69 episodes

PEM Currents is a evidence-based podcast focused on the care of ill and injured children in the Emergency Department. The host is Brad Sobolewski, author of PEMBlog.com and an Associate Professor of Pediatric Emergency Medicine at Cincinnati Children's and the University of Cincinnati.

PEM Currents: The Pediatric Emergency Medicine Podcast Brad Sobolewski

    • Medicine
    • 4.6, 38 Ratings

PEM Currents is a evidence-based podcast focused on the care of ill and injured children in the Emergency Department. The host is Brad Sobolewski, author of PEMBlog.com and an Associate Professor of Pediatric Emergency Medicine at Cincinnati Children's and the University of Cincinnati.

    Multisystem Inflammatory Syndrome in Children

    Multisystem Inflammatory Syndrome in Children

    Multisystem Inflammatory Syndrome in Children (MIS-C) is an evolving clinical entity that is occurring, possibly in association with or following a COVID-19 infection. This episode of PEM Currents expands upon a recent PEMBlog post, as well as includes information from two studies published in The Lancet as well as included in a recent CDC webinar. This episode also provides recommendations on lab workup and the evolving criteria for diagnosis and the current case definition from the CDC.







    PEMBlog







    @PEMTweets on Twitter







    The Facebook page







    References







    CDC Webinar: Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). May 19, 2020.







    CDC Health Alert Network: Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). Accessed May 15, 2020.







    Riphagen et al. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020. Advance online publication, doi: 10.1016/S0140-6736(20)31094







    Verdoni et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020. Advance online publication, doi: 10.1016/ S0140-6736(20)31129-6 

    • 15 min
    Pulmonary Embolism

    Pulmonary Embolism

    Yes, PEM Currents is a Pediatric Emergency Medicine podcast, but during the COVID-19 pandemic we may be tasked with seeing patients outside of our area of expertise. Plus, there’s a lot we can learn from big people that we can extrapolate to children. I have partnered with POPCoRN, the Pediatric Overflow Planning Contingency Response Network to deliver content that will benefit those of us who may have been asked to care for adults both in their native habitat, and in our pediatric facilities. David Shore, a 4th year Internal Medicine/Pediatrics Resident from Penn State delivers some timely content on PE diagnosis and management, including an instructive case of a young adult that is very applicable to the Pediatric Emergency Department in this brief, focused episode.







    References







    Aujesky et al. Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial. Lancet. 2011 Jul 2;378(9785):41-8. doi: 10.1016/S0140-6736(11)60824-6. Epub 2011 Jun 22.







    Aujesky et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med. 2005 Oct 15;172(8):1041-6. Epub 2005 Jul 14.







    Kline et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost 2004; 2: 1247–55.







    Stein et al. Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest. 1991;100(3):598.







    Wells et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med. 2001 Jul 17;135(2):98-107. PubMed PMID: 11453709.

    • 19 min
    Vasopressors

    Vasopressors

    Vasopressor use in the Pediatric Emergency Department has been a moving target for my entire career. Back when I was a resident and fellow we used Dopamine. Then we went to epinephrine because it can be given through a peripheral IV because norepinephrine was too dangerous to run peripherally. But maybe that’s not entirely true. I talked about initial pressor choice and more in a recent recorded Zoom conference call with Critical Care Attending Matt Zackoff from Cincinnati Children’s. I hope you find his thoughts on vasopressor selection, pitfalls, and the emerging therapies as illuminating as I did.







    Follow me on Twitter @PEMTweets







    Check out the facebook page







    PEMBlog.com







    References







    Sadoway et al. A systematic review of local complications from central and peripheral administration of vasopressors in the pediatric population. Canadian Journal of Emergency Medicine, 2019.







    Surviving Sepsis Campaign: Initial Algorithm for Children







    Weiss et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children.Pediatr Crit Care Med. 2020;21(2):e52. 

    Stroke in Adults

    Stroke in Adults

    Yes, PEM Currents is a Pediatric Emergency Medicine podcast, but during the COVID-19 pandemic we may be tasked with seeing patients outside of our area of expertise. Plus, there’s a lot we can learn from big people that we can extrapolate to children. I have partnered with POPCoRN, the Pediatric Overflow Planning Contingency Response Network to deliver content that will benefit those of us who may have been asked to care for adults both in their native habitat, and in our pediatric facilities. Marie Pfarr, a Hospital Medicine physician from Cincinnati Children’s delivers some timely content on stroke in adults in this brief, focused episode.







