Investigation of Pediatric Headaches

In Noggin-cast part 2, we explore the relevant literature with regard to investigating headaches in children.  No magic answers yet, but we discovered a few useful tips along the way… and found a handful of references you can impress your colleagues with. When faced with a worried family, we all would like to offer the appropriate reassurance, or do the appropriate test – without being...

May 9th, 2013 by colinparker 

Headaches in kids

Pediatric Emergency Departments see a few children a day with headache. So how do we pick out the serious ones? In this “noggin-cast” we explore the causes of headache, including Primary headache like migraine and tension headache, secondary headaches from viral illness, and a few other strange ones… Headache PEMcast [ 31:39 ]
April 18th, 2013 by colinparker 

Appendicitis tests in children

It seems that this one slipped under the radar, when we originally published it… Because I followed it with a tongue-in-cheek summary post about the (lack of) utility of tests for appendicitis, and did not leave enough of a gap between the two posts, iTunes only picked up the abbreviated jokey version, leaving the original PEMcast undiscovered by many… So here it is again, for the benefit...

March 22nd, 2013 by colinparker 

Clearing the Paediatric C-Spine

Excluding a broken neck or a spinal cord injury: can be tricky. We know what to do when there is an obvious bony, ligamentous or cord injury… but do you want to be the one who takes responsibility to give the ‘all clear’? Fortunately, serious injuries to the cervical spine, whether bony, ligamentous, or spinal cord injury, are uncommon in the really young… which is lucky for...

June 2nd, 2011 by colinparker 

Cervical Spine Assessment in Children

Neck Injuries in kids are fortunately quite uncommon, but the assessment of a child with a potential cervical spine injury remains stressful and challenging.  No-one wants to miss a broken neck… Because of the anatomical, physiological and behavioural differences, we can’t just do what we do for adults either. How common is SCIWORA? How aggressively do we need to apply immobilisation...

May 19th, 2011 by colinparker 

Cranial CT for Minor Head Injury

Most children with a minor head injury (GCS 14-15) have an excellent prognosis, but a small number will deteriorate unexpectedly, and go on to require neurosurgical intervention.  The last decade has seen valiant attempts at trying to define and predict this subgroup of kids who need a cranial CT, to pre-empt this deterioration. Clinical Decision Rules seem to be the fashion when it comes to making...

April 7th, 2011 by colinparker 

Minor Head Injury

A little bump on the head… could cause a lot of trouble for you and me. Minor Head Injury used to mean GCS 13-15, nowadays it means GCS 14-15. This is the vast majority of head injury cases, and therefore we need to be really comfortable with their assessment and management. Plug in and join us as we discover the origins of the 4-hour myth, the creative definition of concussion, and the correct...

March 24th, 2011 by colinparker 

Appendicitis: Improving Diagnostic Accuracy

Appendicitis is the most common surgical condition in children, and an important condition not to miss.  Can we use clinical features, scoring systems, blood tests or radiological investigations to improve our diagnostic accuracy? In this episode we put the diagnostic process under the microscope and try to figure out the most helpful symptoms, signs and tests to confirm or exclude appendicitis. ...

February 10th, 2011 by colinparker