Practical Pediatrics by Amy Levine, MD
 
Why has this child been intermittently refusing to walk for six weeks?
It’s been another busy night, mostly flu patients but a few other scattered maladies and injuries to keep life interesting. The next case, for instance, doesn’t sound much like flu. The nurse has just put a 15-year-old boy in bed 10 with a complaint of fever and facial swelling. Variety is the spice of life. Off you go to check him out.
It was a dark and stormy night . . . seriously. And it didn’t hurt your volume any; you’ve been running steadily since you arrived. Now you’re entering the wee hours and the flow is ebbing just a bit in the pediatric ED. You look at the next chart and read a chief complaint that almost never arrives in the sober light of day: excessive crying in an infant.
Infants with fever and positive flu don’t need the full bacteremia work-up
Constipation in children may seem mundane, but it’s no joke. Here are the tried-and-true treatment options for kids who are all jammed up.
An 8-year-old girl is experiencing mysterious bruising on her left shoulder. A thorough H&P reveals nothing remarkable, so you head to the computer...
Everyday, in EDs across the planet, children are poked and prodded. We draw blood, we clean wax out of ears – little things, but they are painful for our patients. Here are a few things that are relatively easy to do, that can reduce the pain we sometimes inflict.
Everyone knows that newborn babies are just different. Heck, there’s an entire field of medicine dedicated to taking care of neonates. They make a lot of folks nervous in the ED and justifiably so – the list of weird things young babies can do in those early days of life can give you gray hairs. One time-honored complaint, “my baby is blue”, is guaranteed to get your attention. Here are some blue baby stories to help illustrate some of the common causes of neonatal cyanosis.
The next patient is a sick metabolic kid, the kind you dread because you can never remember all those metabolic pathways from medical school. Citrullinemia, maple syrup urine disease, gluteric acidemia – it makes your eyes cross.
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