PEM Rules

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PEM Rules is a dedicated Pediatric Emergency Medicine podcast designed to help medical students, residents, physicians or anyone who cares for children in the acute setting. Visit my website at pemrules.com *Content does not constitute medical advice. P

Yaron Ivan


    • May 26, 2025 LATEST EPISODE
    • every other week NEW EPISODES
    • 14m AVG DURATION
    • 130 EPISODES

    Ivy Insights

    The PEM Rules podcast is an incredibly valuable resource for anyone interested in emergency management in a pediatric ED. With episodes that cover a range of topics, from common red flags to watch out for with certain chief complaints to practical advice on documentation and working efficiently on a team, this podcast provides real-world insights and lessons that can be applied in various healthcare settings. The hosts' expertise and experience shine through each episode, making it feel like you're receiving one-on-one teaching from seasoned professionals.

    One of the best aspects of The PEM Rules podcast is how it goes beyond textbook information. Instead of just providing a surface-level overview, the hosts delve deep into each topic, sharing their years of practice and knowledge. This meaty content is filled with gems of wisdom that can only come from experience. Whether you're a medical student looking to gain insight into critical care questions or a seasoned healthcare professional seeking ongoing learning opportunities, this podcast offers valuable information that will help you grow.

    Another standout aspect of The PEM Rules podcast is its practicality. The hosts take the time to provide real-world scenarios and examples, allowing listeners to apply the knowledge they've gained in their own practice. This hands-on approach makes the information more relatable and easier to remember, ensuring that listeners can effectively implement what they've learned.

    While there are many positive aspects to The PEM Rules podcast, one potential drawback is the focus solely on pediatric emergency medicine. While this specialization is undoubtedly important and necessary for those working in this field, it may not appeal to individuals with broader interests or those working outside of pediatrics. It would be beneficial if the podcast occasionally explored topics that could apply to emergency medicine as a whole.

    In conclusion, The PEM Rules podcast is an invaluable resource for anyone involved in emergency management in a pediatric ED. With its wealth of practical knowledge and real-world examples, this podcast offers listeners an opportunity to learn and grow alongside experienced professionals. Whether you're just starting your medical career or have years of experience under your belt, this podcast is sure to provide valuable insights and help you navigate the complexities of pediatric critical care.



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    Latest episodes from PEM Rules

    Episode 113: The Challenge of Teaching PEM to EM Residents with Dr. Steven Nazario

    Play Episode Listen Later May 26, 2025 29:41


    Though teaching is something I love doing, sometimes teaching PEM to an ED resident is challenging (for many reasons). Dr. Steven Nazario has been a physician and an educator for many years which is why I invited him on the show to talk about the challenges of teaching PEM to EM residents.  Here is the link to the Video Stephen was referring to. The EKG Changes of hyperkalemia.  https://pemrules.com/hk/   Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode: 112: Best way to Examine a Newborn and Keeping Things Simple

    Play Episode Listen Later May 12, 2025 10:42


    Newborns are small and examining them the “right way” does not take much and is worth doing, and why it is important (and helpful) to look at Pediatric Emergency Medicine as Simple.

    Episode 111: Primary Care Practice In The ED. What To Do (or Not) and How To Reassure Those Very Worried Parents.

    Play Episode Listen Later Apr 28, 2025 29:23


    The further away I am from my general pediatric training the more I forget how to manage chronic complaints and “primary care like” presentations. That is why I brought Dr. Noah Makovsky again to help us (PEM clinicians) do a better job with those patients.  

    Episode 110: Enemas, Making Decisions and What to Do After Intubations

    Play Episode Listen Later Apr 14, 2025 9:51


    Sometimes enemas are not just for treatment only. Why is it important to keep making decision and not dwell and contemplate for too long and what is the best thing to do after intubations.

    Episode 109: PEM Hero- An Inspiring Story From a Peds Hospitalist (Who Is Also a PEM physician)

    Play Episode Listen Later Mar 31, 2025 19:44


    We all meet some people in our life that inspire us to do better. For me Dr. Ellen Fitzpatrick is one of those people. Listen to her truly amazing life story. 

