HipPEMcrates FOAM Roundup | July 2026

A monthly guide to the best new Pediatric Emergency Medicine FOAM

Welcome to the first HipPEMcrates FOAM Roundup!

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.

July’s content ranged from major new evidence on pediatric pulmonary embolism and anaphylaxis observation to practical refreshers on drowning, SCFE, catatonia, neonatal diagnoses, and summer infectious diseases.

Overall Pearls from July’s PEM FOAM

Avoid diagnostic closure when the presentation does not quite fit. Knee pain may originate from the hip, red urine may not be hematuria, behavioral withdrawal may be catatonia, and meconium in a diaper does not guarantee normal anorectal anatomy.
Risk-stratified care continues to replace rigid habits. July’s resources questioned fixed anaphylaxis observation times, routine reduction of selected wrist fractures, CT imaging in low-risk children with suspected PE, and azithromycin for preschool wheeze.
The physical examination still matters. Careful assessment of the pupils, hips, perineum, newborn upper extremities, and head position revealed some of the month’s most important diagnoses.
Order the test that answers the actual clinical question. Cyclospora testing, GAS testing, urine microscopy, and pediatric PE assessment all highlighted the consequences of misunderstanding what a test can – and cannot – tell you.
Summer brings its own differential. Drowning, sea bather’s eruption, and prolonged foodborne diarrhea deserve renewed attention during the warm-weather months.

⚡ This Month in 30 Seconds

🌐 Sources monitored: 10 blogs and 12 podcasts
📚 Resources featured: 31
📝 Blog posts, cases, and journal-club resources: 18
🎙️ Podcast episodes: 9
📄 One-page educational resources: 4

⭐ Featured Read: PERC-Peds Rule Could Change How Children Are Evaluated for Pulmonary Embolism — Academic Life in Emergency Medicine

🎧 Featured Listen: EM Quick Hits 72: Pediatric Neurocritical Care and Pediatric Wrist Fractures — Emergency Medicine Cases

🔥 Major themes: Diagnostic reasoning • Risk-stratified care • Deimplementation • Summer emergencies • High-value physical examination

⭐ Featured Read

PERC-Peds Rule Could Change How Children Are Evaluated for Pulmonary Embolism

📝 Academic Life in Emergency Medicine
Published: July 21

A practical review of the PECARN BEEPER study evaluating PERC-Peds in children with a clinician-estimated probability of pulmonary embolism below 15%. The post explains the rule’s high sensitivity, its potential to reduce CT use, and the limitations clinicians should understand before routine implementation.

🎧 Featured Listen

EM Quick Hits 72: Pediatric Neurocritical Care, Pulmonary Hypertension, Pediatric Wrist Fracture, and More

🎙️ Emergency Medicine Cases
Published: July 21

The pediatric portions of this wide-ranging episode include a case-based approach to the rapidly deteriorating child with an intracranial hemorrhage and a review of the CRAFFT trial examining cast-first management for selected displaced distal radius fractures. Both segments are concise, clinically focused, and immediately relevant to emergency practice.

Jump to a topic

Infectious Disease

Respiratory, Allergy & Immunology

Summer Emergencies & Dermatology

Neurology, Concussion & Mental Health

Neonatology & Congenital Conditions

Orthopedics & Musculoskeletal Medicine

Gastroenterology & Abdominal Complaints

Diagnostic Reasoning & Clinical Examination

Education, Communication & Literature Discovery

🦠 Infectious Diseases

Cyclospora: Persistent Summer Diarrhea That’s Easy to Miss

📝 PEM Blog
Published: July 10

A timely guide to recognizing cyclosporiasis in children with persistent or relapsing watery diarrhea. It reviews exposure history, the limitations of routine stool testing, and treatment with trimethoprim-sulfamethoxazole.

Cyclospora

🎙️ PEM Currents
Published: July 20

This companion episode translates the recent Cyclospora outbreak into a practical ED approach. It is particularly useful for understanding when targeted testing is needed and why not every gastrointestinal multiplex panel reliably identifies the organism.

Group A Strep

🎙️ Core EM
Published: July 14

A focused review of group A streptococcal disease, from uncomplicated pharyngitis to invasive infection and toxic shock. The episode addresses pediatric testing strategies, antibiotic selection, and why adult-derived clinical scores should not be used as stand-alone pediatric decision rules.

Neonatal Group B Streptococcal Infection

📄 PedsCases
Published: July 10

A one-page overview of early- and late-onset neonatal GBS disease, including presentation, risk factors, evaluation, prevention, and treatment. This is a quick learner-friendly refresher for anyone caring for neonates and young infants.

