A 14 year old girl is carried in by her parents after “passing out” at home. The parents report that she had an abortion 2 weeks ago after which she was transfused multiple units of blood. They report she has been complaining of increasing abdominal pain and fatigue over the Read more…
A 2-year old previously healthy boy is brought to the emergency department for choking episode, throat pain & frequent coughing that started suddenly while playing with some toys. On examination, he looks comfortable in no respiratory distress, no drooling. Normal ear/nose/throat exams. Chest is clear with no wheezing. Just as Read more…
A 14 year old boy is brought in by his mother on Saturday at 9.00am because he woke her up at 6.00am vomiting clear liquid and complaining of lower abdominal pain. You start taking the history from the young man, but he seems uncomfortable with pain and prefers his mother speak to you. You order some ibuprofen while talking to the mother. She says he’s been well with no fevers. She says he has not been traveling, has been having regular home cooked meals and has been voiding without pain and stooling regularly with no change in bowel movements.
He has no medical or surgical history, not on any medication, is fully immunized and was fine yesterday. No one at home has this problem and all his regular school friends have been fine according to the boy.
You examine his HEENT, heart, lungs and abdomen and are surprised with how benign the exam actually is. Rovsings and are Obturator negative, and he tolerates the mashing of your hand on his belly and costovetebral angles. His skin is well perfused and he has a normal neurological and MSK exam.
1. What has the resident forgot to examine in this male child with lower abdominal pain?
2. The attending completes the exam and beckons you over to look at his finding. Click the answer below to see what the attending discovers.
22 months old previously healthy girl was brought to the ED by her parents with chief complaint of limping on right side while walking and running for 1 day. They noticed this after she fell at home while running. Parents denied any fever, runny nose, cough, rash and joint Read more…
Limping is one of the most common complaints in the Pediatric Emergency Department. Most children will have a limp at some point or another in their lives. Limping poses a challenge in the pediatric population, as it is difficult to diagnose, given the variable causes for it in a growing Read more…
CLEARING CHILDRENS’ CERVICAL SPINES IS A PAIN IN THE NECK! So, it’s been a couple of years since the blog has discussed cervical spine clearance in children. It’s a notoriously difficult task because the Nexus criteria* and the Canadian C-Spine Rule* (both developed for adults but often applied to children Read more…
Greetings everyone from sunny Florida! As you all know, I’m finishing up my 1st year of my peds EM fellowship and I just couldn’t stay away from County so I wanted to write a short blog article. I figured we could talk about something very common in both the pediatric Read more…