    Episode 108: Clinical Care Tips – Consulting with Parents, Avoiding Some Tests and (Not) Trying To Make Everyone Happy

    Play Episode Listen Later Mar 17, 2025 13:45


    Why is it useful to sometimes “consult” with your patient's parents. What tests you should really never do and why cant we just make everyone happy

    Episode 107: My List of I Never Want to Miss It with Dr. Jay Fisher - Intussusception

    Play Episode Listen Later Mar 3, 2025 25:55


    In this new segment of PEM Rules Dr. Jay Fisher, who has been practicing PEM since 1992 is back to discuss intussusception and how can we all do a better job identifying those children among the sea of children with constipation.  

    Episode 106: Ophthalmological Emergencies and Some Other Eye Problems We See (No Pun Intended )

    Play Episode Listen Later Feb 17, 2025 30:45


    With the exception of corneal abrasions and conjunctivitis, ophthalmological presentations always make me a bit nervous. That is why I invited Dr. Mitchell Strominger to talk about some common ophthalmological emergencies.    Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 105: Clinical Care Tips - Distracting Injuries, "Funky" Neurological Complaints and More.

    Play Episode Listen Later Feb 3, 2025 11:41


    Distracting injuries can be tricky but should always be taken into account. What should you think about in a child with LLQ abdominal pain and odd Neurological complaints and more about giving yourself a break. 

    PEM Rules - Winter Break Announcement

    Play Episode Listen Later Dec 31, 2024 1:15


    Thank you all for listening and supporting PEM Rules. I will be taking a short winter break to collect more material and enjoy the cold Nevada Winter (which I love). PEM Rules will be back in four weeks with more information, more medicine, more rules and, of course more music. 

    Episode 104: What Does a Pediatric Surgeon Think About The Rule of 6?

    Play Episode Listen Later Dec 30, 2024 35:15


    I (finally) got a pediatric surgeon to come and talk on the show. Most importantly I was curious to know what he thinks about my Rule of 6. Listen to Dr. Erik Pearson and his wonderful advice. Here is the link to Erik's Website https://www.citizensurgeon.com/recourses     consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC   DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 103: Clinical Care Tips – Preparedness, Trainees and Time

    Play Episode Listen Later Dec 16, 2024 10:31


    How prepared should you be? Maybe Over-prepared? What to do with your trainees and why it wise to buy time (if you can).

    Episode 102: Adult Disease in the Pediatric Emergency Department

    Play Episode Listen Later Dec 2, 2024 32:20


    It seems to me that due to the obesity epidemic more and more children suffer from "adult problems" such as Type 2 diabetes, hypertension etc. That is why I decided to bring Seth Ball, a PEM physician who is also trained in General EM to the show to discuss the management of those children.    Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC   DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 101: Discussion with Dr Rammy Assaf Who Has Some Great Rules of His Own.

    Play Episode Listen Later Nov 18, 2024 19:44


    So apparently I am not the only one with "rules". Dr. Rammy Assaf contacted me via the PEM Rules website and wanted to share some of the rules and wisdom he has learned over the year. Thank you Rammy for coming on the show and sharing you knowledge. 

    Episode 100: Finding the Best EM Job for You. Some Rules for Optimizing Where You Land.

    Play Episode Listen Later Nov 4, 2024 34:20


    The goal of our long (and exhausting) training is to find the ultimate job. Here are some tips from Dr. Rick Saladino (my fellowship mentor and the inspiration behind PEM Rules) on the process.

    Episode 99: Clinical Care Tips – History, Expectations and Calling Consultants.

    Play Episode Listen Later Oct 21, 2024 12:11


    What is the “best way” to take history, talking about patients expectations and what you must do before calling your consultants.

    Episode 98: Pediatric Neurology In the Peds ED. Discussion with Dr. Amy Goldstein

    Play Episode Listen Later Oct 8, 2024 30:28


    Children with Neurological complaints represent a significant portion of what we see in the Peds ED. From Status Epilepticus to febrile seizures to the child who (maybe) had a seizure at home. This is a discussion I had with Dr. Amy Goldstein, a Pediatric Neurologist at CHOP.   Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 97: EBM Review with Sophia Wang, Are Steroids Necessary for Anaphylaxis?