Common Pediatric Infections

📄 PedsCases
Published: July 3

This infographic summarizes the presentation, workup, and treatment of several common childhood infections. It is broad rather than PEM-specific, but could serve as a quick reference for students and junior trainees.

The Crystalloid Debate Answered: PRoMPT BOLUS

🎙️ EM Pulse Podcast
Published: July 22

A discussion of the landmark PRoMPT BOLUS trial comparing balanced crystalloids with normal saline in children treated for suspected septic shock. The episode reviews the finding that fluid type did not meaningfully change clinical outcomes and discusses what the results mean for bedside resuscitation.

🫁 Respiratory, Allergy & Immunology

SGEM #515: Now the Azithromycin Don’t Work for Preschool Wheeze

🎙️ The Skeptics’ Guide to Emergency Medicine
Published: July 18

A critical appraisal of the AZ-SWED randomized trial, which found that azithromycin did not improve symptoms, length of stay, or revisits in preschool children with moderate-to-severe wheezing. This is one of the month’s clearest deimplementation messages.

Anaphylaxis: Do All Children Really Need 4 Hours of Observation?

📝 Don’t Forget the Bubbles
Published: July 14

This post reviews a large multicenter study of repeat epinephrine use after pediatric anaphylaxis and supports risk-stratified rather than fixed observation periods. Children with cardiovascular involvement, persistent symptoms, or repeated epinephrine still require longer monitoring.

The OxyKids Trial

📝 Don’t Forget the Bubbles
Published: July 28

A review of the OxyKids trial comparing oxygen saturation thresholds of 88% and 92% in previously healthy children hospitalized with acute respiratory distress. The lower threshold shortened time to discharge readiness without an observed safety signal, although uncommon and long-term harms remain uncertain.

PERC-Peds and Ketamine for Refractory Status Epilepticus

🎙️ Peas on a Pod
Published: July 22

Drs. Rusty Walker and Seth Ball discuss two new pediatric emergency medicine studies: the PERC-Peds rule for excluding pulmonary embolism without radiation and the use of early ketamine plus midazolam for refractory convulsive status epilepticus.

🌊 Summer Emergencies & Dermatology

Pediatric Drowning & Submersion Injuries

📝 Pediatric EM Morsels
Published: July 24

A comprehensive summer-season review of pediatric drowning terminology, pathophysiology, prehospital priorities, ED assessment, respiratory support, and disposition. It offers a practical framework for an uncommon but high-stakes presentation.

Sea Bather’s Eruption

📝 Pediatric EM Morsels
Published: July 3

A memorable review of the intensely pruritic eruption caused by marine larvae becoming trapped beneath swimwear. The post covers the characteristic distribution, relevant exposure history, symptomatic treatment, and prevention of recurrence through proper cleaning of swimwear.

🧠 Neurology, Concussion & Mental Health

Pediatric Catatonia

📝 Brown EM Blog
Published: July 19

Using an adolescent case, this review emphasizes that catatonia is a syndrome that may arise from psychiatric, neurologic, inflammatory, infectious, medication-related, or substance-associated conditions. It is an important diagnostic-safety reminder for children presenting with mutism, withdrawal, poor intake, posturing, or marked psychomotor slowing.

Persistent Post-Concussion Syndrome

📝 Don’t Forget the Bubbles
Published: July 2

This article reviews persistent symptoms after pediatric concussion, including risk factors, symptom clusters, assessment, and multidisciplinary management. It is useful for clinicians counseling families when recovery extends beyond the expected early period.

What We Still Do Not Know About Pediatric Mental Health Emergencies: The PECARN Research Agenda

📝 Academic Life in Emergency Medicine
Published: July 13

A summary of 51 consensus research priorities for pediatric mental and behavioral health emergencies. Suicide prevention, agitation management, restraint reduction, boarding, safety planning, follow-up, and equity feature prominently among the major unanswered questions.

👶 Neonatology & Congenital Conditions

Anorectal Malformations

📝 Don’t Forget the Bubbles
Published: July 21

A practical neonatal review built around a deceptively simple lesson: meconium in the diaper does not prove that the anus is normally formed. The post emphasizes fully visualizing the perineum, recognizing obstruction, looking for fistulae and associated anomalies, and involving pediatric surgery when indicated.

Brachial Plexus Injury

📄 PedsCases
Published: July 15

A concise infographic covering neonatal brachial plexus injury, including typical examination findings, prognosis, therapy, and referral. Serial assessment of motor recovery is emphasized because delayed improvement may identify infants who require specialized evaluation.

