empem.org

Kiddy Tox

Fortunately for us, younger kids are less dedicated in their efforts to harm themselves with a variety of poisons… On the other hand, their sneaky inventiveness knows no bounds, when it comes to getting hold of something that they shouldn’t. The principles of Clinical Toxicology are similar in kids and adults, but there are a few additional aspects to consider. Join us on a sketch of...

ISAAC blows wheezy whistle on APAP

This debate is going to be HUGE… Does paracetamol (acetaminophen) cause asthma? A series of large international studies and reviews dedicated to the question raise some interesting questions.  There appears to be an epidemiological association – not the same as a causal association – but something’s going on… For those of us who have been using APAP (=acetaminophen,...

Well Baby Oddities

Well babies can cause angst too… Except that neither parents nor doctors can be sure that they are well, until they have been properly assessed. From funny breathing to blue lips, baby boobs to milk regurgitation, a range of neonatal and infant oddities can present to our Emergency Departments. Some of these babies have real pathology and some have a minor but scary condition, with a great...

Sick Baby: undifferentiated infant under 3 months

Young infants under 3 months can be pretty scary when they get properly sick. It seems quite ‘veterinary’, and in many ways we just have to screen and treat for sepsis – and ask questions later… But there are a number of other differentials to consider. Signs of illness may be obvious, such as when we are presented with a pale, floppy baby, or they may be more subtle –...

Just Awful

Here’s a bit of fun… And some lessons for Pediatric Emergency Medicine, from 1971. It’s a kid’s book, about a boy who hurts his finger at school, and has to see the school nurse.  James feels Just Awful – until after the 3-part treatment. We learn about assessing, cleaning and dressing wounds, and gain some insights into a child’s perspective of being a patient. Enjoy. ...

MeningoCoccal Disease: Pearls and Pitfalls

A tiny, frightening little bug: Neisseria meningitidis.  The challenge for us in healthcare is to squash this little bug before it wreaks its havoc… Join us for a discussion of ways to protect yourself, and your patients, against the nasty threat of meningococcal disease. It creeps up on you… when you least expect. Standard Podcast [ 20:13 ]

Meningitis: Steroids or not?

The most important thing about treating meningitis is to give antibiotics as soon as possible.  The second most important thing is to institute appropriate supportive care.  Whether or not to give steroids as an adjunctive treatment is perhaps less clear to us… A recent Cochrane review goes a long way to pointing us in the right direction, but still leaves a few questions open.  Join us...

Meningitis Diagnosis and Management

The word strikes fear into the heart of parents. You dare not mention the ‘M’ word unless you back it up with action, or a whole heap of calming reassurance… The clinical features of meningitis are less straightforward in younger children, and CSF findings can be tricky to interpret. In this episode, our local Paediatric Infectious Diseases expert guides us through the topic with...

UltraSound uses in Pediatric Emergency Medicine

Everyone’s doing it… Is it time for your Pediatric ED to join the UltraSound craze?  For adult Emergency Medicine, there seems to be a strong following and a reasonable evidence-base.  That may be coming to the kiddy world, but maybe it’s not all that it’s cracked up to be? In this episode, we discuss the evolution of bedside clinical ultrasound use in the pediatric emergency...

Intussusception-Rotavirus Vaccine Risk

Last time we spoke about intussusception and its treatment.  This week, we try to discover whether there is a real link between rotavirus vaccines and this rare cause of abdominal pain in infants. Discussing vaccine efficacy and risks often engenders strong feelings from both sides of the river… the traditional believers AND the ‘anti-vaxxers’.  As with many controversies, it...