Welcome to the Ped EM Morsels!
Why “Morsels?” Simply put, I like desserts more than I like jewelry.
Additionally, the overall goal of continuing our education is to enhance our comfort with the vast topics that exist in the medical arena. What is more comforting: solitary and expensive calcium carbonate rejected by a mollusk or delicious, sweet tidbits that were just delivered to you fresh and warm? I agree: Morsels beat Pearls.
The goal of these Pediatric EM Morsels is to continue to encourage us all to enhance and refine the care of pediatric patients. The care of pediatric patients often brings up a myriad of diverse topics ranging from the common to the very unusual. It is difficult to stay abreast of the appropriate management of some many diverse entities, particularly when they may be quite different from those of our adult patients.
I encourage you to explore the Morsels that already exist… and if you are interested, subscribe in order to receive the weekly Morsel directly.
Thank you for your interest and dedication.
Have a great day,
Sean Fox, MD
Associate Professor
Department of EM
Carolinas Medical Center
Charlotte, NC
Interested? Let’s see what this week’s Morsel is!
I would really like to receive the weekly morsel
Thanks so much
Kate
Absolutely! You can subscribe by using the “envelope” up on the right hand column. Or I can do it for you… let me know your preference. -sean
Hi Sean,
I was delighted to stumble upon this website, and follow on twitter. I wondered if you had a morsel to the approach to a child’s rash! Not asking for much, I know, but the toddler/baby rash is probably the one thing that I struggle with – rashes in adults are complex enough – but if they look well, it’s more reassuring. With little ones, although I’m guessing the same philosophy follows, the concern is missing that one ‘viral’ looking rash that turns out to be something nasty.
Any advice would be much appreciated
Many thanks
Kesh
Twitter @KiefKhullar
Dr. Khullar,
Thank you for the interest in the Morsels first of all! I appreciate the comment.
As for rashes… I hope no Dermatologist is reading… I HATE RASHES! Adult and Pediatric!
I have covered a few different rashes in the Morsels:
Molluscum Contagiosum, ITP, Staph Scalded Skin, Perianal Strep, Intertrigo, and Meningococcemia to name the ones I can easily remember.
The way I approach rashes is simple (because I am simple minded in general).
1) Identify presence or lack of Petechiae, Purpura, Vesicles, Bullae, Target Lesions, or Desquamation. If any of these are present, it is time to think a little harder (ex, petechiae can be present for benign reasons like vigorous vomiting or coughing, but a single petechiae below the nipple line is concerning for meningococcemia).
2) If the above are not present, then look for common childhood rashes. Molluscum, pityriasis rosea, 5ths Disease, etc.
3) If neither #1 nor #2 are readily apparent and the child looks well… I admit defeat and tell the family that I am not sure what this particular rash is but I do not think it is life threatening.
Certainly there are caveats to #3. Kawasaki Disease is a great example because the associated rash can be almost any type (generally not bullous though). So the “maculopapular” rash that is often seen with viral exanthems can easily be apart of the Kawasaki Disease presentation… but naturally, there are other findings that should alert the provider to that condition.
I hope that that helps. I will look at covering some more typical rashes in the coming Morsels.
Thank you for your question and comment!
Have a great day,
sean