Pediatric Emergency Medicine
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Acute Treatment of Pediatric Migraine
Migraines occur in young children, but may be challenging to diagnose. Migraines can have a great impact on pediatric patients’ quality of life with school absence and limitations on extracurricular activities. Treatment of pediatric migraines or possible migraines is difficult secondary to the lack of evidence for effective therapies in pediatric patients. Treatment includes traditional therapy with dopamine receptor antagonists (DRAs), nonsteroidal anti-inflammatory drugs (NSAIDs), triptans, and combination therapies. Newer therapies include magnesium, valproic acid (VPA), and peripheral nerve blocks. The authors review the clinical presentation of migraines in children, guidelines for diagnosis, and therapeutic options.
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Update on Urinary Tract Infections in Children: What’s New in 2019?
Urinary tract infections (UTIs) are a potential cause of fever in the pediatric patient. Early testing and a timely diagnosis are critical to avert complications and potential scarring of the kidneys. Complication rates in children younger than 90 days of age include bacteremia, meningitis, and urosepsis. The authors present a concise review of the current status of the diagnosis and management of pediatric UTIs.
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Pediatric Cardiothoracic Point-of-Care Ultrasound: Part II
Ultrasound has emerged as a critical tool for use at the bedside to guide both diagnosis and treatment strategies. In this article, the authors discuss cardiac arrest, congenital abnormalities, pneumothorax, pleural effusion, and pneumonia.
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Pediatric Ocular Trauma: A Clinical Perspective
Eye trauma can be devastating to a child and challenging to the clinician. These authors review common traumatic eye injuries and provide tips for the clinical evaluation of our youngest patients.
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What Is Really BRUEing?
In May 2016, the American Academy of Pediatrics (AAP) published clinical practice guidelines titled Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants, suggesting a new terminology, an evaluation based on the risk of recurrent events or serious underlying causes, and key action statements (management recommendations) for patients meeting the brief resolved unexplained events (BRUE) definition for lower-risk patients. The authors review and discuss the definitions and key management strategies recommended in these new guidelines.
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Viral Influenza Infection and Complications: A Pediatric-focused Review
As influenza season approaches, it is important that clinicians prepare themselves with the current literature on clinical presentation, best and most rapid diagnostic testing, and treatment strategies in pediatric patients. The literature shows that antiviral agents are underutilized in children, a critical issue for this vulnerable population. The authors provide insight and evidence for diagnostic and therapeutic practice for the upcoming influenza season.
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Pediatric Abdominal Ultrasound: A Comprehensive Guide to Making the Diagnosis — Part II
Ultrasound is evolving rapidly as the ideal imaging modality for many common pediatric complaints. In the second part of this series, the authors discuss point-of-care use of ultrasound for concerns regarding the kidneys, ovaries, testicles, gallbladder, and small bowel obstruction. The ability to make critical diagnoses safely and rapidly with ultrasound is an invaluable clinical tool to facilitate and improve pediatric care.
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Pediatric Sepsis and Septic Shock
Pediatric sepsis is a high-stakes diagnosis that requires vigilance to make an early, timely diagnosis. Aggressive resuscitation, including fluids, antibiotics, and vasoactive agents, may be necessary. Rapidly changing standard of care also makes sepsis a critical diagnosis for clinicians.
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Approach to Pediatric Eye Discharge and Periorbital Swelling
Eye problems, particularly conjunctivitis and periorbital swelling, are very common. The majority are managed easily, but more serious disease processes must be considered. Early recognition and prompt treatment of more serious etiologies, such as gonococcal conjunctivitis and herpes simplex virus, can prevent vision loss.
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Hypersensitivity Reactions in the Pediatric ED: The Tip of the Iceberg
Hypersensitivity reactions are very common. Understanding the different types, including serum sickness-like reactions, Stevens-Johnson syndrome, toxic epidermolytic necrolysis, and drug reaction with eosinophilia and systemic symptoms, is valuable both for an accurate and timely diagnosis as well as appropriate management.