SplintER: Knee pain after the jump

tibial tubercle fracturesA 15 year-old male presents to the emergency department with left knee pain and swelling after jumping while attempting to dunk a basketball. You obtain a knee x-ray (image 1 courtesy of Mark Hopkins, MD). What is your diagnosis? What patient population is at risk for this injury? What other injuries occur in this anatomical location? What is your emergency department management?

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SAEM Clinical Image Series: Tick Bite

Rocky Mountain Spotted Fever tick bite hand rash

A 14 year old girl presenting from Mexicali with altered mental status. Her mother reports a rash about a week ago following a tick bite. She had been going to school until 4 days ago when she became very fatigued with associated vomiting, diarrhea, tactile fevers, and headache. She subsequently collapsed at home today and was difficult to arouse which prompted EMS activation. Her mother denies any prior complaint of neck stiffness, shortness of breath, cough, hematemesis, or hematochezia.

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Trick of the Trade: Directed Saline Irrigation for Nasal Suctioning

You are just starting out your mid-January evening shift, and you go to the room of an 8-month old male with nasal congestion. He is afebrile, and mildly tachycardic, but his lung exam is fairly benign and he’s breathing easily without retractions. You can clearly see he has congestion. You instruct the parents to use saline irrigation and then nasal suctioning to clear the congestion as needed, and they say, “How can we do this if our child struggles? Won’t we just end up with a wet, angry, and congested child?”

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PECARN: Its relevance and importance in pediatric emergency care

PECARNDid you know that many of the landmark pediatric emergency medicine (EM) studies come from the Pediatric Emergency Care Applied Research Network (PECARN) collaborative? It works to address the challenging pediatric questions that only multicenter studies can. In this blog post, we highlight PECARN’s goal to translate, disseminate, and implement evidence to all providers of emergent and urgent care for pediatric patients.

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By |2020-01-07T02:33:42-08:00Jan 7, 2020|Pediatrics|

Ultrasound for the Win! 3-year-old with abdominal pain #US4TW

ultrasound for the win intussusception

A 3-year-old Hispanic female with no significant past medical or surgical history presents to the Emergency Department with her mother for a 3 day history of crampy abdominal pain, intermittent bloody diarrhea and fever. There has been no recent travel, admissions, or antibiotic use. Her older sister reports similar symptoms, which have resolved. The patient saw her pediatrician the day prior, who recommended supportive care including oral rehydration.

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By |2019-11-19T01:47:58-08:00Dec 4, 2019|Pediatrics, Ultrasound, Ultrasound for the Win|

SAEM Clinical Image Series: Bellybutton Mass

BellyButton Mass umbilical granuloma

A 4 week-old female infant presents due to yellow discharge from her umbilicus and mom noticing a red mass coming from the umbilical area after changing her diaper today. She is a healthy infant born at 40 weeks by vaginal delivery without complications and weighed 6 lbs 1 oz at birth. She is feeding 4 oz of formula every 3-4 hours. She received immunizations at birth and has an established pediatrician.

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