Keywords: Delayed Umbilical Cord Separation, Omphalitis, Leukocyte Adhesion Deficiency (PubMed Search)
Umbilical Cord Problems
Keywords: DKA, Cerebral Edema, Mannitol, Risk Factors (PubMed Search)
Cerebral Edema in Patients with DKA
Keywords: Ferbrile Seizures, Bacteremia, Fever (PubMed Search)
Keywords: Neonatal Conjunctivitis, Chlamydia, Gonorrhea, Red Eye (PubMed Search)
Neonate with Red Eye
Keywords: Laceration, Dermabond, cyanocrylate (PubMed Search)
Cyanocrylate Tissue Adhesive is an excellent product to use when repairing linear lacerations.
A few things to remember:
The wound needs to be irrigated as you would any other wound prior to closure.
Gravity works. Consider where the product may drip to before you apply it (Eyes, Ears, Nose, etc).
Use Surgi-Lube (or other petroleum product) to create a barrier to limit the flow of the cyanocrylate.
For long lacerations, you may use steri-strips to help approximate edges before applying the tissue adhesive.
What to do if the glue gets out of control and drips onto the eyelids... may also apply to Krazy-Glue:
Use copious irrigation and then Mineral Oil (not acetone or alcohol - which won't go well in the eyes).
Often there will be an associated corneal abrasion... treat it as other corneal abrasion.
Keywords: Back Pain, Leukemia, Lymphoma, Neuroblastoma (PubMed Search)
Pediatric Back Pain
Keywords: Ketamine, RSI, TBI (PubMed Search)
Ketamine and RSI for pts p TBI
Keywords: ITP, Leukemia, Steroids, IVIG, Anti-Rh(d), Bone Marrow Aspiration (PubMed Search)
Pediatric ITP – Bone Marrow Aspiration
Keywords: RSV, Apnea, Congenital Heart Disease, Chronic Lung Disease, Prematurity, Rapid testing (PubMed Search)
Bronchiolitis: Use of RSV rapid testing
Purcell K, Fergie J. Concominant serious bacterial infections in 2396 infans and children hospitalized with respiratory syncytial virus lower respiratory tract infections. Arch pediatr adolesce med. 2002; 156: 322-324.
Keywords: Childhood Cancers, Leukemia, Lymphoma, pallor, fatigue (PubMed Search)
Pediatric Leukemia/Lymphoma Presentation in the ED
Jaffe D, Fleisher G, Grosflam J. Detection of cancer in the pediatric emergency department. Pediatr Emerg Care. 1985 Mar;1(1):11-5.
Keywords: Limp, Antalgic Gait, Trendelenburg Gait, Septic Arthritis, Legg-Calve-Perthes Disease, SCFE (PubMed Search)
Child with a Limp
Grossman, Emblad, Plantz. Orthopedic Emergencies in Pediatric Emergency Medicine Board Review. 2nd Edition. 2006. p305.
Keywords: Child Abuse, Fractures (PubMed Search)
Keywords: Neonatal Respiratory Distress Syndrome, RDS, Cold Stress, Surfactant (PubMed Search)
The Premature Infant Delivered in Your Department
An ode to my final NICU Call… just because you don’t work in a Pediatric ED, doesn’t mean you won’t encounter premature infants.
What do you need to remember when a premature infant is born in your ED (or the ambulance / cab / car)?
Keywords: Pediatric Airway, Pierre Robin Syndrome, Micrognathia, Emergent Tracheostomy, LMA (PubMed Search)
Pierre Robin Syndrome
Baraka, A. Laryngeal Mask Airway for Resuscitation of a Newborn with Pierre-Robin Syndrome. Anesthesiology. 83(3):646-647, September 1995.
Keywords: Proteinuria, Orthostatic Proteinuria, Creatinine (PubMed Search)
Chandar J, Gomez-Martin O, del Pozo R, et al. Role of routine urinalysis in asymptomatic pediatric patients. Clin Pediatr (Phila). 2005; 44:44-48.
Hogg RJ, Portman Rj, Milliner D, Lemley KV, Eddy A, Ingelfinger J. Evaluation and management of proteinuria and nephritic syndrome in children recommendations from a pediatric nephrology panel established at the National Kidney Foundation Conference on Proteinuria, Albuminuria, Risk, Assessment, Detection, and Elimination (PARADE). Pediatrics. 2000; 105: 1242-1249.
Keywords: Stroke, Embolus, Retinal artery occlusion (PubMed Search)
Majeed Al-Mateen, et al. Cerebral Embolism From Atrial Myxoma in Pediatric Patients. Pediatrics, Aug 2003; 112: e162 - e167.
Keywords: Rheumatic Fever, Jones Criteria, Heart Disease, Salicylates, Chorea (PubMed Search)
Keywords: Heart Transplantation, Rejection, Syncope, Chest Pain (PubMed Search)
Children s/p Heart Transplantation – Rejection
Woods, WA. Care of the Acutely Ill Pediatric Heart Transplant Recipient. Pediatric Emergency Care. 23(10):721-724, October 2007.
Keywords: Severe Asthma, Refractory to standard therapy, intubation, atrovent, magnesium, noninvasive ventilation, heliox, ketamine, singulair (PubMed Search)
Severe Asthma in Pediatrics (Using “the kitchen sink” when all else fails)
Every effort should be made to avoid intubating an asthmatic pt. Here are some possible options to consider:
Keywords: Sepsis, Shock, Tachycardia, Hypotension (PubMed Search)
Pediatric Septic Shock
Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005 Jan;6(1):2-8.