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Case Conference - Dr. Lawson
1. Leukemia is the most common form of childhood cancer (30% of all pediatric malignancies)2. Presenting symptoms for acute leukemia are typically non-specific and the WBC is usually normal! Have a...
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Case COnference COre Concepts - Dr. Young
1) Not all vomiting in the Peds ED is gastroenteritis! Consider trauma, metabolic, foreign body, etc..2) Always do your own history and exam; never assume that previous providers thought of...
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Pediatric Burns - Dr. Weihmiller
Always consider NAT for burn patientsCan use palm of a child as 1% TBSAMetabolic response -> end organ damage and can last several weeksCXR may not show pulmonary damage for 24-28 hoursFull...
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Case Conference - Dr. Goode
• Urethral injury should be suspected and excluded in patients with pelvic fractures• Although efforts have been made to standardize capacity assessments, they are complex and subjective. Take...
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Pediatric Seizure Disorders - Dr. Bryant
It is important to know pediatric weight based dosing for seizure managementMake it simpleFirst line (Benzos)Ativan: 0.1mg/kgVersed/Valium 0.2mg/kgSecond/Third lineAll starting doses 20mg/kgRule out...
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CMC Case Conference - Dr. Mollo
1. Cervical check every pregnant patient who presents with potential labor.2. Start with transabdominal US for pregnant patients before advancing to transvaginal US. Sometimes "dates" are...
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ITP, DIC, & TTP - Dr. Thomas
1. ITP is a diagnosis of exclusion, laboratory findings other than isolated thrombocytopenia and the associated symptoms should suggest an alternative diagnosis.2. TTP has an extremely high mortality...
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SBRIT in the ED - Dr. Griggs
1. SBIRT is an effective strategy to change behavior of patients with substance abuse problems2. Standard screening tools exist to identify patients that would benefit from Motivational Interviewing....
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Pediatric Fever - Dr. Young
1) "The brownie on eights are tricky" - translated to febrile neonates are tricky - must remain vigilant! 2) knowledge is important, but we must recognize limitations (regarding studies, gray areas,...
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Heavy Metals - Dr.Kopec
ARSENICAcute arsenic toxicity can present wiht abdominal pain, vomiting, fluid shifts, hemolysis and prolonged QTc.Chronic arsenic toxicity leads to peripheral sensory neuropathy, skin...
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HyperKalemia - Dr. von Marschall
1) Use both EKG and absolute K value, in addition to clinical picture, to determine necessity for treatment of hyperkalemic emergency2) Suspect HyperK in any renal patient who presents with...
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Carolinas Case COnference - Dr. Lawson
Case 1:1. Hyperkalemia may manifest as junctional escape rhythm2. Do not underestimate dehydration as a cause for AKI and hypotension3. Don't forget to fill the tank before you squeeze itCase 2:1....
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Case Conference - Dr. Lounsbury
• Any penetrating wound between the base of the neck and the inguinal region is a considered thoracic• ACLS protocol has little to no role in trauma resuscitation• Resuscitation can be undertaken for...
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ICH Update - Dr. Asimos
Based on the combined results of INTERACT-2 and ATACH-2, for spontaneous ICH patients presenting with an SBP of 150-220 mmHg, a target systolic blood pressure of 140 mm Hg is safe and can be effective...
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Carolinas Case Conference - Dr. Lounsbury
• Never assume that an airway will be straightforward!! • Upper airway edema is a common complication of supraglottic device use and should be expected• King LT’s can be safely exchanged in the...
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Tracheostomy Emergencies - Dr. Lounsbury
Recall the DOPES mnemonic for any intubated or trach’d patient in distressPrepare your airway adjuncts when replacing a trach including an elastic bougie, size 6 endotracheal tube, and fiberoptic...
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Thoracic Trauma - Dr. Colucciello
- The “Chest” exam should include: Assessment of neck veins Search for paradoxical movement (flail) Respiratory distress Palpation for...
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Tox Tips - Dr. Snow
1) Always be able to explain anion gapped metabolic acidosis.2) Remember K.I.L.R for causes of AG metabolic:KetosisIngestionLactateRenal3) If no ketosis, elevated lactate, and no renal failure you...
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Unusual Infections and cutaneous manifestations - Dr. Young
Thorough history and exam are essentialBeware the persistent diaper rashAlways consider mimics to common pediatric illnessesNeonatal pustules - not always benignBe on the lookout for HSV
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Case COnference Core Concepts - Dr. Goode
• When your sepsis workup doesn’t reveal a source, continue the search, often times these patients need a surgeon.• When presented with an acute decompensation after a recent illness, consider it’s...
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