Archive for category: Pediatrics

Approach to the Critically Ill Child: Shock

15 Oct
October 15, 2018

If you mainly treat adults or both adults and children like me, then you have probably heard the (very annoying) quote, “kids are not just small adults”, and so I won’t say it again. Well, I guess I just did, but at least I wont stop at this quote, but attempt to explain how kids […]

IV and/or Nebulized MgSO4 in Pediatric Asthma Exacerbations?

09 Aug
August 9, 2018

Background: Acute asthma exacerbations are a common presentation to pediatric emergency departments (EDs). Standard treatment with inhaled beta agonists and corticosteroids are often sufficient in mild asthma but can fall short in the treatment of moderate to severe exacerbations. Magnesium sulfate (MgSO4) has long been touted as an adjunct treatment due to its bronchodilatory properties (both […]

Pediatric DKA: Do Fluids Really Matter?

11 Jul
July 11, 2018

Background: The most feared complication in the clinical course of children with diabetic ketoacidosis (DKA) is the development of cerebral edema. Cerebral edema is rare (<1%) but is the leading cause of death in pediatric DKA. Many of the details about the risk factors as well as the mechanisms leading to DKA related cerebral edema […]

REBEL Cast Episode 49: Pediatric Pain Management Pearls with Sebrina Perkins

26 Apr
April 26, 2018

Background: There has been lots of research published in past years on how to minimize pain and anxiety in children brought to the ED.  Unfortunately, as we all know there is often a lag time from research publication to clinical application.  It has been my experience that health care professionals tend to provide inconsistent and […]

The PARIS Trial: HFNC in Infants with Bronchiolitis

09 Apr
April 9, 2018

Background: Bronchiolitis is an acute inflammatory injury of the distal smaller airways, most commonly caused by viral infections.  There have been a host of medications studied in the treatment of bronchiolitis, including steroids, albuterol, epinephrine, and  inhaled hypertonic saline, with none proving to be effective in treatment.  Oxygen therapy via high-flow nasal cannula (HFNC) as […]