This post is adapted from teaching sessions and educational materials developed by Dr. Hannah Barber Doucet for pediatric and emergency medicine learners. The content has been edited for clarity and expanded into a written format for HipPEMcrates, with the goal of translating bedside teaching into a practical, on-shift reference for pediatric emergency clinicians. Stay tuned […]
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PEM Clinicians: If you find this kind of breakdown useful, HipPEMcrates delivers concise, evidence-based PEM insights and expert conversations – without oversimplifying the science. Go to HipPEMcrates.com/subscribe to get new posts directly to your inbox. Hot Off the Press! Last week, JAMA published a new study titled “Prediction of Bacteremia and Bacterial Meningitis Among Febrile
Hot Off the Press! This past Monday, JAMA published a new study titled “Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger.” The study evaluated whether the PECARN Febrile Infant Prediction Rule (you know the one – negative urine, serum procalcitonin ≤0.5 ng/mL, and ANC ≤4000/mm3) can be applied to
TEASER…The Study That Will Change Everything (for Febrile Infants) Read More »
Even the most experienced trauma teams can overlook the basics in the chaos of a resus. These pearls focus on three simple but critical steps – ones that improve communication, prevent missed injuries, and keep care consistent. Let’s get sharper. These pearls are based on video and patient reviews done at the Children’s Hospital of
Not Just ABCs: 3 Overlooked Trauma Essentials Read More »
The Case A 2-month-old boy was seen by his pediatrician earlier in the day for fussiness and poor feeding. At that visit, he was noted to be tachycardic, but the elevated heart rate was attributed to crying and irritability. That evening, his parents brought him to the ED because he continued to breathe rapidly and
Clinical Scenario: The Cranky, Tachypneic Baby Read More »
The Case A 3-month-old breastfed male is brought to the ED with: On exam: You pause. The baby’s floppy. He’s not febrile. He’s not actively seizing. But something is clearly wrong. Diagnosis: Infant Botulism This is classic: a floppy, constipated infant with descending paralysis. Pathophysiology: Key Clinical Clues PEM Pearl: A floppy, afebrile infant with
Clinical Scenario: The Floppy Infant with Constipation Read More »
🧠 The Case A 5-month-old infant presents to the ED with: Initial Workup: “The blood drawn looked… brownish.” 🩸 The Turn: Chocolate Blood + Unexpected Hypoxia Blood gas reveals a methemoglobin level of 31.6%(normal is <1.5%) You immediately recognize this as methemoglobinemia—a condition where hemoglobin is oxidized (Fe²⁺ ➝ Fe³⁺) and can no longer carry
Clinical Scenario: The Baby Who Turned Blue Read More »
Pediatric emergency departments often see children with a wide range of conditions, from mild illnesses to life-threatening diseases. It’s helpful when serious conditions like volvulus present with clear and obvious symptoms, such as bilious emesis in a newborn. However, the challenge—and anxiety—arises when an urgent or emergent condition mimics a more benign presentation. Two such
2 High-Stakes Misses in the Pediatric ED Read More »
You see a 51-day-old infant in the ED brought in for “fussiness” and ear tugging. She’s afebrile but has a red, bulging tympanic membrane. Do we still need to work her up? Or can you just treat the ear infection and move on? Acute otitis media (AOM) is a common diagnosis in infants, but it
Clinical Scenario: AOM and IBI in Young Infants Read More »
A 64-day-old male is brought to the ED for fever to 100.9°F at home. He’s well-appearing, feeding normally, and has mild nasal congestion and cough. No vomiting, rash, or decreased urine output. Vitals are stable. A respiratory viral panel returns positive for RSV. Your intern asks, “Since he’s over 60 days and RSV-positive, do we
Clinical Scenario: SBI in Febrile Infants with Viral Illness Read More »
