About Josh Bukowski, MD

Resident
Department of Emergency Medicine
University of California, San Francisco
3 07, 2017

PEM Pearls: Treatment of Pediatric Diabetic Ketoacidosis and the Two-Bag Method

2017-07-03T08:47:10+00:00

diabetic ketoacidosisInsulin does MANY things in the body, but the role we care about in the Emergency Department is glucose regulation. Insulin allows cells to take up glucose from the blood stream, inhibits liver glucose production, increases glycogen storage, and increases lipid production. When insulin is not present, such as in patients with Type 1 diabetes mellitus (DM), all of the opposite effects occur.

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8 05, 2017

PEM Pearls: Search & Rescue of Ear Foreign Bodies – Picking the Right Tool

2017-05-11T00:34:08+00:00

baby otoscope ear foreign bodiesWhile ear foreign bodies can happen at any age, the majority occur in children less than 7 years of age.1 The younger the patient, the less likely they are cooperative with the exam and, therefore, the less chance of successful foreign body removal. The first attempt at removal is the best, so it is important to make it count. Similarly, different types of foreign bodies call for different “tools” for removal. It is important to understand when to attempt removal in the emergency department (ED) and what tools are available. This blog post will help you optimize your first pass success at foreign body removal by understanding what tools are at your disposal.

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1 03, 2017

PEM Pearls: Pediatric Sepsis Management – Understanding the Basics

2017-06-04T14:37:36+00:00

pediatric sepsis managementJust as in adults, pediatric sepsis is a complex topic with continued research. In the United States, there are an estimated 75,000 cases per year of pediatric severe sepsis with an in-hospital mortality of 5-10%.1,2 This is one of the deadliest conditions treated in children. In addition, after the Rory Staunton case, New York State passed regulations requiring all hospitals to have pediatric specific recognition, treatment, and data reporting systems. Several other states have adopted, or are considering, similar requirements. Thus it is critical that emergency physicians understand at least the basics of pediatric sepsis management.

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