Pediatric Mental Health

John Misdary, MD, FACEP

FCEP Pediatric EM Committee Co-Chair

Pediatric psychiatric holds have been the norm for years in the emergency department (ED) with a shortage of pediatric beds nationwide. Unfortunately, the problem has only grown worse during the pandemic. With schools closed, routines disrupted, and parents anxious over lost income or uncertain futures, children are shouldering burdens that many were unequipped to bear. With the number of hospitalized coronavirus disease 2019 (COVID-19)  patients, bed space is even scarcer for these patients.  Most states are seeing upwards of a 400% increase in pediatric psychiatric holds.  Kids’ mental health-related visits have climbed steadily since the start of the pandemic, according to a recent Centers for Disease Control and Prevention (CDC) report. This has created a crisis of its own in pediatrics. read more

Active Learning: Tips to Improve Learner Engagement

Cheryl Yang, MD

With the transition to more virtual learning over the past year, capturing learners’ attention can sometimes feel like an uphill battle. What are some tips and strategies to improve learner engagement?

 

Active learning is an instructional method that engages students in the learning process. Active learning is superior to traditional lectures as it improves knowledge retention1, facilitates deeper understanding2, and encourages self-directed learning3.

Active learning strategies range from simple techniques that require minimal preparation to complex techniques that require more extensive preparation. Most techniques can be adapted for virtual learning (Tables 1-3). read more

Financial Wellness

Amanda Bogie, MD

How many of you knew that April was “Financial Wellness Month?” I certainly did not and IN TRUTH actually prefer “Margarita Month” or something that brings less internal conflict with my mental health. However, I do believe this is the ideal time to discuss financial wellness, as the COVID pandemic has re-enforced its importance.

Financial wellness is similar to health wellness. If left to random chance and luck, the outcomes may not be as expected or desirable. In essence, the compound effect is in play here, which means reaping huge rewards from a series of small, smart choices. (Darren Hardy, The Compound Effect) read more

Lidocaine Toxicity

Jonathan Eisenberg, MD

I use topical preparations of lidocaine daily in the emergency department (ED) to temporarily anesthetize an area of skin for a procedure.  It is painless, has quick onset, works well, and has a low side effect profile.  With older children, I will inject lidocaine with similar results and only a small poke.  But a “low” side effect profile does not mean “no” side effects.  What happens when too much lidocaine is injected or a pre-procedure application at home goes awry? read more

Acute COVID-19 in Children: A Primer for PEM Physicians

Francisco Gonzalez, MD and Noah Kondamudi, MD, MBA, FAAP, FACEP

This article is intended to be a brief primer about COVID-19 illness among children with a focus on emergency department management. For readers that would like more in depth information, we refer them to these recently published review articles [1, 2, 3]

So far, over 3.4 million cases of pediatric COVID-19 cases have been reported in the U.S for a prevalence of 4525/100,000 children, out of which approximately 0.1-2.2% resulted in hospitalization and 0.04% resulted in death4. As cases of SARS CoV-2 infections continue to overwhelm hospitals and emergency departments around the country, it is important for emergency physicians to recognize signs and symptoms of this disease, cohort cases to avoid endangering staff and other patients, distinguish which individuals require testing, and ultimately manage them appropriately. read more