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About Steven Bin, MD

Associate Clinical Professor of Pediatrics and Emergency Medicine
Division of Pediatric Emergency Medicine
University of California, San Francisco
1 02, 2017

PEM Pearls: Brief Resolved Unexplained Events (BRUE)

2017-10-26T14:33:24+00:00

A 2-month old boy was brought in by his mother after an episode of the child’s face turning blue and a pause in breathing. Mom reports this lasted a few seconds. The mother was terrified, so she brought the baby to the ED.

Sometimes infants briefly stop breathing or go limp. How do we determine if an infant is low-risk for serious illness? Earlier last year, the American Academy of Pediatrics (AAP) released guidelines on the evaluation and management of Brief Resolved Unexplained Events (BRUE, replacing a 30-year old label “apparent life-threatening event” or ALTEs).1
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7 03, 2016

PEM Pearls: Pediatric Concussions

2017-10-26T14:34:13+00:00

pediatric concussions canstockphoto0691281A 9-year boy was hit in the head during a soccer game and was out for a few seconds. He regained consciousness quickly, but was repetitive for EMS. By the time the patient arrived at the ED, he was back to his normal self. Did this patient sustain a concussion? If so, what discharge instructions, anticipatory guidance, and resources do you have for your patient and his family? Here’s a quick 170-second animated video tutorial to sum up some thing for you.

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31 08, 2015

PEM Pearls: Migraine Treatment for Pediatric EM Patients

migraine treatment for pediatric em patients © Can Stock Photo / SergiyNYou are working your evening shift at the pediatrics emergency department, and you walk into a darkened patient room with a distressed mother and her otherwise healthy 10-year old son who is curled in a ball, holding his head and crying. Her mother tells you that the around-the-clock ibuprofen has barely touched his 2-day headache.

After determining that your patient has no neurologic deficits and that this is most likely a primary headache, what can you do to break his symptoms?

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8 08, 2013

Pediatric febrile seizure: When do I need to do a lumbar puncture?

2016-11-11T19:02:46+00:00

LP_collect copyYou are in the ED when a 7 month old is brought in by EMS after a witnessed generalized seizure. The grandmother reports that the child has had URI symptoms for a couple of days and then developed a fever today. Shortly after giving ibuprofen, the child began to seize with arms and legs twitching. The episode lasted approximately 8 minutes and when EMS arrived, the child was sleepy, but arousable. The glucose was 92 mg/dL en route. On exam in the ED, child is awake and staring at you to make the next move…

Vitals: Temp 39C, P 136, RR 28, Sat 100%

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