    Play Episode Listen Later Sep 23, 2024 18:40


    There are many “unanswered” questions in Pediatric EM where the scientific literature does not have a good, definitive answer. Whether to use or not to use steroids in anaphylaxis is one of them. Sophia Wang (our PEM fellow from previous episodes) looked into it.   Here are some of the articles Sophia used in her research  Alqurashi W, Ellis AK. Do Corticosteroids Prevent Biphasic Anaphylaxis?. J Allergy Clin Immunol Pract. 2017;5(5):1194-1205. doi:10.1016/j.jaip.2017.05.022 Gaffney LK, Porter J, Gerling M, Schneider LC, Stack AM, Shah D, Michelson KA. Safely Reducing Hospitalizations for Anaphylaxis in Children Through an Evidence-Based Guideline. Pediatrics. 2022 Feb 1;149(2):e2020045831. doi: 10.1542/peds.2020-045831. PMID: 35059724; PMCID: PMC9250079. Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis--a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115(5):341-384. doi:10.1016/j.anai.2015.07.019 Michelson KA, Dribin TE, Vyles D, Neuman MI. Trends in emergency care for anaphylaxis. J Allergy Clin Immunol Pract. 2020;8(2):767-768.e2. doi:10.1016/j.jaip.2019.07.018 Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020;145(4):1082-1123. doi:10.1016/j.jaci.2020.01.017   Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 96: Clinical Care Tips- Having a Discussion and Understanding Your Patients

    Play Episode Listen Later Sep 9, 2024 11:30


    Sometimes it is good to give your patients (or parents) some options regarding their care (some people call it shared decision making). How a short conversation can help you better understand your patients and their needs.

    PEM Rules Online Store

    Play Episode Listen Later Sep 3, 2024 1:42


    After many months of work and some requests I am excited to open my online PEM Rules Store where listeners can order some fun PEM Rules merchandise. Please click the link below to check out the store and maybe purchase a T-shirt, a hat or whatever product you like.   Thank you for all the support, the downloads, comments and requests. Yaron Ivan   PEM Rules Online Store. https://www.redbubble.com/shop/ap/164385928 www.pemrules.com      

    Episode 95: Physician Wellness with Dr. Jake Snow

    Play Episode Listen Later Aug 26, 2024 23:40


    Every once in a while I meet a physician who does a great job “taking care of himself / herself”. He or she are engaged in multipule activities or hobbies and don't seem to be suffering  “burnout”. Listen to my discussion with Dr. Snow and his advice on how to achieve wellness.   

    Episode 94: Finding reasons (or not), Failing, and the Most Important Vital Sign.

    Play Episode Listen Later Aug 12, 2024 12:31


    Having a goal before you see the patient is crucial and it should not be to find a diagnosis. It is ok to fail but not so ok not to try and what about the patient's mental status? 

    New Affiliate Program with Guitar Coach Magazine

    Play Episode Listen Later Aug 1, 2024 2:20


    If you are like me you probably do most of your guitar learning online or using videos. So here is an opportunity to learn some classic guitar riffs and get a discount via this link. Check out Guitar Coach and all the resources they have and use the link below to get a discounted price for the 42 All-Time Classic Guitar Riffs program using muscle memory.  It's a great way to up your guitar playing game. bit.ly/3Wv6R72     Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.    

    Episode 93: Interview with Joshua Washington, a Physician Coach from Orlando FL

    Play Episode Listen Later Jul 29, 2024 21:45


    Like most professionals, physicians and clinicians can always use a good advice. Especially on approach to the challenging patient when you seem to be doing everything right but nothing seems to work. That is why I invited Josh to the show. Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.

    Episode 92: Statistics Comfort and Being Curious

    Play Episode Listen Later Jul 15, 2024 12:27


    Why knowing statistics is important for us EM providers, what is the “best” way to treat the patient and being curious. Here are the studies I speak of in the episode https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359077/ https://pubmed.ncbi.nlm.nih.gov/20627219/ Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. 

    PEM Rules Survey - How to Get Hired in PEM

    Play Episode Listen Later Jul 8, 2024 3:35


    On episode 100 coming this November, Dr. Saladino will be discussing his advice on how to maximize your chances of finding the best job in PEM, EM or just in medicine. Please take a minute to fill up this survey so Dr. Saladino and I can have a beneficial discussion for the listeners.  https://www.surveymonkey.com/r/8WP7DQB     Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com  Copyright PEM Rules LLC   DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 91: The Tik-Tok Challenges

    Play Episode Listen Later Jul 1, 2024 22:31


    None accidental ingestions and overdoses are common scenarios in the Pediatric Emergency Department. Now (unfortunately) driven by some social media posts. Knowing how to recognize and manage these patients is critical. That is why I invited Dr. Daria Falkowitz to discuss some of these common Tik-Tok Challenges

    Facebook page updated.

