Tara's kids...doing all the same things other kids do!!! A while back now, I got an email from Weingart stating that he had received correspondence form a Canadian paramedic by the name of Tara Anema. Tara really wanted to get the word out about a particular pediatric patient population that she had seen mismanaged by all levels of emergency provid…

Buck Kyle MD...AKA pediatric cardiologist extraordinaire... is back to finish up part two of our in-depth look at pediatric syncope and the thirteen causes of sudden cardiac death. Never feel threatened by the patient with a chief complaint of DFO (done fell out) again! For the next hour we will cover the rest of the electrical, structural, and mis…

Welcome back to the show Dr. Buck Kyle! Dr. Kyle is a attending pediatric cardiologist at Texas Children’s Hospital and on this episode we will discuss what causes all those little kids to pass out before they come to your ER and then look so fantastic. Are they all OK to go home? Is there anyone in there that’s truly sick and if so how do we ident…

Canon - a general law, rule, principle, or criterion by which something is judged No one has changed the face of how we approach difficult airway more than Rich Levitan, MD. In this episode I review five of Rich's most important contributions to how we approach emergent intubations. These are techniques you can take to the department tomorrow to im…

It is hard to put into words or even imagine the concept of someone intentionally hurting a child, but it happens more frequently than we'd like to believe. In this episode, I had the privilege of discussing some of the cornerstone exam findings and history flags for occult abuse with Marci Donaruma-Kowh, MD a child abuse expert from the Baylor Col…

TOP = AUTO PEEP BOTTOM = NORMAL FLOW “Set the Vent in SIMV at 7cc/kg and an I:E ratio of 1:4/1:5 and check a blood gas!” — Andrew Sloas, DO, RDMS, FAAEM iTunes Link Wow! We've made it to the end of three episodes on asthma. We've covered everything from diagnosis to treatment and everything in between. We now know how to best educate our patients t…

What's the best oral steroid to treat acute asthma exacerbations you may ask? Well, we're here to answer that for you. Please welcome Dr. Annie Andrews, MD, MSCR who has written all the articles you will find listed below on just that subject. In this podcast we will prove that dexamethasone is not only the most cost effective steroid to prescribe …

In this episode, the first of a three part series on asthma, we will cover the diagnostic and treatment strategies that will help you rapidly move patients through your ED. No, of course you don't need the patient's asthma classification, but you DO NEED to understand which patients need more treatment and when it's OK to stop. I will break that al…

THE DERMA-Q How many times have you seen a square object inserted into a round hole.....of an ear canal??? It's quite a quandary and can be the source of frustration for both you and the patient. You may end up waiting two to three hours just to be able to sedate the little bugger because they have usually just choked down a cheese burger and fries…

Dr. Facilier begged the question..."Are you ready for Transformation Central?" Transformation? My ER runs just fine. What could I need to be ready for or transform my ER into??? Well, there's this little thing standing between you and poop in your underwear; most of us call them pediatric patients. What should scare you is that 30% of the hospitals…

Now I've got your mind palatable to the fact that young thin kids can get cholecystitis too, lets figure out how to weed those kids out from the hundreds of gastroenteritis that you're still going to see each week. On this episode we'll explore which labs and rads get you to the place you want to be.... not just a disposition, but the correct dispo…

You may think that Miley Cyrus' on-stage theatrics was the most shocking thing to happen in 2013, but au contraire mon frère. Hold on tight, because the most outrageous thing you've heard between stanzas of "Auld Lang Syn" is that kid's are getting gallbladder disease. This is especially frequent in the good ole US of A where we have mid-morning ch…

How many times have you been involved in an adult or pediatric shoulder reduction that you just can't relocate. Very frustrating, but here's your solution: Dr. Jay Park has invented a method that allows you to reduce a shoulder without sedation (RNs love that) and without any pain to your patient (Press Ganey scores will rise faster than your salar…

Red eyes usually come in pairs and so do podcasts on the subject. In part two of the red eye disorders we discuss the non-threatening maladies that can turn into eye threatening disorders if missed. Sit back and relax and let dear ole' dad tell you one more time why it's going to be OK...If you listen to him. Otherwise you may get spanked. I'm seri…

Harold Andrew Sloas Jr, DO, CAPT, USN-R is a board certified ophthalmologist (and my dad). He had a competition with his son Harold Andrew Sloas III, DO, RDMS, FAAEM to see who could get get more letters behind their name. As it turns out none of those letters have any bearing on what we'll be talking about today. You're in for a real treat because…

I have had the opportunity to work with some truly amazing people in my life and Dr. Matt Bayes, sports medicine physician extraordinaire, is no exception. Dr. Bayes is the only person I have known to successfully ask about a “code red” and somehow avoid receiving one. Dr. Bayes now resides in St. Louis, Missouri (Bayes from The Lou) and has been p…

