Start with a free account for 3 free CME credits. Already a subscriber? Sign in.

A Disposition Conundrum?!

Early Appy in Kids

Mike Weinstock, MD and Mizuho Morrison, DO
00:00
20:35
Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Tags Appendicitis · Pediatrics

Children present with appendicitis atypically and decision to workup a child should take age/presentation into consideration.

 

To view chapter written summaries, you need to subscribe.

Sign up today for full access to all episodes.

Miriam M. -

Love the section on Cannibinoid Hyperemesis syndrome, I saw a guy recently in Greymouth ED with CHARF -"cannabinoid hyperemesis acute renal failure", said he had vomited 40X+ in the previous 2-3 days. He is the first patient though that swore by a cold pack rather than hot pack, however, had classical history and resolved +++ with olanzapine. I hear that some people also use haloperidol. I had not heard of topical capsaicin cream 0.075% so will get the ED stock it in the after hours medications. Has been in a couple of times now so advice has not sunken in. I printed him out the wiki page -I also find this page to be considered reputable from the patients point of view!

Mike W., MD -

Thx for your comments - it's always funny w the temperature thing, like w low back pain; heat... ice... just not room temperature! Keep up the great work!

Amber L. -

Crud! I just missed an appy in a 3 yo female who had decreased appetite, vomiting and fever- no localized pain and negative psoas. Came back 2 days later with increased abdominal pain, per the return precautions. She had a ruptured appy so here I am soaking up all the appy info that's available, figuring out what could I have done better..

Mike W., MD -

HI Amber, classic appy is easy - my neighbor can figure it out. Which is why WE are there. I have missed an appy as I guessing have most experienced clinicians - the trick is to not start scanning and CBCing everyone as that will cause more hard than good. The most important teaching point I give is the aftercare instructions to reliable parents; return immediately w fever, increased pain, vomiting and return for a recheck in 8-12 hours if still symptomatic at all. Tough case as often at this age, the nonspecific initial symptoms are nondiagnostic

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
A Disposition Conundrum?! Full episode audio for MD edition 207:57 min - 98 MB - M4AHippo Urgent Care RAP - June 2017 Summary 283 KB - PDF