PEM Currents: The Pediatric Emergency Medicine Podcast

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, Brad Sobolewski discusses advanced imaging in pediatric emergency care with Dr. Jennifer Marin (jennifer.marin@chp.edu) from UPMC Children's Hospital of Pittsburgh. They explore the evidence behind ultrasound, CT, and MRI, strategies to reduce low-value imaging, and the role of shared decision-making in selecting the appropriate diagnostic […]

In this episode, we tackle the clinical mischief of Parvovirus B19, a common viral infection with a surprisingly wide range of manifestations—from the classic “slapped cheek” rash of erythema infectiosum to aplastic crises in children with hemolytic anemias and fetal hydrops in pregnant contacts. We'll break down the virology, epidemiology, clinical presentation, and complications of Parvovirus […]

This episode of PEM Currents: The Pediatric Emergency Medicine Podcast focuses on the approach to unvaccinated or undervaccinated children aged 3–36 months presenting to the ED with fever. Host Brad Sobolewski reviews differences in immune response, risk for serious and invasive bacterial infections, and outlines evaluation strategies including labs, imaging, and empiric antibiotics. He highlights data showing […]

In this episode we dive into the resurgence of Mycoplasma pneumoniae—an atypical bacterial cause of community-acquired pneumonia that's making waves in pediatric emergency medicine. We'll cover its clinical presentation, epidemiology, diagnostic approach, and management, including why standard beta-lactam antibiotics won't work. Plus, we'll discuss whether M. pneumoniae even needs to be treated in the first place! Learning Objectives […]

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, we explore the complex and often underrecognized issue of inhalant misuse. From the early days of glue sniffing to the recent rise of nitrous oxide misuse, fueled by brands like Galaxy Gas and viral trends on TikTok and Instagram, inhalant misuse has evolved into a […]

In lieu of a traditional episode this holiday season I wanted to share a reading of the Pediatric Emergency Medicine version of a famous Christmas poem. Transcript ‘Twas the night before Christmas, and I'm working a shift,The symptoms were varied, the pace was quite swift.The screens glowed with orders, the rooms filled with care,In hopes […]

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, we explore pertussis, also known as whooping cough – a disease that remains a public health challenge despite widespread vaccination efforts. We will review the clinical presentation, diagnostic strategies, management protocols, infection control practices, and vaccination updates. This episode also covers what healthcare providers need […]

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, I explore the complexities of gastroesophageal reflux (GER) and gastritis in children and adolescents. I'll make the important distinction between gastritis – which is diagnosed only via endoscopy – and dyspepsia, the term best used to describe the symptoms many patients experience. I'll dive […]

This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals. While ECPR shows promise in […]

Syphilis has gone by many nicknames over the years including “The Great Pretender” and “The Great Imitator.” Emily Labudde, MD, a Pediatric Emergency Medicine fellow at Children's Healthcare of Atlanta and recent pediatric residency graduate from Cincinnati Children's discusses the various manifestations of this sexually transmitted infection, and how we can't miss this very treatable, […]

Cervical Spine Injuries are fortunately rare in children. this episode is all about learning when to suspect them, how to immobilize the C-spine properly, and which imaging test to choose. It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging […]

Febrile Seizures are among the most common neurological problema in young children, occurring in 1 out of 50 children between the ages of 6 months and 5 years of age. This episode of PEM Currents: The Pediatric Emergency Medicine Podcast is a Question and Answer style exploration of some of the most common learning points […]

This episode will help you better prepare for and manage children with inborn errors of metabolism in the Emergency Department. Consider it a supplement to what you remember from Biochemistry and the instructions on the family's laminated care plan sheet. My special guest podcaster, Emily Groopman, is an actual Pediatric Geneticist in training and we […]

Newborn infants need intramuscular injections of Vitamin K in order to produce critical clotting factors. If they don't get it they can have potentially life threatening bleeding. PEMBlog @PEMTweets on… sigh “X” (Twitter) My Instagram My Mastodon account @bradsobo References Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome […]

This episode will help you recognize cellulitis and even differentiate it from erysipelas which is totally a different thing. You'll also learn about treatment, whether or not a blood culture is necessary, and a whole lot more. PEMBlog @PEMTweets on… sigh “X” (Twitter) My Instagram My Mastodon account @bradsobo References Chen AE, Carroll KC, Diener-West […]

Laryngomalacia, is the most common cause of infant stridor. Early diagnosis is crucial as it can impact a child's growth and development. Most infants get better on their own, but those with severe symptoms need surgical interventions like supraglottoplasty. Learn all about diagnosis and management of this common problem in this brief podcast episode. PEMBlog […]

Meckel diverticulum is a congenital anomaly of the small intestine that can present with various clinical manifestations, including rectal bleeding and obstruction. Recognizing the characteristic features and understanding the differential diagnosis is crucial in managing patients with lower gastrointestinal bleeding. This episode will help you recognize and diagnose this surgical condition that you probably remember […]

