Confessions of an Emergency Department Kid Helper

FrightenedChildAs I was rounding the corner from the adult area of the emergency department to the pediatric area I heard a child screaming at the top of his lungs, “I DON’T WANT A SHOT”. I knew at that moment I was being summoned. I walked into the room and I saw a mother with her 5 year old son in a full headlock, while a new intern was trying to look in his ears. I made eye contact with the intern said “maybe I can help” then turned my attention to mom and son.

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2016-11-20T07:15:20-07:00

Patwari Academy videos: PALS

Screen Shot 2013-09-06 at 5.59.30 PMPediatric Advanced Life Support (PALS) guidelines were most recently reviewed in Circulation 2010 1 based on the International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science which includes treatment recommendations. Dr. Rahul Patwari nicely summarizes these findings in this series of 8 videos

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2019-01-28T21:55:35-07:00

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

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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2016-11-11T19:02:46-07:00

Patwari Academy videos: Neonatal Resuscitation

Screen Shot 2013-07-10 at 12.11.02 PM

What is your approach to neonatal resuscitation… that is, after you pause a millisecond to first take a deep breath. Stay calm in this always stressful scenario. Dr. Rahul Patwari goes over the basics from the 2010  Circulation publication on Neonatal Resuscitation (free PDF). What should you be thinking of and doing in the first “golden minute”?

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2019-01-28T21:58:43-07:00

Patwari Academy videos: The Crashing Neonate

Screen Shot 2013-07-02 at 4.50.44 PMIn this series of videos, Dr. Rahul Patwari reviews the approach to the crashing neonate. Because these cases are often stressful, it is paramount to keep in mind a broad list of potential causes, such as “THE MISFITS” mnemonic:

  • T rauma/abuse
  • H eart disease
  • E ndocrine (CAH, hyperthyroid)
  • M etabolic (hypoglycemia, hyponatremia)
  • I nborn errors
  • S epsis
  • F ormula mishaps
  • I ntestinal catastrophes
  • T oxins (home remedies)
  • S eizures

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2019-01-28T21:58:31-07:00