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EM and PEM webucation... PEMcasts: Paediatric Emergency Medicine - basic and advanced topics - brought to you by EMPEM.org, a humble EM and PEM webucation shack...
||Constipation in Kids||Constipation... Does it make you want to run and hide? Or leave it for someone else to sort out? Join us for a structured approach to the diagnosis and management of constipation. And let us know your favourite recipe, or a few poo pearls...||21 11 13||Free||View In iTunes|
||Holmesian Diagnostics||ACEM 2013 Winter Symposium in Broome was amazing. Here is Colin Parker's talk about Holmesian Diagnostics for a Nautical Model. A bit left-field, but we think you'll pick up a few handy hints... Scroll through the slides as you listen - on empem.o[...]||23 6 13||Free||View In iTunes|
||Investigation of Pediatric Headaches||When faced with a worried family, we all would like to offer the appropriate reassurance, or do the appropriate test - without being too blase or too anxious. Headaches, in particular, are important because the tests are usually not required, and a[...]||9 5 13||Free||View In iTunes|
||Headaches in kids||In this "noggin-cast" we explore the causes of headache, including Primary headache like migraine and tension headache, secondary headaches from viral illness, and a few other strange ones... Pediatric Emergency Departments see a few children a day[...]||18 4 13||Free||View In iTunes|
||Appendicitis tests in children||It seems that this one slipped under the radar, when we originally published it… Because I followed it with a tongue-in-cheek summary post about the (lack of) utility of tests for appendicitis, and did not leave enough of a gap between the tw[...]||22 3 13||Free||View In iTunes|
||Pediatric UTI Controversies||Although the evidence is far from complete, the landscape of pediatric UTI is definitely changing, and the discussion is driving a less aggressive approach to investigating and following up UTI in children. But are we swinging too far in the other [...]||19 12 12||Free||View In iTunes|
||UTI in children||Why is Urinary Tract Infection in children different from cystitis or pyelonephritis in adults? In this podcast we discuss the diagnosis, important differentials, and treatment of pediatric Urinary Tract Infection.||12 12 12||Free||View In iTunes|
||Kiddy Tox||The principles of Clinical Toxicology are similar in kids and adults, but there are a few additional aspects to consider. Join us on a sketch of assessment and management of the poisoned child... or the potentially poisoned child.||25 2 12||Free||View In iTunes|
||ISAAC blows wheezy whistle on APAP||This debate is going to be HUGE… Does paracetamol (acetaminophen) cause asthma? A series of large international studies and reviews dedicated to the question raise some interesting questions. There appears to be an epidemiological associatio[...]||25 1 12||Free||View In iTunes|
||Well Baby Oddities||From funny breathing to blue lips, baby boobs to milk regurgitation, a range of neonatal and infant oddities can present to our Emergency Departments. In this episode we discuss a few common problems, and provide some pointers towards differentiat[...]||11 1 12||Free||View In iTunes|
||Sick Baby: undifferentiated infant under 3 months||Young infants under 3 months can be pretty scary when they get properly sick. In many ways we just have to screen and treat for sepsis - and ask questions later... But there are a number of other differentials to consider. In this episode, we consid[...]||28 12 11||Free||View In iTunes|
|12||VideoJust Awful||Some lessons for Pediatric Emergency Medicine, from 1971 - a children's book, about a boy who hurts his finger at school, and has to see the school nurse. James feels Just Awful - until after the 3-part treatment...||14 12 11||Free||View In iTunes|
||MeningoCoccal Disease: Pearls and Pitfalls||A tiny, frightening little bug: Neisseria meningitidis. Join us for a discussion of ways to protect yourself, and your patients, against the nasty threat of meningococcal disease. It creeps up on you... when you least expect.||30 11 11||Free||View In iTunes|
||Meningitis: Steroids or not?||The role of steroids as adjunctive treatment for meningitis seems a bit unclear... A recent Cochrane review goes a long way to pointing us in the right direction, but still leaves a few questions open. Join us for a quick tour of the literature and[...]||16 11 11||Free||View In iTunes|
||Meningitis Diagnosis and Management||Meningitis: dangerous, scary, tricky. The clinical features of meningitis are less straightforward in younger children, and some aspects of diagnosis and treatment are still up for discussion. Join us for a discussion with our local Paediatric Inf[...]||3 11 11||Free||View In iTunes|
||UltraSound uses in Pediatric Emergency Medicine||In this episode, we discuss the evolution of bedside clinical ultrasound use in the pediatric emergency medicine setting. Is it time for your Pediatric ED to join the UltraSound craze?||20 10 11||Free||View In iTunes|