Just because you can test for dozens of viruses with a single swab should you? Is this actually measuring a current infection, or a recent virus from which the child has since recovered. And what about the cost? Are these tests expensive (spoiler alert: They are!). Learn about the situations when we should get these […]

Where else is the poop going to be? Constipation is by and large a clinical diagnosis. This episode reviews how to make the diagnosis, red flags, and why X-Rays don't necessarily help assess stool burden adequately in most children. This podcast episode is designed to disseminate the important work of Choosing Wisely, an initiative of the […]

Labs or CT scans are not necessary to provide additional diagnostic information or reassurance for most children who recover completely following simple febrile seizures or unprovoked first time generalized seizures. The rate of abnormalities on these studies is very low, and the cost and downsides are too high to justify ordering them on a regular […]

For most children requiring admission to an inpatient psychiatric facility laboratory studies are generally not required. Many of the children and adolescents being admitted already have an established mental or behavioral diagnosis, and a reassuring history and exam. The heterogeneity of clinical settings makes it challenging to establish processes that account for the needs of […]

For most children with children with bronchiolitis, croup, asthma, or first-time wheezing chest X-Rays are not necessary. These X-Rays are often obtained due to the possibility of missing pneumonia. But, these radiographs are hard to interpret, increase length of stay and the cost of care, and expose children to excess radiation. This podcast episode is […]

Henoch–Schönlein Purpura (HSP) is a common vasculitis seen in younger children. The classic skin finding is palpable purpura in gravity dependent areas of the body (buttocks and legs). Children can also have arthralgias, abdominal pain and intussusception, and even nephritis. Learn about the diagnosis and management of Henoch–Schönlein Purpura (HSP) in this brief podcast episode. PEMBlog @PEMTweets […]

It is summertime, so the bees and bugs are out! In this episode, Dr. Ben Grebber, a pediatric resident at Boston Children's Hospital/Tufts Children's Hospital, discusses Bee Stings and Spider Bites. A very common pediatric summer complaint in emergency departments, urgent cares, and primary care offices, this episode covers common signs and symptoms, some pathophysiology, […]

We are in the midst of a staggering mental health crisis. Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. This podcast episode hosted by Brad Sobolewski (@PEMTweets) and co-authored by Dennis Ren (@DennisRenMD) is all about what we should consider when boarding children in the […]

There are protocols in place that assist highly trained Emergency Medical Service providers in assuring that agitated children are safely transported to their destination. This podcast episode hosted by Brad Sobolewski (@PEMTweets) and co-authored by Dennis Ren (@DennisRenMD) is all about what pre-hospital providers should do to get these agitated children safely to the ED. […]

When we think of managing agitated patients we think of medicines – but that shouldn't be our first option. However, medications can be adjuncts to non-pharmacologic means to help keep agitated children safe from harm. This podcast episode hosted by Brad Sobolewski (@PEMTweets) and co-authored by Dennis Ren (@DennisRenMD) is all about age-appropriate pharmacologic management […]

Agitated children should always be treated with dignity and respect. This entails utilizing the least invasive non-pharmacologic means of assisting them, before moving to physical or chemical restraints. This podcast episode hosted by Brad Sobolewski (@PEMTweets) and co-authored by Dennis Ren (@DennisRenMD) is all about age-appropriate non pharmacologic management strategies for agitated children. It is […]

Most children who present to Pediatric Emergency Departments these days with mental health concerns – including agitation – have a known psychiatric problem or diagnosis. Furthermore, the connection between physical and functional symptoms is inextricably linked in many patients. Why then do we persist with the “is it medical/organic or psych” question? Ultimately, this episode […]

Dr. Kit Carney and Dr. Kristen Humphrey discuss gun violence, its impact on our patients and their families, as well as practical tips on advocating for safe storage of firearms, and how we can support victims of violence.

The epiglottis is the toilet seat of the airway. That's a useful function. But what if becomes so swollen and inflamed that it leads to airway obstruction and respiratory failure. That's bad. That's also what epiglottitis is. You can also call it supraglottitis. Either way you need to recognize this potentially life threatening malady and […]

Norovirus is the leading cause of viral gastroenteritis worldwide and is also a major cause of food borne illness. It spreads rapidly and causes vomiting and diarrhea that lead to many ED visits. Hopefully this brief episode will enrich the discussions that you have with patients and their families when making the diagnosis of viral […]

“Neurodivergent” is a term used to describe brain functionality and how it differs in some people. These individuals perceive, interpret and interact with the world in ways that are different than what we typically encounter. The Emergency Department is a potentially challenging and stressful place for Neurodivergent children, and this episode discusses strategies to help […]

Commotio cordis is caused by the blunt impact of a hard object directly over the heart occurring during a specific window of ventricular repolarization leading to immediate collapse, ventricular fibrillation, and cardiac arrest. This episode focuses on risk factors and management of this rare but catastrophic injury. PEMBlog @PEMTweets on Twitter My Mastodon account @bradsobo […]

