Healthy 17-month-old with vomiting. Have you seen one of these? 
altPossible child abuse? Be your own CSI 
 Two “head problems,” two differentials 
Is this infant vomiting blood?
Nursing babies present special problems...but there is help. 
The Infant Stress Test 
Sometimes the chief complaint is not the problem
A soft sling in seconds. 
It was “wait and see” until the bleeding began, and wouldn’t stop. 
July 07:
Foreign Body? Jet the Other Nostril
No one works very long in an emergency department without running into a child with a foreign body up the nose. Sometimes things go well in your attempts at retrieval. Other times…
Anyway, here’s a trick to think about the next time you have a neurologically normal child, older than 6 months, with, say, a bead up the nose. Have the child sit up with the arms restrained.
Take a bulb syringe filled with about 7 ml of sterile saline and gently advance it up the opposite nostril until you get a good seal. Give a firm, forceful squeeze. The foreign body should come shooting out the other side.

Caveats: wear protective gear, as things can get a little messy when they come shooting out at you. Also proceed with confidence but with the strict understanding that you are only going to get one shot at this.

For the academically inclined, this technique is described in Lichenstein R, Giudice EL. Nasal wash technique for nasal foreign body removal. Pediatr Emerg Care 2000;16:59-60.
August 07:
Get kids to take Mebendazole (Vermox):
The Candy Bar Method

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Subscribe to EPM