56 episodes

You make tough calls when caring for acutely ill and injured children. Join us for strategy and support -- through clinical cases, research and reviews, and best-practice guidance in our ever-changing acute care landscape.

Please visit our site at http://PEMplaybook.org/ for show notes and to get involved with the show -- see you there!

Pediatric Emergency Playbook Tim Horeczko, MD, MSCR, FACEP, FAAP

    • Medicine

You make tough calls when caring for acutely ill and injured children. Join us for strategy and support -- through clinical cases, research and reviews, and best-practice guidance in our ever-changing acute care landscape.

Please visit our site at http://PEMplaybook.org/ for show notes and to get involved with the show -- see you there!

    Major Burns in Children

    Major Burns in Children

     



     



    Lund and Browder Chart to Estimate Burn Size in Children



     


     

     

     



     


     
     




     


     
    Parkland Formula for Burns Amount needed in addition to maintenance fluids:
    4 mL/kg x BSA% = X  Add 1/2 of X to maintenance over the 1st 8 hours
    Add the other 1/2 of X to maintenance over the next 16 hours
     




     


     
    Escharotomy Guide and the "Roman Breastplate"



     


     

     

     



     


     
    Yin et al. Bedside Escharotomies for Burns




     


     
    Classic Paragraph

    Selected References
    Mahar PD et al. Clinical differences between major burns patients deemed survivable and non-survivable on admisssion. Injury. 2015; 46:870-873.
    Mathis E et al. Pediatric Thermal Burns and Treatment: A Review of Progress and Future Prospects. Medicines. 2017; 4:91.
    Osuka A et al. Glycocalyx shedding is anhanced by age and correlates with increased fluid requirement in patients with major burns. Shock. 2017; 50(1):60-65.
    Sebastian R et al. Percutaneous pigtail catheter in the treatment of pneumothorax in major burns: The best alternative? Burns. 2015; e24-227
    Sherren PB et al. Lethal triad in severe burns. Burns. 2014; 1492-1496.
    Strobel AM et al. Emergency Care of Pediatric Burns. Emerg Med Clin N AM. 2018; 441-458.




     





     



     

    • 43 min
    Anemia. Now What?

    Anemia. Now What?

    PEMplaybook.org

    • 43 min
    Pediatric Sports Injuries

    Pediatric Sports Injuries

    PEMplaybook.org

    • 39 min
    EtCO2 Masterclass

    EtCO2 Masterclass

    • 45 min
    Neck Masses in Children

    Neck Masses in Children

    The differential diagnosis is long... You need an approach.  
    The Rule of 3s: 3 minutes -- Traumatic 3 days -- Inflammatory 3 months -- Neoplastic 3 years -- Congenital  
    3 Minutes?  Traumatic
      3 Days?  Inflammatory [caption id="attachment_1777" align="alignnone" width="262"] Cervical Node Chain; Lymphadenopathy[/caption] [caption id="attachment_1773" align="alignnone" width="298"] Bacterial Lymphadenitis[/caption] [caption id="attachment_1772" align="alignnone" width="300"] Bacterial lymphadenitis with small abscess[/caption] [caption id="attachment_1771" align="alignnone" width="300"] Large Abscess[/caption]
      3 Months?  Neoplastic
      3 Years?  Congenital [caption id="attachment_1784" align="alignnone" width="300"] Thyroglossal Duct Cyst[/caption] [caption id="attachment_1783" align="alignnone" width="300"] Thyroglossal Duct Cyst[/caption] [caption id="attachment_1776" align="alignnone" width="278"] Branchial Cleft Cyst[/caption] [caption id="attachment_1775" align="alignnone" width="263"] Branchial Cleft Cyst[/caption] [caption id="attachment_1774" align="alignnone" width="233"] Branchial Cleft Cyst[/caption] [caption id="attachment_1779" align="alignnone" width="300"] Cystic Hygroma[/caption]
     
    [caption id="attachment_1778" align="alignnone" width="235"]  Cystic Hygroma[/caption]
      Selected References Enepekides DJ. Management of congenital anomalies of the neck. Facial Plast Surg Clin North Am 2001; 9:131.
    Lin ST, Tseng FY, Hsu CJ, et al. Thyroglossal duct cyst: a comparison between children and adults. Am J Otolaryngol 2008; 29:83.
    Mandell DL. Head and neck anomalies related to the branchial apparatus. Otolaryngol Clin North Am 2000; 33:1309.
    Marler JJ, Mulliken JB. Current management of hemangiomas and vascular malformations. Clin Plast Surg 2005; 32:99.
    Silverman, J. F., Gurley, A. M., Holbrook, C. T., Joshi, V. V. (1991) Pediatric fine needle aspiration biopsy. American Journal of Clinical Pathology 95: 653–659
    Sonnino RE, Spigland N, Laberge JM, Desjardins J, Guttman FM. Unusual patterns of congenital neck masses in children. J Pediatr Surg. 1989 Oct;24(10):966-9.

    • 39 min
    Intraosseous Devices

    Intraosseous Devices

    https://www.youtube.com/watch?v=cQVKIpLc8bk
     

    Selected References


    Barnard, et al. Rapid sequence induction of anaesthesia via the intraosseous route: a prospective observational study. Emerg Med J. 2014; Jun 24. pii: emermed-2014-203740.

    Jousi M, Saikko S, Nurmi J. Intraosseous blood samples for point-of-care analysis: agreement between intraosseous and arterial analyses. Scand J Trauma Resusc Emerg Med. 2017;25(1):92. Published 2017 Sep 11. doi:10.1186/s13049-017-0435-4

    Knuth, et al. Intraosseous Injection of Iodinated Computed Tomography Contrast Agent in an Adult Blunt Trauma Patient. Annals of Emergency Medicine. 2011; 57 (4) 382-386

    Miller LJ. et al A new study of intraosseous blood for laboratory analysis.Arch Pathol Lab Med. 2010 Sep;134(9):1253-60.

    Miller, et al. Utility of an intraosseous vascular system to deliver contrast dye using a power injector for computerized tomography studies. Annals of Emergency Medicine. 2011; 58 (4) 240-241.

    • 46 min

Customer Reviews

desertem ,

One of the best

I listen to a lot of podcasts. This is one of my favorites. He is entertaining as well as brilliant. These are mandatory for anyone taking care of sick kids. His delivery and format create maximum retention...

ContrivedUserID ,

So good even a nurse would like it.

I won’t lie- I’m your typical cranky, older, jaded nurse who is super unimpressed with doctors. Nursing podcasts don’t cut it for me though, because what we need is the HOW and the WHY to help me do better.

This podcast breaks down all of the factors I need to get better at what I do and apply what I’ve learned. (And the approval of the snarky nurse is not an easy thing to get!)

Pbh30 ,

Peds Resident

This podcast has helped me better evaluate patients in the ED with creating broad differentials. It has helped me to decide when to admit children to the hospital vs. going home and also better understand why we do some of the things we do. I have told anyone who will give me an ear about this podcast. Please keep them coming!! Also, love the way you present topics. The pace of the podcast makes it easier to remember some of the facts. I also noticed the research you talk about has now been attached in the title. Love it. Thank you thank you

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