Peritonsillar Abscesses are the most common deep neck infection in adolescents and young adults. You will see them in grade schoolers as well. Learn about the diagnosis and management, including making the choice between needle aspiration versus wielding a scalpel for incision and drainage. PEMBlog @PEMTweets on Twitter My Mastodon account @bradsobo References Ungkanont K, […]

Tongue lacerations are surprisingly common in the Emergency Department. Fortunately most of them don't require any specific interventions. You just let them go and they heal on their own. Really. But if you do have to repair I offer advice in this brief episode. PEMBlog @PEMTweets on Twitter My Mastodon account @bradsobo Resource from the […]

Perioribital cellulitis (AKA Preseptal cellulitis)is a soft tissue infection of the eyelids and skin anterior to the orbit. It must be differentiated from the more invasive and dangerous orbital cellulitis. Treatment varies depending on the original source (sinusitis, local trauma, stye etc,.). Learn all about periorbital cellulitis in this brief episode of PEM Currents: The […]

Bad things happen when you don't have enough neutrophils. After getting cytotoxic chemotherapy you tend to have even fewer neutrophils. This can put you at risk for neutropenic enterocolitis which should be suspected in an immunocompromised child with fever and abdominal symptoms. Treatment is broad spectrum antibiotics and the imaging test of choice is CT […]

Dewdrops on a rose petal. You've all heard the description, right? But how many of you have actually seen chicken pox in the wild. And what about monkey pox – does it look the same? How can I tell them apart? I wish there was a brief podcast episode focused on varicella that would help […]

Hand, Foot, and Mouth (and Butt) disease is incredibly popular in the summer/warm weather months in the Northern Hemisphere (August through October). It is so popular that I guarantee you will see it many times. This brief episode will teach you how to make the diagnosis and review strategies for management – which are largely […]

Laceration repair is one of the quintessential procedures that children undergo in Emergency Departments. Minimizing pain and anxiety for children is a much better idea than just holding them down and getting it done. This episode will teach you all about local anesthetics, when to use anxiolytics and procedural sedations s well as the considerable […]

Lyme disease prevalence continues to rise – especially in places where we didn't see it before (like Ohio!). this podcast episode focuses on making the diagnosis, the different stages of disease, as well as when to prophylaxis, treat, and how testing works – all in under 15 minutes. PEMBlog.com Follow @PEMTweets on Twitter Check out […]

Toxic Shock Syndrome can be hard to recognize and differentiate from clinical entities such as Kawasaki, MIS-C, and DRESS. This brief podcast episode will raise awareness of situations in which TSS can occur and drive home important management pearls – like why you need to add Clindamycin. PEMBlog.com Follow @PEMTweets on Twitter Check out the […]

Iron ingestions always show up on standardized tests and are definitely one of those “many kids are fine but some aren't and it's hard to figure out who's fine and who isn't” ingestions. Suzan Mazor from Seattle Children's helps iron out the details… PEMBlog.com Follow me on Twitter @PEMTweets Check out the Facebook page CME […]

Now this is a frightening ingestion! Calcium channel blockers are hard to manage with refractory shock being one of my main “please don't let this come to the ED” nightmares. Suzan Mazor breaks it all down and discusses management of this challenging ingestion. PEMBlog.com Follow me on Twitter @PEMTweets Check out the Facebook page References […]

There are some scary ingestions out there and I think we'd all agree that bupropion (Wellbutrin) is on the short list of drugs that should make us worry. Learn how to recognize and manage toxicity, especially the neurogenic and cardiac effects of bupropion in the first episode of the third season of Toxicology podcasts from […]

This episode of PEM Currents: The Pediatric Emergency Medicine podcast is focused on the use of ultrasound to make the diagnosis of acute appendicitis. You'll learn about how a right lower quadrant ultrasound is performed, what we look for on the images, how to interpret positive, negative, and intermediate/equivocal results and much more! This episode […]

You will see a child with a nosebleed in the ED. It is a mathematical certainty. Chances are it has already stopped. Even if it hasn't you can stop it – and figure out why it happened – and provide reassurance and education to the patient and family. Yes, all of those things for one […]

Any list of “Top 10 Emergency Department diagnoses in children you can't miss” should include intussusception. This episode reviews the diagnosis and management in practical manner that should help you on your next shift. It also features the talents of Kriti Gupta, MD, a Pediatric Emergency Medicine fellow from NewYork Presbyterian Brooklyn Methodist Hospital who […]

This episode of PEM Currents: The Pediatric Emergency Medicine Podcast is a brief review of the management of urinary retention in children. The most common causes are UTI and constipation – but you must be aware of neurological problems and assure that you history is thorough and your physical exam complete. PEMBlog.com Follow @PEMTweets on […]

Your time is valuable and so is mine. That's why I'm sharing brief, focused podcast episodes that will hone in on a single problem. This time, it's deep venous thromboses (DVT). Learn how to suspect them in the first place and make the diagnosis. PEMBlog.com Follow @PEMTweets on Twitter Check out the Facebook page References Jaffray […]