Welcoming the Worst: Breathing Life into your Trauma Resuscitation

Being one of the few pediatric emergency departments to care for pediatric trauma patients up to age 18, St. Louis Children's Hospital sees more than its fair share of action.  While this exposure catapulted my experience, confidence, and clinical skills, hearing the trauma pager beep during my first few months as an attending evoked a Pavlovian response only completely summarized as nail-biting,  diaphoretic anxiety.  While the butterflies still flutter away to this day when that pager goes off, I learned to "welcome the worst" into the ED by taking several fast and easy steps to anticipate Read more [...]
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Stayin alive– there is an app for that!

What is your chance survival if you were to drop dead while walking down a busy street in the US? As they say in real estate- location, location, location... Your survival depends on where you live and who is around you.  While cardiopulmonary arrest (CPA) affects individuals of all ages and health status, each minute of without high quality CPR increases the chance of death.  CPA kills half a million people each year and is the third leading cause of death in the US.  Unfortunately, in the US < 3 % of the population receives CPR training each year-- in contrast this number is Read more [...]
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MD Cents–Bringing Sexy Back

Okay so this would be a much cooler post if it were written by Justin Timberlake but it isn't.  It is written by a lowly PEM attending in flyover country.  Father's Day was 2 days ago and as is appropriate on days like this (Mother's Day and Thanksgiving also cause me to be reflective) I thought about something that my parents taught me. They instilled in me from a young age the need to be on a budget. Not the kind of kill yourself if you spend one penny over in a certain category budget, but more a know where your money is going, make sure you live beneath your means, and pay yourself first Read more [...]
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Do the Right Thing but Do No Harm: No Really, It’s Not Always Easy

It’s 11 pm and I’m running the ED patient list with my resident. She has a lot of questions. The patient in room 3 seems like he has a classic appendicitis but the ultrasound is “unable to visualize” the appendix. Should he now get a CT scan or should I insist the surgeons consider operating without it? In room 11, this young child’s forearm fracture is not too displaced and the textbooks say that it will likely heal well as is. But should we sedate her anyway to get it in perfect alignment and place it in a cast? And that patient in room 8 watching The Incredibles has a matching Read more [...]

Mythbusting Dry Drowning

      It's 10am on a Monday. You walk into the room of a 7 year old boy and his mother. His mother is very concerned that her son, who was swimming in the pool all weekend, may now be “dry drowning.” She read about dry drowning in a parenting magazine and became concerned when she noticed he was "lethargic" this morning and only wanted to lay on the couch and watch cartoons. You ask about respiratory symptoms and, now that you mention it, her son has a DRY cough.  As a matter of fact, now she is really concerned because SHE has a dry cough too -- and could Read more [...]

Hospital cited after Intern forgets to include how “cute” baby is in handoff

*warning - satire* During a recent visit by the joint commission at a major academic hospital, auditors reviewed the hospital course of an adorable 6-day old baby boy who was admitted for hyperbilirubinemia and were shocked to find that the intern caring for the baby failed to include the patient’s cuteness level in any of his handoffs. One auditor anonymously commented: “This was not solely an issue of information missing from the chart. Even on the paper to-do list exchanged during handoff, you could clearly see next to the patient sticker a little checkbox next to ‘qdaily hematocrit/neonatal Read more [...]
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Google Hangout on Air: Fellowship Directors answer your Questions about Applications

Application season for Pediatric Emergency Medicine fellowship is starting again.  This time, we have several Program Directors from across the country answering some common questions on Fellowship application process – from the Program Director’s point of view.  If you have questions you’d like to ask, give us a Comment right here!  Future Hangouts will be announced too.  Please distribute as you see fit:  https://youtu.be/QhsX55KJfSc?t=6m44s