HipPEMcrates FOAM Roundup | August 2026

A monthly guide to the best new Pediatric Emergency Medicine FOAM

One of the greatest strengths of Pediatric Emergency Medicine is the community of educators who freely share their expertise through blogs, podcasts, cases, infographics, and other educational resources. The challenge is finding the time to keep up with all of it. This monthly newsletter is designed to help. The goal is not to replace the original content, but to guide you toward it – highlighting what was published, what each resource offers, and where you may want to spend your limited reading or listening time.

August’s content ranged from major new evidence on sickle cell pain and pediatric pulmonary embolism to practical refreshers on dextromethorphan overdose, embedded earrings, trauma, endocrine emergencies, and the human factors that shape care under pressure.

Overall Pearls from August’s PEM FOAM

“Negative” trials can still teach us about care. The PECARN STArT trial did not demonstrate that intravenous arginine shortened time to pain-crisis resolution, but the substantial hospital-level variation in crisis duration and opioid use highlights the need to examine differences in care.
Decision rules work only in the population in which they were studied. PERC-Peds may reduce unnecessary testing in carefully selected low-risk children, but it should not replace clinician assessment or be applied indiscriminately.
Small procedures benefit from a deliberate plan. Embedded earrings, pediatric elbow injuries, and head trauma all reinforce the value of analgesia, anatomy, appropriate imaging, and knowing when escalation is needed.
The dramatic presentation is not always the dangerous diagnosis. Summer penile syndrome and many causes of torticollis may be benign, but both require clinicians to recognize the findings that point toward infection, trauma, neurologic disease, or another urgent alternative.
Human factors are clinical skills. Situational awareness and cognitive debiasing can be practiced, particularly when a child is deteriorating and the team is working under pressure.

⚡ This Month in 30 Seconds

🌐 Sources monitored: 10 blogs and 12 podcasts
📚 Resources featured: 26
📝 Blog posts, cases, and journal-club resources: 13
🎙️ Podcast episodes: 10
📄 One-page educational resources: 3

⭐ Featured Read: Sickle Cell Acute Pain Episodes: Lessons Learned from the Prematurely Halted PECARN STArT Trial – Academic Life in Emergency Medicine

🎧 Featured Listen: The PEM Podcast: Sepsis 2026 with Dr. Scott Weiss – The PEM Podcast

🔥 Major themes: Evidence appraisal • Risk-stratified care • Practical procedures • Diagnostic reasoning • Human factors

⭐ Featured Read

Sickle Cell Acute Pain Episodes: Lessons Learned from the Prematurely Halted PECARN STArT Trial

📝 Academic Life in Emergency Medicine
Published: August 24

A review of the PECARN STArT trial, in which intravenous arginine did not shorten acute sickle cell pain episodes. The post emphasizes the substantial variation among study sites and reinforces the importance of rapid, protocolized analgesia in the ED.

🎧 Featured Listen

The PEM Podcast: Sepsis 2026 with Dr. Scott Weiss

🎙️ The PEM Podcast
Published: August 24

Drs. Bob Belfer and Scott Weiss discuss the PRoMPT BOLUS trial, balanced crystalloids versus normal saline, and key updates from the 2026 pediatric sepsis guidelines. The conversation also covers sepsis screening, vasoactive medications, biomarkers, and the future role of artificial intelligence in pediatric sepsis care.

Jump to a topic

Dermatology & Procedures

Endocrinology, Nephrology, & Urology

Gastroenterology

Infectious Disease

Pediatric Mental Health

Clinical Reasoning & Human Factors

Neonatology & Literature Discovery

☠️ Toxicology

“Robo-Tripping”: Dextromethorphan Overdose

📝 Pediatric EM Morsels
Published: August 21

A practical review of dextromethorphan misuse and overdose, including expected toxidromes, important complications, diagnostic evaluation, and management.

Push Dose Pearls: Cannabinoid Hyperemesis

🎙️ EM Pulse Podcast
Published: August 4

A practical review of cannabinoid hyperemesis syndrome, including the roles of haloperidol, droperidol, capsaicin, fluid resuscitation, and electrolyte replacement. The episode also addresses QTc risk, discharge treatment, and communicating the connection between chronic cannabis use and recurrent symptoms.