    Play Episode Listen Later Jun 22, 2024 1:25


    Please check out PEM Rules on Facebook and become a follower. I finally found the time to put some educational material for you to learn from. https://www.facebook.com/PEMRules  

    Episode 90: Approach to The Child With (possible) Toxic Ingestion

    Play Episode Listen Later Jun 17, 2024 25:48


    Toxic ingestions are always on my differential diagnosis of any child with acute onset "odd symptoms". That is why I invited Dr. Brian Schultz to discuss this important (and often challenging) topic.

    Episode 89: Clinical Care Tips – Normal Exam, Worst Case Scenarios and Taking Risks

    Play Episode Listen Later Jun 3, 2024 13:05


    Sometimes (it is not often), a normal physical exam is actually more concerning, why it is a good idea to be pessimistic? and how to be comfortable with risks?    

    Episode 88: What Are PEM Facility Directors Look for In Their Teams Members They Hire and What Are Their Challenges

    Play Episode Listen Later May 20, 2024 17:16


    What do our “future bosses” look for in their candidate and how can we become a more competitive applicants for our next job?. I discuss that and other important questions with Dr. Todd Zimmerman a PEM attending in Las Vegas.  

    Episode 87: Clinical Care Tips - Testing, Asking the Right Questions and What Not To Do

    Play Episode Listen Later May 6, 2024 11:55


    Sometimes there are "odd reasons" for using a test, Getting a good history is key and some questions are more important than others and a bit about knowing what not to do.        Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC       DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 86: Emergencies in the Primary Care Office. What to Do and When to Send?

    Play Episode Listen Later Apr 22, 2024 32:11


    Just like I lost many of my “primary care” skills many primary care pediatrician feel uncomfortable treating emergencies or urgencies in their office. That is why I had a discussion with Dr. Noah (from a previous PEM Rules episode) about what to do when these situations arise.     Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC       DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.    

    Episode 85: Clinical care Tips – Intermittent Conditions, being a Trainee and Starting with The Basics

    Play Episode Listen Later Apr 8, 2024 9:13


    What do you do when the patient in front of you has no symptoms (at the moment). Why you should enjoy being in training and what all of us PEM clinicians should know very well.    Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC     DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 84: Interesting Case In the Peds ER. By Codey Pedersen

    Play Episode Listen Later Mar 25, 2024 14:54


    What do you do when a teenager with odd (and concerning) neurological symptoms walks into you ER and how do you apply the PEM Rules to work him up step by step?

    Episode 83: Clinical Care Tips – Your Limited Exam, the Patient's Trust and Your Compassion

    Play Episode Listen Later Mar 11, 2024 11:03


    Often times I see none verbal patients (be it newborns or children who are neurologically devastated) who come in by EMS or perhaps their parents / caregiver. In those situations, I find it important to be more conservative. How do I gain the parent's trust? Simple gain the child's first.  

    Off Schedule Episode: (Another) Case of Pediatric Acute Pneumonia

    Play Episode Listen Later Mar 4, 2024 16:04


    Hours after last weeks episode was published I heard from Dr. Jay Fisher about a very similar (and unfortunate) case one of his APP's had in their ED. I decide to bring Jay to the show (again) to discuss the case so we can all learn from this experience.  Below is the link to the patient's Chest X rays. https://pemrules.com/pneumonia-patient/     Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.    

    Episode 82: The “Fever for Over 5 days Patient”. What to Do, What to Think About and How to Make Sure You Are Not Missing Anything”?

    Play Episode Listen Later Feb 26, 2024 19:03


    What is the appropriate differential diagnosis for a well appearing child with fever for over 5 days and what is the best way to work these patients up? I discuss this important Issue with my Former colleague Dr. Fatma Levent, a pediatric Infectious Disease Attending.

    Episode 81: Clinical Care Tips – Addressing “Issues”, Pin-Pointing The Syndromes and Adjusting Your Care

    Play Episode Listen Later Feb 12, 2024 14:24


    There is a certain way to address the chief complaint in the ED and it is often advantageous to do it this way. Why is it important to know what syndrome the child has? and how can we all give better care to our patients?

    Episode 80: How to Handle Neurosurgical Emergencies in the Peds ER? Interview with a Pediatric Neurosurgeon Dr. Todd Hankinson

    Play Episode Listen Later Jan 29, 2024 23:15


    As a PEM Physician, I get to take care of children with neurosurgical problems fairly often. Sometimes it is children with known issues such as hydrocephalus with a shunt and sometimes it is a patient with traumatic injury.  Pediatric neurosergeons are often life savers in those situations. Here is a conversation I had with Dr. Todd Hankinson, a Pediatric Neurosurgeon at Children's Hospital of Colorado.    

