PEM Review 010 – ANAEMIA // MENINGITIS // EYE ANATOMY // SICKLE CELL // WHEEZE // POOR FEEDING

PEMgeek3

Back after a little summer break, here is the latest collection of PEM pearls for your perusal:

casper         1. ANAEMIA, IRONED OUT

This podcast is a good one for the juniors – anaemia is a pretty common incidental finding when you’ve sent off some bloods from a child in ED. This podcast (featured on @pedscases) will help you rationalise your approach when thinking about further investigations.

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asth       2. THE SALBUTAMOL PARADOX

Why do the smaller kids sometimes seem to need a truckload of salbutamol to shift that wheeze? Physics gets interesting/relevant thanks to @sailordoctor

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eye        3. EYE LOVE ANATOMY

Here is a three part series on the eye, presented by @AndyNeill of Emergency Medicine Ireland, offering a useful recap of anatomy and physiology for anyone who is facing upcoming exams (or who just wants to impress the ophthalmologist with their next referral…)

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bounce      4. MENINGITIS BOUNCEBACKS

‘You know that patient you discharged the other day…’ …is a phrase that can induce immediate tachycardia and sweaty palms in most ED doctors. This podcast from @AnnalsofEM is a fascinating discussion of a recent paper which found that in a group of 521 children hospitalised with meningitis, 1 in 5 had visited an emergency department (and been discharged) in the preceding five days. HOWEVER – in this study, these patients who ‘bounced back’ more unwell, had similar outcomes to those who were diagnosed and admitted on their first presentation. So many issues are raised by these findings (and this would be a great paper to discuss at journal club) – I urge you to listen to the podcast and formulate your own thoughts.

Here is the original paper – unfortunately not free open access. First author Samuel Vaillancourt (@vaillancourtSam)

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sickle     5. IMAGE OF THE WEEK

13y child with sickle cell disease and abdo pain. It’s not a sickle crisis… what’s the diagnosis? (from the radiology website of Virginia Commonwealth University @VCU). More detail about this particular complication here

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lazy panda      6. A ‘LAZY’ BABY..?

@emcases and @croccoag team up in this podcast to talk about a case of poor feeding in a 5 day old infant presenting to the ED. The differential diagnosis for poor feeding is huge, and in this particular case there was a slightly unusual underlying problem.

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play    7. TO PLAY OR NOT TO PLAY?

Our play specialists have a vitally important role in the ED. Guest author on ADC blog, @spencer_sian reminds us that play should be a consideration in every encounter we have with a child, whether or not a play specialist is available at the time. Taking a few minutes to connect with the child and family in play could be the best possible way to normalise a ‘scary’ clinical situation.

It’s worth having a browse through Sian’s excellent blog as well.

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