Varicoceles
We have discussed testicular issues, like Torsion and HSP associated pain in the past and we are all aware that a painful scrotal mass should be considered torsion until proven otherwise. The common way to assess for that is with…
Category 2013 Morsels
Scary Ascaris
We have discussed many commonly encountered issues throughout the Ped EM Morsels, but many of us stay interested in our jobs because of the significant vastness of topics that we encounter. When the child’s foster mother told me that she…
Parental Satisfaction
In Annals of Emergency Medicine this month is an article about Parental Satisfaction (Byczkowski TL, et al. A Comprehensive View of Parental Satisfaction With Pediatric Emergency Department Visits. Annals of EM. Oct 2013; 62(4): pp.340-350). The pressures of “patient…
Cat Scratch Disease
We have discussed lymphadenopathy previously and last week we spoke of a specific condition that is associated with enlarged lymph nodes: Kawasaki Disease and Incomplete Kawasaki Disease. While Kawasaki Disease is fun to think about, there is another condition that…
Delayed Diagnosis of Kawasaki Disease
Vigilance can be the most difficult part of our job. After being inundated with kids who have all started back to school and swapped their various viruses with one another and now have new fevers (after having just got…
Traumatic Lumbar Puncture
Lumbar Punctures are commonly done in the Emergency Department and we have discussed several important issues pertaining to them in the past (Positioning, Variance of Analysis based on Age, and Neonatal HSV), but we have yet to discuss the most…
Delayed Sequence Intubation
We often instruct with absolutes. “Never let the sun set on a pleural effusion.” “You’re not dead until you’re warm and dead.” “Never intubate an asthmatic.” Well, often medical decisions exist in a much less dichotomous realm. It is great…
Options to Intravenous Fluids
The Morsels have focused a lot on pediatric dehydration topics in the past. We have covered the utility of Probiotics and the need to be vigilant against Hypoglycemia. We have discussed specific infections, like Salmonella, and whether antibiotics are necessary. …
Typhlitis
We all care for many children who present with fever, nausea, and vomiting. Naturally, one of our first goals is to consider severe and life-threatening conditions and, fortunately, many times these are apparent on clinical exam. Unfortunately, certain patient populations,…
Pneumonia Detection
Over time we all become quite confident in our clinical exam, which is routinely justified. Occasionally, however, we do have to take a step back and ask ourselves whether our detective skills are refined enough to make the diagnosis all…