||Intussusception-Rotavirus Vaccine Risk||Discussing vaccine efficacy and risks often engenders strong feelings from both sides of the river... the traditional believers AND the 'anti-vaxxers'. In this episode, we try to discover whether there is a real link between rotavirus vaccines and t[...]||6 10 11||Free||View In iTunes|
||Intussusception||In this episode, we explore the clinical presentation, investigation and management of this bowel-threatening condition. The classic triad is not commonly found, so be on the lookout for intussusception, an uncommon cause of belly-pain, unwellness [...]||22 9 11||Free||View In iTunes|
||Assessing Self-Harm Risk||Assessing the risk of self harm or suicide in adolescents is a daunting concept for the occassional player. Last time, we discussed the HEADSS assessment tool for communicating with adolescent patients, and this is a great place to start. In this e[...]||8 9 11||Free||View In iTunes|
||Adolescent Mischief||The challenges of being an adolescent, and of caring for adolescents! We have a good look at the HEEADSSS assessment tool, which will help you to structure your interaction with teenage patients in an open-minded and non-judgemental way.||24 8 11||Free||View In iTunes|
||Fluid Controversies||Treating the wrong children with fluids will cause harm... as a recent NEJM paper about fluid boluses in very sick African children showed. We thought we'd get in on the discussion, before everyone goes throwing the baby out with the bathwater. I[...]||11 8 11||Free||View In iTunes|
||Metabolic Kids in your ED||So, a well-looking child turns up to triage and gets given a high triage priority, simply because they have a Congenital Metabolic Disorder. Do we really have to jump to it, put in an IV cannula, and call the specialist? There are individual subtl[...]||28 7 11||Free||View In iTunes|
||Metabolic Stuff for Dummies||Most 'flat' babies with acidosis will be septic, some might have another condition, but occasionally we will have the opportunity to diagnose and treat a congenital metabolic condition. Individually these conditions are rare, but as a group they ar[...]||14 7 11||Free||View In iTunes|
||Treatment Options in Neonatal Jaundice||Phototherapy treatment will be sufficient for the vast majority of infants with unconjugated hyperbilirubinaemia who need treatment. When it gets more serious, we turn to higher-risk treatments like IntraVenous Immunoglobulin or exchange transfusi[...]||30 6 11||Free||View In iTunes|
||Neonatal Jaundice||It takes a long time and a lot of exposure to become comfortable with jaundiced newborns. Maybe we just become less cautious or less thorough over time... Most of us feel the need to slow down and consider all the possibilities, before jumping to a [...]||16 6 11||Free||View In iTunes|
||Clearing the Paediatric C-Spine||Fortunately, serious injuries to the cervical spine, whether bony, ligamentous, or spinal cord injury, are uncommon in the really young... which is lucky for us, because these youngsters are also more difficult to assess, and some clinicians feel un[...]||2 6 11||Free||View In iTunes|
||Cervical Spine Assessment in Children||No-one wants to miss a broken neck... The assessment of a potential cervical spine injury in a child is a bit different when compared to adults, due to the anatomical, physiological and behavioural differences. In this PEMcast we walk through a sug[...]||19 5 11||Free||View In iTunes|
||Septic Arthritis, or Transient Synovitis?||Septic Arthritis: scary and dangerous. Transient Synovitis: bit of a limp for a few days... So how do we risk stratify children when these conditions look the same in the first couple of days? What clinical features, and what blood tests can we use[...]||4 5 11||Free||View In iTunes|
||Limping Child||Watchful waiting or invasive investigations? A limping child may have transient synovitis, or something more serious such as septic arthritis, osteomyelitis, or Perthes Disease.||21 4 11||Free||View In iTunes|
||Cranial CT for Minor Head Injury||With the recent expansion of observational data in minor head injuries, we seem to be getting closer to a sensible decision-rule for when to do a cranial CT scan for a child with a minor head injury. How do we balance the radiation (and other) risk[...]||7 4 11||Free||View In iTunes|
||Minor Head Injury||Minor Head Injury (GCS 14-15) is a source of many Emergency Department visits. Do we really need to keep these kids under observation for several hours? In this PEMcast we discuss the assessment and management of Minor Head Injuries, and explore co[...]||24 3 11||Free||View In iTunes|
||Asthma Medications: where’s the evidence?||In severe acute asthma in children, nothing seems to work as quickly or as well as we'd like... so where's the evidence that these intravenous medications actually work? This time, we skip joyfully through some hand-picked papers informing the use o[...]||10 3 11||Free||View In iTunes|
||Asthma||We see a LOT of asthma in children in our Emergency Departments - so we should know what to do when we are faced with severe or life-threatening asthma... But more often, we'll be dealing with mild and moderate asthma. Join us for an audio tour of [...]||24 2 11||Free||View In iTunes|
||Appendicitis: Utility of Tests||30-second summary of the utility of blood tests, imaging and scoring systems for diagnosing appendicitis.||10 2 11||Free||View In iTunes|