Congenital Hand Anomalies

🎙️ PedsCases
Published: July 22

This episode reviews the embryology, classification, systemic associations, examination, and surgical timing of congenital hand differences. It is particularly helpful for understanding why radial ray and thumb abnormalities should trigger consideration of broader hematologic, cardiac, renal, or vertebral disease.

Pierre Robin Sequence

📄 PedsCases
Published: July 26

A one-page review of Pierre Robin sequence, including micrognathia, glossoptosis, airway obstruction, and associated cleft palate. It provides a quick overview of recognition and initial airway, positioning, and feeding management.

🦴 Orthopedics & Musculoskeletal Medicine

From Slip on Skateboard to Slip of Femoral Head: A Case of Pediatric SCFE

📝 Brown EM Blog
Published: July 11

A case-based reminder that SCFE may initially be attributed to a minor injury and may present primarily as knee pain. This is an excellent refresher on examining the hip, obtaining bilateral imaging, restricting weight-bearing, and involving orthopedics promptly.

Question: Torticollis

📝 PEMSource
Published: July 14

This diagnostic question uses pediatric torticollis to explore age-related anatomy and the broad differential behind an abnormal head position. It offers a quick prompt to reconsider traumatic, infectious, inflammatory, dystonic, ocular, and neurologic causes rather than labeling every case muscular.

🍎 Gastroenterology & Abdominal Complaints

#187: Weight For It… New Guidelines on Faltering Weight!

🎙️ The Cribsiders
Published: July 29

A review of the new AAP guidance on faltering weight, including how to use z-scores, distinguish inadequate caloric intake from underlying disease, and decide when nutritional intervention should precede diagnostic testing. Although more general pediatrics than PEM, it is relevant to children presenting with poor weight gain, feeding concerns, or possible malnutrition.

Acute Abdominal Pain

🎙️ PedsCases
Published: July 5

A structured approach to one of the most common pediatric complaints, organized around age-based differential diagnoses, red flags, history, examination, and initial investigations. The episode is geared toward learners but provides a useful framework for avoiding missed surgical and extra-abdominal disease.

🧪 Diagnostic Reasoning & Clinical Examination

Red Urine

📝 PEMSource
Published: July 21

A short diagnostic guide beginning with the essential question: is the urine actually bloody? It walks readers through dipstick and microscopic interpretation and highlights the distinction among true hematuria, hemoglobinuria, myoglobinuria, and non-heme pigments.

Question: Oncology

📝 PEMSource
Published: July 7

A question involving an infant with ptosis and anisocoria that directs readers toward recognizing Horner syndrome and considering an underlying sympathetic-chain lesion such as neuroblastoma. It is a compact but valuable “do not miss” diagnostic exercise.

The 103rd Bubble Wrap x Wrexham Park Hospital

📝 Don’t Forget the Bubbles
Published: July 9

This journal-club roundup considers parental anxiety, pediatric lung ultrasound, testicular ultrasound, healthcare use after concussion, and prehospital analgesia. It is a good option for readers who prefer several brief critical appraisals rather than one long-form review.

📚 Education, Communication & Literature Discovery

You Don’t Always Need to Fix It: Active Listening as a Human Factors Skill

📝 Don’t Forget the Bubbles
Published: July 7

An engaging discussion of active listening as a clinical and patient-safety skill. It examines how slowing down, reflecting, clarifying, and resisting premature problem-solving can improve communication with families, patients, trainees, and colleagues.

Bubble Wrap PLUS — July 2026

📝 Don’t Forget the Bubbles
Published: July 7

A broad literature-discovery resource compiled from 34 pediatric journals. Rather than deeply appraising each paper, it provides a useful starting point for finding studies for journal club, teaching, or closer review.

Bubble Wrap PLUS — June 2026

📝 Don’t Forget the Bubbles
Published: July 2

Although the reading list covers June’s literature, the resource itself was published in July. It offers another wide-ranging scan of recent pediatric research and may be useful to readers who missed the preceding month’s journal-club roundup.

🏛️ New on HipPEMcrates

Don’t Play with Fire: Five Decisions in Pediatric ED Burn Care

A practical review of five decisions that shape pediatric burn management, from initial assessment and wound care to fluids, consultation, and disposition.

The 3: Cyclosporiasis Is Making Headlines – What Do I Need to Know?

A practical guide to the growing outbreak, including who to test, which diagnostic studies to request, and how to treat confirmed infection.

The 3: Pediatric Button Battery Ingestions

A high-yield review of the children at greatest risk, the injuries coin cells can cause, and the time-sensitive actions that should begin before removal.

The Reassuring Case of the Blown Pupil

An interesting explanation for a patient with acute unilateral mydriasis – a “blown pupil.”

❤️ 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.