PEM Review 003 – May 5th 2015

PEMgeek3Your weekly roundup of the best new paediatric #FOAMed resources starts here. Enjoy ūüôā

ENT // ADRENAL CRISIS // GROWTH // COMMUNICATION // TECH // DKA // SEIZURES

1. OTITIS MEDIA Issues in acute OM: antibiotics, decongestants, antihistamines, pain relief? How much of your normal treatment strategy is backed up by good clinical evidence? Brilliantly short and digestible summary. @Cochrane_Child @TREKKca

fatigued adrenal glands2. ADRENAL CRISIS This week @pedseducation features the case of a child with septo-optic dysplasia who presents in adrenal crisis. What are the possible triggers for a crisis, and what do you need to consider when initiating urgent treatment?

¬†3.¬†FALTERING GROWTH (What’s this doing on a PEM blog?) Hold on, keep reading! Yes, faltering growth is mostly worked up by paediatricians in¬†general paeds clinics – but how do these kids come to their attention? Sometimes it’s only a chance ED presentation that will flag up these issues. This practice statement from the Canadian Paediatric Society gives an overview of faltering growth workup and makes it clear why it is so important to monitor growth opportunistically. @CanPaedSociety

¬† ¬†¬†4.¬†COMMUNICATION if you haven’t yet had to deal with a set of seriously peeved parents in the ED, you haven’t been working in EM long enough. Common sense strategies to de-escalate a potentially fraught scenario from @pemfellowscom .

sb ¬† 5.¬†C BOTULINUM – a ‘D-list superbug'(!) Extremely rare, with a non-specific presentation, potentially life threatening, but treatable if detected early. (Who doesn’t occasionally dream of a ‘House’ moment?) Nice little article from @emdocsdotnet

¬†6.¬†‘HANDI’ TO KNOW Musgrove Park Hospital (@musgrovepark) in the UK has developed an app aimed at parents to help them manage common symptoms at home (fever, D+V, respiratory symptoms etc). It uses the ‘traffic light’ system (similar to the NICE guideline for fever in the under 5’s) to guide parents towards seeking further help if needed. It’s free to download, so it’s worth a look. Personally I feel it would be useful for parents of older children but advice for smaller ones is a little limited (ie, doesn’t make it clear that fever in under 3 months needs to be evaluated urgently by a doctor, not managed primarily at home) – perhaps future versions will address this.

¬†¬†7.¬†DKA: podcast of the week goes to this, from @EMcases. A detailed discussion of key issues in DKA, including really important points about fluid resuscitation (‘Don’t just do something, stand there…’) and how essential it is to FOLLOW A GUIDELINE. The podcast is an hour long so save it for when you have some time to kill.

¬† ¬† ¬† ¬†¬†8. NOT ALL THAT SHAKES… is a seizure. If you have five minutes this is a great short piece that will help boost your differential diagnosis when things don’t quite fit. From @PedEMMorsels.
baby¬†¬†And finally… Sometimes what we do day to day seems so routine – but over the past 40 years, there have been some incredible developments in the care we deliver to children. This video from @AmerAcadPeds highlights the importance of the paediatric research that has brought us to where we are today.
Keep visiting, new posts coming on a weekly basis!
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