    Episode 79: Clinical Care Tips - What to Do with Your Team, What To Look For and How To Learn From Each of Your Patients.

    Play Episode Listen Later Jan 15, 2024 10:43


    As a good leader there are certain ways you can work with your team to let them excel. How do we work up our patients “appropriately”? and what can we learn from our patients?

    Episode 78: Interview with Jason Zamkoff, a Pediatric Hospitalist In Denver CO.

    Play Episode Listen Later Jan 1, 2024 19:54


    Probably the Pediatric Sub-specialists I interact with the most are the pediatric hospitalists. Not only they accept my admissions but often give advice about the work up that the patient needs and serve as an extension of the Pediatric Emergency Department. That is why I invited Jason Zamkoff, a Pediatric Hospitalist from Denver CO to talk about the relationship between PEM Clinicians and the Peds Hospitalists.    Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC       DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.    

    Episode 77: Clinical Care Tips – Consultants, Boxes and Antibiotics

    Play Episode Listen Later Dec 18, 2023 12:21


    It is important to communicate to your consultants and hospitalists the way they want to be communicated to and “speak their language”. Why is it important not to think linearly and when is it “Not OK” to use antibiotics.

    Episode 76: Dealing with Acute (and Chronic) Pain in the Pediatric Emergency Department

    Play Episode Listen Later Dec 4, 2023 29:02


    As a PEM physician, treating pain is a big part of my life and sometimes it is easier said than done. This why I invited Dr. Alan Bielskay, a Pediatric Anesthesiologist (and pain expert) from Denver CO to talk about pain treatment in children.     Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.

    Episode 75: Clinical Care Tips – Making Decisions, Testing for Bacteremia and “Going with Your Gut”

    Play Episode Listen Later Nov 20, 2023 10:19


    Sometimes decisions are hard to make, nonetheless, in the ED world it is important to make a decision and sometimes sooner rather than later. Why getting a blood culture (without giving antibiotics) makes no sense to me and more about going with your gut feeling.   Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC   DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 74: Child Abuse in the Pediatric Emergency Department, How Can We Make Things Better?

    Play Episode Listen Later Nov 6, 2023 28:41


    As a PEM Physician, child abuse, sexual abuse and child neglect cases are those cases I never want to miss or overlook. That is often easier said than done. This is a discussion I had with Dr. Stephen Boos, a child abuse doctor in Western MA.

    Episode 73: Clinical Care Tips – Taking care of yourself and Making Big Deals Small ones.

    Play Episode Listen Later Oct 23, 2023 7:41


    Probably the best advice I got in my career was to take care of myself before I take care of any patients and how I address some over-medicalized issues.

    The PEM Rules Facebook Page

    Play Episode Listen Later Oct 19, 2023 1:19


    I am excited to announce the launch of the PEM Rules Facebook page. Please visit, become a follower and communicate what you like, wish to hear or just keep in touch.  Here is the link to the page https://www.facebook.com/PEMRules Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC     DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Episode 72: The Medicolegal World of PEM With Brady Pregerson

    Play Episode Listen Later Oct 9, 2023 26:52


    What medicolegal aspects of medicine should we PEM Providers be familiar with and how can we all better protect ourselves while providing excellent care for our patients?  I discuss these question and more with Dr. Brady Pregerson an expert in the field.   Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.  

    Pickaso Guitar Bow Promo Code - Coming Back Soon.

    Play Episode Listen Later Sep 29, 2023 2:16


    My apologies to all of you who tried purchasing merchandise from Pickaso Guitar Bow and use PEM Rules Promo code. It came to my attention that the promo code stop working. Please be patient, check out the following link https://www.pickasobow.com , decide what you want to buy and be on the lookout for a new method of getting a discount via PEM Rules. The Pickaso Guitar Bow is fun to have and use to enrich your musical skills.   

    Episode 71: Clinical Care Tips – When Things Don't Work, Strikes and Endorphins.

    Play Episode Listen Later Sep 25, 2023 8:02


    What should you do when things don't seem to work they you want them to, what happens when a patient visits the Peds ED 3 times (or more) in a short time interval and what endorphins can potentially be.

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