One of the most sphincter tightening overdoses to deal with in adults and pediatrics is the CCB overdose. In this podcast I cover all the treatments that work, don't work, and you would think should work to give you a recipe for success. Hold on to your insulin; it's not just for diabetics and critically ill patients anymore. Intralipids??? How the…

Our resident cardiologist Dr. Buck Kyle completes the second part of his lecture series on pediatric ECG reading. This time we get into the most common cardiac disease processes that occur in the pediatric population. What’s black and white and read all over??? OK, yes the newspaper, but ECGs are too....don’t steal my punch lines..... ECG 1 ECG 2 E…

The Squiggly Line Rule: The more squiggly lines in the outline/border lines of a state, the cooler/more fun it is to live in that state. In, for example, the state of California, the squiggly lines are found on the coastline adjacent to the pacific ocean ~ Urban Dictionary It also happens to be true that if you are an electrocardiogramophile than t…

The finale in the Urology trilogy. In this episode Dr. Sean Stroup, CDR, USN, MC and I wrap-it-up with a series of "down-there" complaints (down-there does not imply that this episode is about Australians with grievances) with the most sensitive of subjects to any male patient, penile complaints, worries about the willie, persevering about the pee …

"Amigo, the only thing in this world that gives orders is balls. Balls. You got that?" ~ Scarface 1983 Every man is attached to their nuts. In this episode CDR Sean Stroup, MD USN and I continue to discuss non painful ballular complaints. You make think your safe with a non-painful swollen scrotum, but oh contraire mon frere, you can lose a nut tha…

"Rub your balls, squeeze your balls so you don't get cancer" ~ Tom Green Few things cause more pain for the patient and fear in the practitioner than scrotal discomfort in a child. I sat down with my good friend and pee-pee doctor CDR Sean Stroup, MD USN at the National Naval Medical Center in sunny, beautiful, oh how I miss it: San Diego, to discu…

I had the privilege to sit down with one of Canada’s finest, Dr. Amit Shah, and discuss his blinded randomized prospective study concerning one of my favorite procedural medications: Ketofol. This is the evidence based follow-up to my last (more opinion based) podcast on “Sedation and Ketofol.” The chocolate in my peanut butter....... Shah A, Mosdo…

There are a lot of ways to sedate, but I would like to provide you with a philosophy and the methodology to put together the safest possible sedation package. Please stay tuned for my next episode in which I get a chance to interview Dr. Amit Shah the lead author on the game-changing Ketofol article listed below. Shah A, Mosdossy G, McLeod S, Lehnh…

This is the second part of a two part series in pediatric airway management. Here we focus on how to use the "Airway Algorithm" that we have created and how to manage the more difficult airways we encounter in the emergency department. The "Airway Algorithm" is designed to be used in both adults and children. Mac Friendly Airway Algorithm iTunes Li…

“Airway is the reason that many go into emergency medicine…” - Jaime McCarthy MD, UT Health Sciences Center at Houston EM Director One of the many things that we do better than anyone in the business is obtain the emergent airway. Unlike our colleagues in other disciplines, we do not have the luxury of planning our airway approach on the golf cours…

Developing a good rule to clinically clear the pediatric cervical spine would be difficult. Very few kids suffer injuries to that region of the body making it nearly impossible to create a well-powered decision instrument. Like with many other attempts in pediatrics you would most likely end up with a guideline that would be fairly sensitive, but h…

If you downloaded the fist version of this (no intro music), delete it and re-downlad. The audio is much better on the second version. Practitioners have a love-hate relationship with this procedure. Whether you embrace it or react to its’ necessity in the same manner you would when finding out you've just been cut-out out of your wealthiest relati…

In this episode we complete our discussion on “Fever Without a Source” in the 2-3 month old population and also cover the 3-month plus age group. Again Dr. Andrea Cruz a subspecialist in emergency medicine and infectious disease at The Texas Children’s Hospital gives us some further insight into when and how to work these kids up. Full disclosure: …

Just in time for the winter season..... Have you seen a bunch of snot-nose kids with fever recently? Do you want to put a needle in their back? Better yet, do you not want to put a needle in their back, but feel really guilty about it? I sat down with Texas Children’s very own Dr. Andrea Cruz who is triple boarded in pediatrics, pediatric emergency…

This is my simplistic take on hypotension (ie. shock) in pediatric patients. All you need is an ultrasound, fluids and a basic understanding of the physiology. iTunes Link Undifferentiated Hypotension Slide RUSH Slide References Podcast 1 - Und Hypotension & Mod RUSHBy Andrew Sloas

Welcome to PEM ED Podcast. Pediatric Emergency Medicine; an Educational and Directional Podcast for the general emergency medicine provider. I hope you find this podcast informative and practice changing. Please click on the link below and enjoy. iTunes Link Podcast 0 - Introductions are in order...By Andrew Sloas