    References







    Candelise L, Gattinoni M, Bersano A, et al. Stroke-unit care for acute stroke patients: an observational follow-up study. Lancet 2007; 369:299.







    Hemphill JC 3rd, Greenberg SM, Anderson CS, et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2015; 46:2032.







    Lansberg MG, O’Donnell MJ, Khatri P, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141:e601S.







    Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2019; 50:e344.

    • 13 min
    Status Epilepticus

    Status Epilepticus

    Status epilepticus can be very stressful in the Pediatric Emergency Department. This episode of PEM Currents: The Pediatric Emergency Medicine Podcast focuses on management, and will guide you through the treatment process, starting with benzodiazepines, followed by a discussion of the recent evidence for second line therapy between fosphenytoin, levetiracetam, and valproate.







    Follow me on Twitter @PEMTweets







    Check out the facebook page







    Visit PEMBlog.com







    References







    Chamberlain et al. Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double-blind, responsive-adaptive, randomised controlled trial. LANCET, March, 2020







    Dalziel et al. Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial. Lancet, 2019.







    Kapur et al. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus. NEJM, 2019.







    Lyttle et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial. Lancet, 2019.

    Hemophilia

    Hemophilia

    Factor First!







    OK, did I get your attention? Hopefully I did, because giving replacement factor to children with hemophilia presenting to the Emergency Department as soon as possible is the most important thing that you can do to positively impact outcomes. This episode of PEM Currents focuses on the different bleeding complications seen in Hemophilia and Von Willebrands and reviews basic management. There is a companion post on PEMBlog.com that has more detailed information that you should check out as well.







    Follow me on Twitter @PEMTweets







    Check out the facebook page







    Visit PEMBlog.com







    I am proud to offer CME for this podcast episode through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.







    References







    Di Michele D, Neufeld EJ. Hemophilia: a new approach to an old disease. Hematol Oncol Clin North Am. 1998;12(6):1315- 1344.







    Di Michele D. Inhibitor treatment in haemophilias A and B: inhibitor diagnosis. Haemophilia. 2006;12(Suppl 6):37-42.







    Labarque V, Stain AM, Blanchette V, et al. Intracranial haem- orrhage in von Willebrand disease: a report on six cases. Heamophilia. 2013;19(4):602-606.







    Melchiorre D, Linari S, Innocenti M, et al. Ultrasound detects joint damage and bleeding in haemophilic arthropathy: a proposal of a score. Haemophilia. 2011;17(1):112-117.







    Nagel K, Pai MK, Paes BA, et al. Diagnosis and treatment of intracranial hemorrhage in children with hemophilia. Blood Coagul Fibrinolysis. 2013;24(1):23-27. 







    Oren H, Yaprak I, Irken G. Factor VIII inhibitors in patients with hemophilia A. Acta Haematologica. 1999;102(1):42-46.







    Schwartz et al. Hemophilia And Von Willebrand Disease In Children: Emergency Department Evaluation And Management. EB Medicine, 2015.







    Witmer C, Presley R, Kulkarni J, et al. Associations between intracranial haemorrhage and prescribed prophylaxis in a large cohort of haemophilia patients in the United States. Br J Haematol. 2010;152(2):211-216. 







    Witmer CM, Raffini LJ, Manno CS. Utility of computed tomography of the head following head trauma in boys wth haemophilia. Haemophilia. 2007;13(5):560-566. 

Customer Reviews

4.6 out of 5
38 Ratings

38 Ratings

Arnold430 ,

Awesome

This podcast is amazing. Very educational and easy to listen to!

melbellu ,

Awesome podcast

PEM currents has become my favorite pediatric podcast (and I’ve listened to a bunch). As a new pediatric nurse practitioner, I have found this podcast to be immensely beneficial. It is full of pertinent and concise info I can use in every day practice! Thank You! Keep the episodes coming!

heidiandty29 ,

Best Podcast for Pediatric Acute Care

This podcast is excellent. It is succinct, up to date with the best and most recent evidence, and it is focused on clinical application. You will literally use the information you gain from these podcasts in your next shift.

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