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AOTW: Undocumented Children

By Sabah Iqbal Given all the turmoil in the world this summer, I chose to use this AOTW to focus on undocumented children, a population that will be growing in our area. Over the weekend, I read this wonderful article in the Washington Post Magazine: it documents the harrowing and difficult journeys many small children […]

EM/HM Conference: ALTE in Infants Take Home Points

by Lenore Jarvis (EM) and Lisa Herrmann (HM), Children’s National Take Home Points: · ALTE is a description, not a diagnosis · Routine screening tests are low yield – use HPI/PE to assess risk and tailor tests o Wide range of practice for workup in the ED – frequently guided by history, physical exam and […]

AOTW: Hematoma Blocks

Title: Evaluating the Hematoma Block as an Adjunct to Procedural Sedation for Closed Reduction of Distal Forearm Fractures   Methods: Randomized control trial of lidocaine vs normal saline injections for hematoma blocks in children that were going to be sedated for forearm fractures already. 90 total patients (50 received lido, 40 NS).  Children were a […]

Hot Seat #41: 14 y.o. with hemorrhagic conjunctivitis

By Lenore Jarvis, Children’s Nationalwith Jamil Madati, Children’s National The Case: 14 yo male hx of hepatitis (thought resolved by family) who recently moved from El Salvador presenting as a referral from the PCP for hyperbilirubinemia, fever, hemorrhagic conjunctivitis, hand desquamation, and sore throat. Five days PTA, he had fevers 102-104F and a sore throat. Fever lasted 2 […]

AOTW: Cost containment in the ER and approach to altered mental status

by Dave Mathison MD MBA Children’s National In this installment of the article of the week, I challenge you to: 1) Consider cost containment in your ED care delivery while you balance patient needs. This commentary in Annals talks about the concept of PRICE TRANSPARENCY in the ED. “You have a migraine? Why don’t you […]