🩸 Hematology

Sickle Cell Acute Pain Episodes: Lessons Learned from the Prematurely Halted PECARN STArT Trial

📝 ALiEM
Published: August 24

A review of the PECARN STArT trial, in which intravenous arginine did not shorten sickle cell pain episodes. The post highlights substantial site-level variation and reinforces the importance of timely, protocolized analgesia.

🧠 Neurology

On Infantile Spasms and Seizures

🎙️ The Cribsiders
Published: August 12

A discussion with pediatric epileptologist Dr. Eva Catenaccio about recognizing infantile spasms and distinguishing them from other abnormal infant movements. The episode reviews when to obtain an EEG, how infantile spasms are diagnosed, and why early recognition and effective treatment are critical.

🫁 Pulmonology

The BEEPER Study: Sounding the Alarm on Paediatric Pulmonary Embolism

📝 Don’t Forget the Bubbles
Published: August 20

A detailed appraisal of the PECARN BEEPER study and PERC-Peds rule, including how the rule may help identify low-risk children who do not need D-dimer testing or imaging.

SGEM #519: Don’t Let Pediatric Pulmonary Embolism Leave You Breathless

🎙️ The Skeptics’ Guide to Emergency Medicine
Published: August 29

A critical appraisal of the BEEPER study and PERC-Peds rule for excluding pulmonary embolism in carefully selected children. The episode highlights the rule’s very low false-negative rate while emphasizing its limited specificity, reliance on clinician-estimated pretest probability, and potential for inappropriate testing if applied indiscriminately.

🦴 Orthopedics & Trauma

SGEM #517: Surgery or Not for Pediatric Displaced Medial Epicondyle Fractures

🎙️ The Skeptics’ Guide to Emergency Medicine
Published: August 8

A critical appraisal of operative versus nonoperative treatment for displaced pediatric medial epicondyle fractures, with attention to functional outcomes and the limitations of the available evidence.

Casting Doubt on Tradition: Boot vs Cast for Toddler’s Fractures

📝 REBEL EM
Published: August 10

This evidence review examines whether young children with radiographically confirmed toddler’s fractures require casting. A removable walking boot provided similar pain control while simplifying care and reducing the burden on families, making it a reasonable alternative for uncomplicated fractures.

Question: Trauma

📝 PEMSource
Published: August 11

A quick diagnostic challenge involving pediatric head trauma and a depressed skull fracture, with a reminder about the limitations of skull radiographs and when CT is needed.

Torticollis

📝 PedsCases
Published: August 10

A one-page infographic reviewing the causes, clinical appearance, evaluation, and management of torticollis in children.

🩹 Dermatology & Procedures

Summer Penile Syndrome

📝 PEMBlog
Published: August 18

A concise review of this benign but dramatic hypersensitivity reaction, including the classic presentation, important alternative causes of penile swelling, and supportive treatment.

Minor Procedures: Embedded Earrings

🎙️ PEM Currents
Published: August 5

A practical approach to removing embedded earrings, including analgesia, local anesthesia, removal techniques, wound care, antibiotics, and higher-risk cartilage piercings.

🧪 Endocrinology, Nephrology, & Urology

Congenital Adrenal Hyperplasia

📝 PedsCases
Published: August 6

A one-page overview of congenital adrenal hyperplasia, including common presentations and fundamentals of management, with particular relevance to recognizing salt-wasting crisis.

Nephrotic vs. Nephritic Syndrome

📝 PedsCases
Published: August 19

A concise infographic comparing nephrotic and nephritic syndromes and organizing the approach to edema, hypertension, hematuria, and proteinuria.

PEAs on a Pod Episode 1: TWIST’d Up

🎙️ PEAs on a Pod
Published: August 24

Drs. Rusty Walker and Seth Ball review pediatric testicular torsion, focusing on time-sensitive diagnosis and management, factors contributing to delays, and how clinical predictors and selective Doppler ultrasound can inform the evaluation of acute scrotal pain.

When Pain Meets Renal Impairment: A Paediatric ED Guide to Analgesia in Renal Disease

📝 Don’t Forget the Bubbles
Published: August 25

A practical guide to providing safe and effective analgesia for children with acute or chronic renal impairment. It reviews the use of paracetamol, NSAIDs, opioids, and regional anesthesia, emphasizing appropriate dose adjustments, safer opioid choices, and monitoring for toxicity.

