The practice of Pediatric Emergency Medicine requires us to stay up to date with a immense amount of information. This column can help us relearn many of those items that seemed to slip out of our brains.
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
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
In my 4th year of medical school, a boy drowned in the lake near my house. It was a shocking event at the time because my perception had been that drowning was a rare tragedy, more abundant and dramatized on television than in reality. However, during my training, I have learned that drowning remains a significant cause of death in children. Although mortality rates have been trending downward in recent years, CDC data from 2019 shows that drowning is still the leading cause of accidental injury death in children aged one to four and remains one of the top three leading causes of accidental injury death in children of all ages over one year. Children under the age of 14 account for one out of every five drowning deaths and there are approximately ten deaths per day due to drowning. It is important to note that these reported numbers relate to mortality rate alone and do not include morbidity from drowning such as neurological deficits or sequelae from a drowning event. The full extent of injury secondary to submersion is difficult to know as data gathering is challenging due to misinformation that persists surrounding drowning among the public, government agencies and even the medical community.read more
It would seem a poor idea to take medical advice from non-medical professionals, for example a president with no formal scientific background, in the realm of toxic and caustic ingestions. Although cola soda should be considered caustic, the true dangers lie mostly underneath the kitchen sink and bathroom. Acid and Base ingestions are reported to be in the range of 5-15 thousand cases per year. There is a bimodal distribution of age groups affected—those under 6 year of age making up a large portion and the other being greater than 21 years of age. The pediatric and adult populations generally have different motivations behind the ingestion—exploration versus self-harm—in the vast majority of cases. Given the difference in volumes ingested in accidental cases, children have lower fatality rates than teenagers or adults. The absence of singular severe symptoms (e.g., oral lesions, vomiting, drooling, dysphagia, hematemesis, dyspnea, abdominal pain) does not reliably indicate future injury or pathology but the presence of three or more symptoms is associated with a higher likelihood of significant injury.read more
As an adolescent and pediatric emergency medicine specialist with an interest in reproductive health, I was asked to write about adolescents and sexually transmitted diseases (STDs). So, I’ve put together a potpourri of important, but not as commonly discussed, issues to help improve adolescents’ and your lives, with two caveats. 1) These are NOT recommendations for sexual assault or child abuse cases. 2) There are apps and websites at the end of this article for further information. These tidbits are more for what to think about when caring for an adolescent who might be sexually active… AKA every adolescent.read more