Pediatric seizures are a common emergency department complaint. The prior definition of status epilepticus (SE) was: “More than 30 minutes of continuous seizure activity or two or more sequential seizures without full recovery of consciousness between seizures.”
A 29-year-old African American male presents to the emergency department
with a chief complaint of left arm pain. The patient states he was
using a power drill with a quarter-inch drill bit several hours prior to
arrival when it accidentally slipped and drilled into his left forearm. This CME will demonstrate how to check forearm compartment pressures with the stryker compartment pressure monitor
Pediatric DKA management has always been fraught with concern regarding fluid management due to the risk of cerebral edema. While cerebral edema is uncommon, it has devastating complications and is always in the forefront of our management techniques.
The patient is a 51-year-old male who presents to the ED with a
complaint of severe abdominal pain and cramping of 8 hours duration
associated with diaphoresis, low-grade fevers, and anorexia. According
to the patient, his symptoms began approximately 1 hour after suffering a
scrotal bite from “some insect” while trying on a pair of boxer shorts
his wife had just given him for Valentine’s Day.
Sickle Cell Disease (SCD) is an inherited disorder that
affects nearly 100,000 Americans. Since its discovery 101 years ago, SCD
has fallen largely under the academic jurisdiction of hematology.
Today, a small group of clinicians/researchers/scientists (mostly
hematologists) works to add to the body of sickle cell literature
The issue of serious bacterial illness in children is an ongoing debate and new articles are emerging that help shed some light on the topic. This journal club will review lab tests that are better indicators of serious bacterial illness, how to reduce the rate of blood culture contaminants, the significance of the clinical examination for the diagnosis of meningitis and whether or not a routine lumbar puncture is necessary in children less than 18 months of age with a first time, simple febrile seizure.
Managing diabetes, in particular DKA, is a staple in the practice of
emergency medicine. The pancreas hasn’t changed since we discovered that
it secreted insulin. So, the treatment has no reason to change either.
Pediatric dehydration continues to be a significant cause of morbidity
and mortality throughout the world and is a frequent issue encountered
in the Emergency Department. Traditionally, IV fluid hydration has
been the mainstay of therapy. However, it is often difficult to obtain
intravenous (IV) access in children who have small, collapsed veins,
and therefore, alternative therapies are being investigated.
While on a recent shift in the ED, I was asked a familiar question by a weekend warrior who had suffered an ankle sprain while playing basketball - “What can I do to get back on the court sooner, Doc?” After explaining the usual RICE protocol (Rest, Ice, Compression, Elevation) my persistent patient asked “What else can I do? What about these platelet rich plasma (“PRP”) injections I hear about?”
Are there any historical or physical examination findings that can help emergency physicians make the diagnosis of UTI? Read the article and take the Quiz for 1 CME credit hour.