Category Archives: Uncategorized

3rd Place EMage Winner-The Tall Tongue

Christopher Redgate, MD, MS

Kelly Kelley, MSN, RN, CPNP, CNS

Manpreet Singh, MD, MBE

Pediatric Emergency Department, Department of Emergency Medicine, Harbor-UCLA

A 13-year-old female patient presented to the emergency department (ED) for left eye pain. A clinician noted prominence in the left side of her tongue (Picture 1). Further history revealed progressive tongue swelling during the prior year along with throat fullness and “discomfort.” At that time, an Otolaryngologist (ENT) stated she had an “enlarged tongue” but subsequent follow-ups were not pursued. Since then, she developed loud snoring with no voice changes or dysphagia. read more

Use of Monoclonal Antibody to Treat COVID-19 in Children and Adolescents

John Misdary, MD

In November 2020, the US Food and Drug Administration (FDA) provided Emergency Use Authorizations (EUA) for virus-neutralizing monoclonal antibody therapies for the treatment of mild to moderate COVID-19 in high-risk groups of adolescents 12-17 years and adults. Multiple studies have shown that this treatment significantly decreased the risk of subsequent emergency department (ED) visits and hospitalizations in adult patients over 18 years. It has become a game changer in the treatment of adult patients. With the first waves of the pandemic a relatively small proportion of COVID-19 infections occurred in pediatric patients, thereby limiting the experience with monoclonal antibody therapy in patients 12-17 years of age. read more

Firearm-Related Injuries Are the #1 Cause of Death in Children and Young Adults: Guidance on Shifting From Primarily Reacting to Preventing Firearm Injuries

Kiesha Fraser Doh, MD

It is a hot summer evening, and you are called overhead for a trauma stat or Level 1, or whatever the terminology is in your institution for penetrating torso gunshot wounds, and you think not again? This is my second one tonight! When the flight team arrives, they relay the history of one child unloading their dad’s gun and shooting the patient, their sibling. You reflect on the previous trauma alert earlier this evening where parents found a teenager with a gunshot wound to his head. These scenarios are increasingly common and entirely preventable. read more

Common Tick-borne Illnesses

Amanda Bogie, MD

Rocky Mountain Spotted Fever (RMSF)

  • Caused by infection with bacterium Rickettsia rickettsii from the tick bite
  • Symptoms include the following: Fever, headache, myalgia, conjunctivitis vomiting, seizures, myocarditis, heart failure, shock, periorbital /facial edema, toxic appearing rash on the ankles and wrists (petechial then truncal), disseminated intravascular coagulation (DIC), purpura fulminans, thrombocytopenia, hyponatremia, elevated aminotransferases.
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