All posts by Jessica Wall

Summertime, and the Kids are Hungry

Author: Danielle L Cullen MD, MPH – Pediatric Emergency Medicine Fellow at Children’s Hospital of Philadelphia

One in five children in the US do not get the food that they need on a daily basis to lead a healthy, active lifestyle. How is it that in a country of wealth and excess, children’s basic needs for life are not being met?

During the academic year, 21.5 million children receive and rely on free and reduced priced school breakfast and lunch as their primary source of nutrition. While summer should be a carefree time of outdoor play, with the absence of school food programs, it is instead too often a time of hunger. Federal Summer Nutrition Programs through the USDA provide meals to children during the summer months. Unfortunately, due to lack of awareness of these programs, they are severely underutilized. Only one in seven children who receive free or reduced-price school meals also participate in summer meal programs.(1) read more

A Case for Ketofol in the Pediatric ED

Imagine it’s a warm day in June when an 18-month old male with a complicated facial laceration involving the oral mucosa from a dog bite presents to your emergency department (ED). His parents are requesting that his lacerations be repaired by a plastic surgeon.   You recognize their concern and are happy to oblige. You want to ensure the best outcome so you decide to do procedural sedation for the repair. You reach for your handy dandy procedural sedation hammer Ketamine. However, while your patient has obviously achieved a dissociative state, he seems to be periodically moving and tongue thrusting. Your consultant is not very pleased at that thought of attempting a delicate repair on a moving child. What can be done? read more

Toxicology Notes: Considerations for Cyanide Treatment in the Emergency Department

While working the overnight shift a child is brought in to your emergency department from a house fire. His burns are minor, but he was found in the house and likely had a significant smoke inhalation. The paramedics have started oxygen therapy, and as an astute emergency physician you add a blood gas with cooximetry, lactate and cyanide level to your initial orders. You are preparing to administer the CYANOKIT (hydroxocobalamin) but you pause for a moment to ask, “Should I be sending additional labs before I give this medications? Will this affect management in the next 24 hours? Are there other options?” read more

Emergency management of concussion in children: How much rest is too much?

March has arrived and the temperatures in the northeast are rising. With the warm weather come spring and summer sports seasons, and a new batch of concussions in the pediatric and young adult populations. Nearly 4 million sports-related traumatic brain injuries occur each year. The number of children seen in emergency departments for concussion has nearly tripled in the past decade. Over the past 10 years, concussion safety laws have been passed in every state, requiring that children be seen by a medical professional prior to returning to sports. As our awareness of the diagnosis of concussion increases, more and more children will continue to present to emergency departments across the country. read more