PEM Review 015 – ECZEMA // SVT // COMMUNICATION // ECG // NICOTINE TOX // VIRUSES

PEMgeek3Here’s your PEM pick n’ mix for this week:

emm ladder

1. ITCHY, SCRATCHY, GREASY

Out-of-control (not necessarily infected) eczema is a pretty common reason for ED attendance, and it’s horrible to see these children driving themselves (and their parents) mad with scratching. Here (picture above) is a useful reference guide to help you step up emollient treatment during a flare up – the itchier the skin, the greasier the cream you need to prescribe.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

74756a43b55b5ad2686e902c2a5c7234.jpg2. ICE, ICE BABY!

Neonatal SVT – (who is more tachycardic right now, you or the baby?) If the answer is the former, read this case study on @tamingtheSRU for some management tips. Follow the APLS algorithm and know where your department keeps the ice!

The article includes an interesting Q&A with some cardiologists from Cincinnati Childrens Hospital (@cincychildrens) regarding more advanced management, electrical and chemical cardioversion.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

fragile     3. COMMUNICATION – PODCAST

The ever inspiring Liz Crowe (@LizCrowe2) visits @stemlyns to talk about handling difficult conversations in the ED when someone has died (and why it is not helpful to think of this interaction as ‘breaking bad news’). If you haven’t already heard it, I also highly recommend her previous @stemlyns podcast about grief.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

dka  4. DKA – THE SUMS

This has been around for a while but I’m sharing this as it ONCE AGAIN came to my rescue on nights last week  🙂 This is a free resource from BSPED (British Society of Paediatric Endocrinology and Diabetes) to help with potentially difficult calculations for paediatric DKA management. Tap in some numbers, and up pop your fluid and insulin infusion rates, and a corrected sodium level. You can also print it out to keep in the patient’s notes.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

going_viral    5. GOING VIRAL

Another great FOAM endeavour from dontforgetthebubbles.com @TessaRDavis, bringing us videos from the Paediatric Acute Care conference. This video is about the emergence of ‘new’ viruses such as enterovirus 71 which aside from causing a relatively mild hand foot and mouth disease, can also have other potentially catastrophic consequences – brainstem encephalitis, flaccid paralysis, pulmonary oedema and aseptic meningitis. Several outbreaks have been seen in Taiwan in recent years.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

ecgw      6. ECG OF THE WEEK

(click here) 5 year old boy with a viral infection and chest pain – what’s the diagnosis?

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

nicotox  7. NICOTINE TOX

Vaping may be a good way to help parents quit smoking, but the rise in e-cigarette use has been joined by a trend in nicotine poisoning amongst young children (how tasty do those little bottles of bright coloured liquid look to a toddler?) @boringem reminds us in this article that even a small amount of the liquid can deliver a fatal nicotine dose, and there can be other dangerous ingredients aside from nicotine (ie oil of wintergreen – causes salicylate toxicity in small doses). Take any suspicion of ingestion extremely seriously.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s