Pediatrics
Infant Botulism
DOI: https://doi.org/10.21980/J8X35WAfter this simulation learners should be able to: 1) develop a differential diagnosis for the hypotonic infant, 2) recognize signs and symptoms of infant botulism, 3) recognize respiratory failure and secure the airway with appropriate rapid sequence intubation (RSI) medications, 4) initiate definitive treatment of infant botulism by mobilizing resources to obtain antitoxin, 5) continue supportive management and admit the patient to the pediatric intensive care unit (PICU), 6) understand the pathophysiology and epidemiology of infant botulism, 7) develop communication and leadership skills when evaluating and managing critically ill infants.
Clinical and Radiologic Features of Fulminant Pediatric Autoimmune Encephalitis: A Case Report
DOI: https://doi.org/10.21980/J8JW75The neurology service was consulted in the ED and multisequence MRI and MR angiography (MRA) of the brain were obtained without and with IV contrast. Diffusion-weighted imaging (DWI) and T2-weighted-Fluid-Attentuated Inversion Recovery (FLAIR) sequences showed multifocal small areas of diffusion signal abnormality in the brainstem and basal ganglia (red asterisks) suggestive of ischemia. Additional multifocal bilateral supra- and infratentorial foci of signal abnormality including subcortical white matter and deep grey matter were highly concerning for encephalitis or demyelinating disease. MRI was repeated on day 3 and day 7 during evolution of disease.
A Lecture to Teach an Approach and Improve Resident Comfort in Leading Resuscitation of Young Infants in the Emergency Department
DOI: https://doi.org/10.21980/J8H36JBy the end of this lecture, participants should be able to: 1) apply a consistent approach to the initial resuscitation of a critically ill young infant in the emergency department; 2) select appropriate medications and equipment for use in resuscitation of critically ill young infants; 3) describe the components of the Pediatric Assessment Triangle,6 which can be used to identify critically ill infants and children; 4) improve comfort in resuscitating young infants in the emergency department.
An Unusual Case Report of a Toddler with Metastatic Neuroblastoma Mimicking Myasthenia Gravis
DOI: https://doi.org/10.21980/J8G35VWhile still in the ED, MRI with and without gadolinium contrast of the brain, orbits, and cervical, thoracic and lumbar spine were obtained to evaluate for possible CNS lesions including encephalitis, myelitis, or demyelination. Imaging, however, demonstrated multiple unexpected findings: a T1 hypointense, T2 hyperintense and heterogeneously enhancing right adrenal mass measuring 2.7 x 2.1 x 3 cm (yellow asterisk) along with heterogenous enhancement at the clivus, C6, C7, T7, T8, T12, and L3 vertebral bodies (red asterisks). There were otherwise no significant intracranial signal or structural abnormalities and normal orbits.
Not Another Presentation of Cellulitis: A Case Report of Erythromelalgia
DOI: https://doi.org/10.21980/J8BD2KEpisodic tender, warm, erythematous swelling of the extremity experienced by this patient is typical of erythromelalgia. Erythematous streaking on the volar surface of the left forearm (red arrow) and tender, warm, erythematous blanching swelling was present on the palmar hand (yellow arrow). Most patients with erythromelalgia also have lower extremity involvement including the dorsum or sole of the foot and toes.1
Cardiac Arrest in an Adolescent with Pulmonary Embolism
DOI: https://doi.org/10.21980/J8135TABSTRACT: Audience: The target audience of this simulation is emergency medicine residents and medical students. The simulation is based on a real case of a 13-year-old female who presented with seizures and hypoxia and was ultimately diagnosed with pulmonary embolism. The case highlights diagnosis and management of an adolescent with new onset seizures, deterioration in status, and treatment options in
A Boy with Rash and Joint Pain Diagnosed with Scurvy: A Case Report
DOI: https://doi.org/10.21980/J89H1XHis lower extremity magnetic resonance imaging (MRI) findings showed abnormal signals in his knees, which were most consistent with scurvy. The white arrows on the T1-weight sequence indicate hypointensity (decreased signal or darker region) of the knees. The white arrows in the T2-weighted short-tau inversion recovery (STIR) sequence indicate hyperintensity (increased signal or brighter region) in an MRI of the knees.
Pediatric Simulation-Based Prehospital Training Course in Botswana
DOI: https://doi.org/10.21980/J8306SThe objective of this educational project was to design, implement, and evaluate a curriculum relevant to an EMS system based in a LMIC, so that it could be a basis for curricula for use in similar contexts. The educational goal is to improve prehospital providers performance in common pediatric resuscitations.
Case Report of Unusual Facial Swelling in an 8-Month-Old
DOI: https://doi.org/10.21980/J8M06FFacial ultrasound revealed local inflammatory changes such as increased echogenicity and heterogeneity in the soft tissues of the right cheek, suggestive of soft tissue edema. There was evidence of a prominent right parotid gland with increased heterogeneity suggestive of a traumatic injury. Additionally, facial ultrasound demonstrated a 6mm ill-defined anechoic collection within the right cheek without increased doppler flow (green arrow), thought to represent a focal area of edema instead of an abscess.
Case Report: Traumatic Tension Pneumothorax in a Pediatric Patient
DOI: https://doi.org/10.21980/J8ZD1SChest X-ray demonstrated significant right-sided pneumothorax (with red outline showing border of collapsed right lung) with cardio mediastinal shift to the left (shown by blue arrows) indicative of a tension pneumothorax