Clinical Scenarios Archives

Measles is Back: The Experts Tell You What You Need to Know

For many practicing pediatric emergency physicians, measles feels like a disease from another era. In fact, measles was declared eliminated in the United States in 2000. But over the past several years, declining vaccination rates and increasing global circulation have pushed measles back into the clinical conversation. The reality is that many emergency clinicians today […]

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Rapid Rounds with HBD: Abdominal Trauma

Clinical Scenarios, Gastroenterology, HBD Rapid Rounds, The 3, Trauma

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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The Interview: Dr. Kuppermann and Dr. Burstein On The Study That Will Change Everything (for Febrile Infants)

Clinical Scenarios, Infectious Disease

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

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TEASER…The Study That Will Change Everything (for Febrile Infants)

Clinical Scenarios, Infectious Disease

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

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Not Just ABCs: 3 Overlooked Trauma Essentials

Clinical Scenarios, Procedures, The 3, Trauma

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

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Clinical Scenario: The Cranky, Tachypneic Baby

Cardiology, Clinical Scenarios

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

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Clinical Scenario: The Floppy Infant with Constipation

Clinical Scenarios, Gastroenterology, Infectious Disease

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

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Clinical Scenario: The Baby Who Turned Blue

Clinical Scenarios, Respiratory, Toxicology

🧠 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

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2 High-Stakes Misses in the Pediatric ED

Cardiology, Clinical Scenarios, Infectious Disease

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

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Clinical Scenario: AOM and IBI in Young Infants

Clinical Scenarios, Infectious Disease

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

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