||Abdominal Pain in Children||Common conditions like gastroenteritis and constipation can mimic more significant diagnoses such as appendicitis and intussusception, so how do we sort the plain old tummy-ache from the more serious causes? In this PEMcast we take a quick tour thro[...]||27 1 11||Free||View In iTunes|
||Croup: the steroid saga||Type and dose of steroid for croup is a quiet controversy that has been evolving over the last two decades or so. In this PEMcast we discuss the evolution of the evidence and the current state of play.||13 1 11||Free||View In iTunes|
||Croup||Croup is a potentially life-threatening upper airway obstruction that has a highly successful and satisfying treatment. The trick is to make sure you are dealing with croup, and not another cause of upper airway obstruction. In this episode we con[...]||30 12 10||Free||View In iTunes|
||Fever: NICE to get guidance||NICE Clinical Guidance CG47: Feverish Illness in Young Children. In this PEMcast we look at the evidence behind the expert consensus, and put ourselves in the position of the front-line clinicians who might benefit from the guidance offered by this[...]||16 12 10||Free||View In iTunes|
||Fever: Fear and Tradition||Fever is probably the commonest presenting complaint we manage in Paediatric Emergency Departments. The cause is usually an infection... but not always. The infection is usually a benign, self-limiting viral illness... but not always. Join us whil[...]||2 12 10||Free||View In iTunes|
||Neonatal Hypoglycaemia||To bolus, or Not to bolus... that is the question. Actually, there are a few more questions too... How low is too low? What are the causes of neonatal hypoglycaemia? Any advances in research?||18 11 10||Free||View In iTunes|
||E for Exposure, Don’t Ever Forget Glucose||Exposure: getting a look at the whole patient, while preventing hypothermia. DEFG: it's easy to get distracted by a sick-looking kid or a serious injury, but: Don't Ever Forget Glucose!||4 11 10||Free||View In iTunes|
||D is for Disability (part 2 of 2)||Severe Head Injury: is any treatment proven to work? Join us as we explore the literature behind currently accepted treatments for serious traumatic brain injury, in particular the role for therapeutic hypothermia.||20 10 10||Free||View In iTunes|
||D is for Disability (part 1 of 2)||AVPU or GCS? What is the utility of the Glasgow Coma Scale in assessing neurologic status in sick or injured children? In this PEMcast, we cover the basics of assessing D for Disability, and delve a little deeper into the GCS and its Pediatric deriv[...]||7 10 10||Free||View In iTunes|
||Bronchiolitis (part 2 of 2)||Bronchiolitis: Effective treatment, at last? Nebulised Hypertonic (3%) Saline may reduce severity and hospital length of stay, if you believe a handful of small trials. In this episode we discuss 4 original papers related to Hypertonic Saline for [...]||23 9 10||Free||View In iTunes|
||Bronchiolitis (part 1 of 2)||Bronchiolitis is a common, usually mild respiratory condition affecting infants. This PEMcast outlines the essential points in diagnosis, assessment of severity, and management.||9 9 10||Free||View In iTunes|
||Circulation (part 2 of 2)||Maintenance intravenous fluids for sick children: what fluid, what rate? Long-held traditions of giving hypotonic intravenous fluids to children have been increasingly challenged, due to dangerous adverse effects. In this PEMcast, we look at a few[...]||26 8 10||Free||View In iTunes|
||C is for Circulation (part 1 of 2)||Shock, dehydration, fluid management... How do we assess and manage the circulation in a paediatric emergency? Learn about the clinical assessment of the Circulation in this PEMcast.||12 8 10||Free||View In iTunes|
||Breathing (part 4 of 4)||What is the role for Non-Invasive Ventilation in the Paediatric Emergency Department? We look at 1 review and 3 original papers to discuss in some depth whether we should be using BiPAP and other non-invasive technologies for children with respirat[...]||29 7 10||Free||View In iTunes|
||Breathing (part 3 of 4)||When should we refer children with breathing difficulty to the Paediatric Intensive Care Unit? How do we set the ventilator to achieve our goals, without causing lung injury? Kate and Dan talk us through it.||15 7 10||Free||View In iTunes|
a good start!
The topics covered so far are the basic building blocks to peds emergency. There are lots of basics sutiable for the medical student and junior doctor but in the more advanced areas of the topics covered the newer literature and techniques are covered to picque the interest of a specialist in the field. Some sections the dialogue are a bit montonous but the introduction of friendly banter helps to relieve this.
Let's face it, what these guys don't know about paediatrics isn't worth knowing. I'm really looking forward to the Croup podcast and the choice of steroid, dose and perhaps even a bit of upskilling on the dose of nebulised adrenaline.
Great Paeds Review!
Welcome back! These topic reviews are a fantastic resource for the Emergency fellowship exam. Thank you for continuing your podcast, and giving us all the opportunity to keep sharp with the little people!