💩 Gastroenterology

The Poop Problem: Surviving Cyclospora

🎙️ EM Pulse Podcast
Published: August 18

A practical discussion of the current Cyclospora outbreak, including transmission through contaminated produce, the characteristic prolonged and relapsing diarrhea, and when ED clinicians should test and treat. The episode also reviews multiplex stool PCR testing, trimethoprim-sulfamethoxazole therapy, and the risk of dehydration and electrolyte abnormalities.

Question: GI

📝 PEMSource
Published: August 4

A clinical question reviewing pediatric cyclosporiasis, including transmission through contaminated produce, the delayed infectivity of shed oocysts, and prolonged watery diarrhea. It emphasizes specifically requesting testing for Cyclospora and reviews treatment with trimethoprim-sulfamethoxazole.

🦠 Infectious Disease

The PEM Podcast: Sepsis 2026 with Dr. Scott Weiss

🎙️ The PEM Podcast
Published: August 24

Saline or Balanced Fluids? What PRoMPT BOLUS Means for Pediatric Sepsis

🎙️ PEM Currents
Published: August 26

A focused review of balanced crystalloids versus normal saline for pediatric septic shock. The episode examines the PRoMPT BOLUS trial, its limitations, and how its findings fit with the 2026 Surviving Sepsis Campaign guidelines and bedside fluid selection.

💭 Pediatric Mental Health

Inside Pediatric Emergency Psychiatry with Dr. Megan Schott

🎙️ Psychiatry Boot Camp
Published: August 10

A discussion of the growing pediatric psychiatric boarding crisis and the role of child psychiatrists in the emergency department. The episode reviews alternatives to hospitalization, the potential consequences of unnecessary admission, management of challenging behavioral presentations, and practical strategies for ED clinicians without immediate access to pediatric psychiatric support.

🧠 Clinical Reasoning & Human Factors

Sats Dropping, Head Rushing

📝 Don’t Forget the Bubbles
Published: August 11

A clinical reasoning case exploring how cognitive errors can emerge when a child deteriorates and the team is working under pressure.

Situational Awareness: Innate Ability or Attained Skill?

📝 Don’t Forget the Bubbles
Published: August 18

A human-factors discussion of situational awareness and the practical skills clinicians can develop to better recognize and respond to changing clinical conditions.

Question: Gender Diverse Patients in the ED

📝 PEMSource
Published: August 25

A clinical question reviewing respectful and medically informed care for transgender and gender-diverse adolescents in the ED. It highlights potential acute complications of tucking and chest binding, considerations related to gender-affirming medications, and the importance of using patients’ affirmed names and pronouns while recognizing associated mental health risks.

📚 Neonatology & Literature Discovery

The 104th Bubble Wrap: DFTB26 Bubble Wrap Live—Neonates

📝 Don’t Forget the Bubbles
Published: August 3

A neonatal-focused journal club reviewing recent evidence and translating it into practical takeaways for clinicians caring for newborns.

Bubble Wrap PLUS—August 2026

📝 Don’t Forget the Bubbles
Published: August 5

A broad pediatric literature-discovery list drawn from 34 journals, with studies relevant to emergency care, pediatric readiness, asthma, foreign-body ingestion, dehydration, and more.

🏛️ New on HipPEMcrates

The 3: What Happens After the Epi in Pediatric Anaphylaxis?

Three practical questions after epinephrine: who is at risk for biphasic reactions, how long to observe, and what patients need before discharge.

The 3 Things You Need to Know Before Calling It Bell’s Palsy

A focused approach to pediatric facial weakness: confirm a peripheral pattern, consider Lyme disease and other mimics, and protect the cornea.

The 3: What You Need to Know About “Dry Drowning”

A myth-busting review explaining why “dry drowning” is not a medical diagnosis, what symptoms after a submersion event matter, and how to counsel families without creating unnecessary fear.

❤️ Thank You to This Month’s PEM FOAM Contributors

This month’s roundup featured work from:

Thank you to everyone creating and sharing free, high-quality Pediatric Emergency Medicine education. Please support these educators by reading, listening, sharing, and engaging with the original content.

Dr. Joshua Belfer, MD, is a Pediatric Emergency Medicine physician at the Children’s Hospital of Philadelphia, and is the Founder and Editor-in-Chief of HipPEMcrates. He can be reached at HipPEMcrates@gmail.com.