A 17 y.o. female with PMH significant for ADHD, anxiety, and depression presents to the Children’s Hospital Emergency Department with a chief complaint of vomiting, accompanied by her mother. She states that she has been vomiting for two days. Since that time, she has lost count of the number of times she has vomited. She denies seeing red or black in her emesis and tried taking Pepto-Bismol but vomited the medication.She was able to shower once which helped a little…
Read MoreThis is a 4-year-old female with a chief complaint of 2 days of rash. She appears to be completely unbothered by the rash, and has been afebrile without any recent infections/illnesses; a complete review of systems is negative. The patient has been eating and drinking well and her behavior is at baseline. Her mother at bedside denies any new exposures such as detergent, lotion, and food. She has no significant past medical history and does not take any medications; she is up to date on vaccines and has not received any new vaccines recently. Vital signs are within normal limits for age. The physical exam is significant for diffusely scattered, erythematous “targetoid” lesions along with equally scattered erythematous, slightly raised wheals. This rash is found on her trunk, extremities, and palms…
Read MoreThe overhead announcement goes off: “Team B to the trauma room”. The report: EMS is bringing a 2-year-old female that was found unresponsive in the family swimming pool by her mother after being alerted by an older sibling. Unknown downtime. The patient is being bagged by bag-valve mask (BVM) and has slow, but palpable, femoral pulses, she is unresponsive, ETA 2 minutes…
Read MoreThe goal of this post is to give you a systematic approach to a pediatric patient with lymphadenopathy. The differential is broad and the etiology ranges from benign to life threatening, and is most commonly benign. As such, to be a successful emergency room practitioner, it is vital to have a defined approach and know when to tune into high risk features…
Read More“EMS called with a pediatric code in progress from a house fire, approximately 5 minutes out. A 2-year-old female with unknown past medical history was brought in with CPR in progress. History was limited as there was no family with the patient. Per EMS, firefighters were called to scene of a house fire and the patient and her sister were found in an upstairs bedroom, both unresponsive and pulseless…”
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