Category Critical Care

ALCAPA – Anomalous Left Coronary Artery from the Pulmonary Artery

ALCAPA - Anomalous Left Coronary Artery from the Pulmonary Artery

Embryology is amazing. Seriously. Think about it. Growing from one cell to all of the complex structures that form our organs is literally miraculous. It is shocking that it is able to occur correctly at all and it should be…

Capillary Refill & Shock

Delayed Cap Refill

The critically ill infant and child can be “tricky” to spot sometimes. Often the phrase “That kid just doesn’t look right,” is heard around the room of critically ill children. So we recognize that “something isn’t right,” but have a hard time putting…

Ogilvie’s Syndrome

Colonic pseudo-obstruction

Caring for people, particularly children, can be very humbling. Just when you think you have a grasp of the potential hazards and pitfalls, a new zebra runs you over. While focusing extensively on “zebras” can be counterproductive, it is useful…

Linear Skull Fracture

Linear Skull Fracture

We all know that traumatic brain injury is a significant concern when evaluating pediatric patients with head injury. Over the years, this concern has lead to significant shifts in imaging and management practices: some for the better and… others perhaps…

Negative Pressure Pulmonary Edema and Croup

Negative Pressure Pulmonary Edema and Croup

Caring for patients is very humbling. I once described the EM Mindset as being one that requires Humble Arrogance (See EMDocs.net) – requiring humility to know you can’t know it all and arrogance to believe that your skills can make a…

Epinephrine for SHOCK

Epinephrine for SHOCK

Pediatric shock warrants great concern. Whether it is caused by Sepsis, Hypovolemia, Obstructive process (ex, Tamponade, PE, Pneumothorax), Cardiogenic  conditions, or “K“ortisol deficiency (Yes, I know it should be “Cortisol”… but then it wouldn’t spell SHOCK.) there are many management…

Occluded Vascular Catheter

Occluded Vascular Catheter

Children with chronic medical problems may require a variety of specialized tools, but what do you do when those tools become the problem. We have previously reviewed issues with Baclofen Pumps as well as Vagal Nerve Stimulators.  We have also…