars look a like sitting on the toilet? Lyrics It might seem crazy
Podcast: ECPR – PEMBlog
This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals. While ECPR shows
Medical Music Mondays: Scabies for the Babies – PEMBlog
Scabies is everywhere! It's also very treatable with permethrin topically. It's also important to remember that patients and families feel unclean and stigmatized by this common infection - but they shouldn't! Also "Scabies for the Babies" will be stuck in your head. I promise... Lyrics It’s scabies for the babies Woo hoo We got scabies for the babies Do you? I
Exploring the Use of Intranasal Dexmedetomidine for Anxiolysis and Minimal Sedation – PEMBlog
Intranasal dexmedetomidine is one of the latest sedative options that’s gaining traction, especially for non-painful procedures. Let’s take a closer look at what makes this medication so useful, particularly when given intranasally. What is Dexmedetomidine? Dexmedetomidine, often known by its brand name Precedex, is a
Medical Music Mondays: At Your Throat Like Strep – PEMBlog
If the Wu Tang clan produced a track about strep throat in children it might sought like this. Also ODB could be "Oropharyngeal Disease Bacteria." Lyrics I'm at your throat like strep erythema, fever and exudate pain when I swallow It hurts and so can relate swollen lymph nodes in the neck belly pain headache and more stuff can you treat it? he is