Comments for Pediatric EM Morsels http://pedemmorsels.com Pediatric Emergency Medicine Education Fri, 17 Apr 2015 11:02:31 +0000 hourly 1 http://wordpress.org/?v=4.1.1 Comment on Injury Prevention by Lawn Mower Injuries http://pedemmorsels.com/injury-prevention/#comment-1057 Fri, 17 Apr 2015 11:02:31 +0000 http://pedemmorsels.com/?p=2138#comment-1057 […] this obsessive behavior of lawn maintenance can unnecessarily endanger our children.  I know that Injury Prevention isn’t the most exciting topic for us to discuss (we have covered Submersions, Firearms, […]

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Comment on Laundry Detergent Pod Toxicity by Research and Reviews in the Fastlane 079 - LITFL http://pedemmorsels.com/laundry-detergent-pod-toxicity/#comment-1056 Thu, 16 Apr 2015 14:10:27 +0000 http://pedemmorsels.com/?p=3396#comment-1056 […] More: Laundry Detergent Pod Toxicity (Pediatric EM […]

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Comment on Autism by Sean Fox http://pedemmorsels.com/autism/#comment-1054 Fri, 03 Apr 2015 17:18:40 +0000 http://pedemmorsels.com/?p=3489#comment-1054 Excellent points Dr. Sobolewski! Thank you for joining in the fun!

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Comment on Autism by Brad Sobolewski http://pedemmorsels.com/autism/#comment-1053 Fri, 03 Apr 2015 14:22:00 +0000 http://pedemmorsels.com/?p=3489#comment-1053 If you have them on site a Child Life Specialist is often (along with parents of course) the MVP when it comes to assessing the autistic patient. I also never sedate until I’m certain I have only a single problem to deal with (abscess, laceration). Consider that “minor” procedures may be better performed with anesthesiology and surgery in the OR if it’s safer for the child.

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Comment on Laundry Detergent Pod Toxicity by Sean Fox http://pedemmorsels.com/laundry-detergent-pod-toxicity/#comment-1049 Sat, 28 Feb 2015 19:18:18 +0000 http://pedemmorsels.com/?p=3396#comment-1049 Dr. Cao,
Thank you so much for the comment on therapeutic considerations!

While ingestion of bleach once got a lot of attention for possible esophageal injury, we may have become somewhat cavalier about this possibility recently; however, your point about needing to consider this with the Pod exposure is important! Especially if the child is intubated, we need to have a low threshold for contacting our specialists to scope the child.

I hope that you are doing well,
sean

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Comment on Laundry Detergent Pod Toxicity by James Cao http://pedemmorsels.com/laundry-detergent-pod-toxicity/#comment-1048 Sat, 28 Feb 2015 18:59:00 +0000 http://pedemmorsels.com/?p=3396#comment-1048 As a treatment recommendation, we tend to watch these kids for 6 hours from the time of ingestion, which was the latest that we have seen significant CNS depression. Anecdotally, kids with significant CNS depression tend to have lots of emesis early on.

Another difficult management question is whether or not these kids need to be scoped for esophageal injury. With emesis and then intubation, it is hard to predict degree of injury. I tend to recommend scopes for evaluation. Recent case series and my anecdotal experience is that these kids do not get severe burns/strictures. See reference: Smith E, Liebelt E, Nogueira J. Laundry detergent pod ingestions: is there a need for endoscopy? Journal of medical toxicology : official journal of the American College of Medical Toxicology. 2014;10(3):286-91.

Cheers,
James Cao

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Comment on Migraine Cocktail by Three reasons why you should not give diphenhydramine as pretreatment in migraines - PEM Blog http://pedemmorsels.com/migraine-cocktail/#comment-1045 Thu, 12 Feb 2015 15:02:57 +0000 http://pedemmorsels.com/?p=3364#comment-1045 […] If you’re a regular reader of the blog you know that I’ve posted on migraines before. For instance, you can check out the “Why We Do What We Do” on antiemetics (prochlorperazine and metoclopramide). Other excellent Pediatric Emergency Medicine educators have posted on the topic recently as well – see Sean Fox’s recent post on PedEMMorsels. […]

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