Posts in Pediatrics
“You Put That Where?!?!” Removal of pediatric foreign bodies

By Hoi See Tsao, MD, and Alicia Genisca, MD

CASE

A 2-year-old previously healthy boy presented to the emergency department with a foreign body in his right nostril.

The patient was staying at his father’s house and the father became concerned about a foreign body when the patient suddenly began complaining of right nostril pain and dark brown nasal discharge. The father did not know what foreign body may have been inserted. On the patient’s return to his mother’s house the next day, he was found to also have right nostril swelling. His mother brought him to the emergency department for evaluation. The mother denied the patient having fever, coughing, gagging, vomiting, diarrhea, or abdominal pain.

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Rounding Out A Case of Acute Pancreatitis

An otherwise healthy 6 year-old female presented with lower abdominal pain and non-bloody, non-bilious emesis since 11:00 PM the previous night. Several hours prior to the onset of her symptoms, she was playfully thrown into a pond where she was swimming. She subsequently had take-out brown rice and vegetables with her family. Nobody else developed symptoms. Her pain was worse with ambulation and bumps in the road. She has had no diarrhea, constipation, fevers, urinary symptoms, or other acute complaints. She had similar but less severe episodes of these symptoms in the past. The patient’s father had a history of a “blood disorder” requiring abdominal surgery…

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Pediatric Diarrhea: History is the Primary Diagnostic Tool

A 5 year-old healthy male presented to the emergency department with his father with a chief complaint of fever, diarrhea, and vomiting. Fever was his first symptom. It started one week prior to presentation and was persistent over the course of the week. His highest temperature was 103.7 °F. Fevers occurred daily despite treatment with antipyretics. After his fever developed, he started having 4-5 daily episodes of watery diarrhea. Dad noted blood in the diarrhea only once. He complained of generalized abdominal pain when having bowel movements…

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The Febrile Seizure

Despite how frequently emergency physicians encounter children who have had a febrile seizure, there tends to be great variation in the diagnostic evaluation of these patients. The algorithm below was created to provide a more simplified approach to the patient presenting with a febrile seizure. The algorithm draws from the 2011 American Academy of Pediatrics (AAP) Clinical Practice Guideline for the Febrile Seizure as well as the clinical pathways published by Seattle Children’s Hospital…

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