This week’s case highlighted a patient with fever and umbilical drainage who progressed into septic shock. The patient was started on ceftriaxone, vancomycin, and clindamycin for septic shock vs TSS. Started on NE in the ED for persistently widened pulse pressures. Transferred to the PICU, where she continued pressors until the next morning. Started on […]
Hot Seat #243: Rash Decisions
Case by Maria Elena Arrate MD, CNH PEM Fellow A 15-month-old female presents to the ED for fever and umbilical drainage. Seen 9 days ago for drainage from the belly button that had been ongoing for 6 weeks, and intermittent fevers. Had been on a course of a first generation cephalosporin for soft tissue infection […]
Push-Pull Fluid Bolus in Pediatrics
✅ Indications for Push-Pull Bolus: Typical Fluid Dose: Push-Pull Technique Using a 3-Way Stopcock Equipment Needed: ✅ Steps to Set Up: ✅ Pro Tips: Keep the IV site visible—stop immediately if infiltration is suspected. Use the largest-bore IV possible for effective flow rates. Limit disconnections to maintain sterility and prevent air embolism. Monitor for signs […]
Nasogastric Tube Placement Guide
✅ Preparation: ✅ Insertion Procedure: ✅ Secure the Tube: ✅ Confirm Placement (Critical Safety Step): ⚠ Safety Tips: ✅ Example: NG Tube Placement Video – OPENPediatrics
Gastrostomy Replacement Guide
Steps to Replace: *Lidocaine jelly can be used to decrease the pain of insertion but there is no literature about the safety or efficacy of its use for this purpose.* ** If a G-tube has been out for several hours, its stoma may have already started to close. If this occurs, a smaller G-tube can […]