A 7 year-old previously healthy male presents to the pediatric emergency department following a bicycle accident. The child was struck by an oncoming sedan traveling at approximately 20 miles per hour, causing him to fall off the bike onto his right side. There was no head strike or loss of consciousness. On arrival, the child is phonating, has intact peripheral pulses, and a Glascow Coma Scale of 15. He is noted to be dyspneic, with absent breath sounds on the right. You prepare to place a chest tube with supervision from your attending. This is your first time placing a chest tube. His mother requests to stay in the room for the procedure…

PediatricsCaroline MeehanJuly 10, 2020Parental Presence, Education, PediatricsComment

Worsening Weakness: An Interesting Case of GBS

An 11 year-old female presents with approximately 2 weeks of bilateral lower extremity pain that is localized to her knees and calves. The pain is worse with ambulation and not relieved with ibuprofen. She has difficulty ascending the stairs at school and recently started having trouble walking on flat ground. The patient also endorses neck, back, and shoulder pain that are less severe. She recalls an illness associated with vomiting and diarrhea that started approximately 1 week ago, which has still not resolved…

Neurology, PediatricsNichole MichaeliJune 12, 2020pediatrics, GBS, Guillain-Barre syndrome, neurologyComment

Tales From Honduras – Ichthyosis, An Unusual Skin Finding

On examination, he has normal vital signs. He is in no distress, comfortable appearing, but acting shy and withdrawn (appropriate for age). His eyes and conjunctiva are normal, but the eyelids are ectropic. He has moist and otherwise normal oral mucosa. The left otic canal is filled with keratinitic debris and once cleared reveals a normal tympanic membrane. The right ear is normal. The remainder of his skin examination reveals diffuse, whole-body brown plaques which are anchored at the center and peeling at the edges…

Pediatrics, Global EMJosh KaineMay 22, 2020ichthiyosis, pediatrics, dermatology, International medicineComment

Brown Sound: Point-Of-Care Ultrasound Diagnosis of Pyloric Stenosis

An ex-full term six-week old male presented to the pediatric emergency department with three weeks of forceful, non-bloody, non-bilious emesis. He was having two to four episodes of vomiting that occurred after feeding. Three weeks prior, the patient had been transitioned from breast milk to formula, and attempts to thicken the formula by adding rice had not improved his vomiting. More recently, he had poor PO intake and his parents were concerned about his weight. He had no fevers, no change in number of wet diapers or stooling, and no other acute complaints…

Ultrasound, PediatricsSean ReidApril 17, 2020Ultrasound, Pyloric stenosis, pediatricsComment

Pediatric Strangulation

Strangulation injuries are defined as any injury that results from a compressive force to the neck, leading to vascular and airway occlusion. Such forces might include hanging or strangulation (postural, ligature, or manual). Strangulation is implicated in 10% of violent deaths in the United States, while hanging is the second most common form of death by suicide…

Pediatrics, TraumaJosh KaineMarch 9, 2020pediatrics, strangulation, hanging, ARDS, cervical injuryComment

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