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Meningitis: dangerous, scary, tricky. The clinical features of meningitis are less straightforward in younger children, and some aspects of diagnosis and treatment are still up for discussion. Join us for a discussion with our local Paediatric Infectious Diseases consultant.

In this episode, we discuss the evolution of bedside clinical ultrasound use in the pediatric emergency medicine setting. Is it time for your Pediatric ED to join the UltraSound craze?

Discussing vaccine efficacy and risks often engenders strong feelings from both sides of the river... the traditional believers AND the 'anti-vaxxers'. In this episode, we try to discover whether there is a real link between rotavirus vaccines and this rare cause of abdominal pain in infants.

In this episode, we explore the clinical presentation, investigation and management of this bowel-threatening condition. The classic triad is not commonly found, so be on the lookout for intussusception, an uncommon cause of belly-pain, unwellness or altered mental state in infants.

Assessing the risk of self harm or suicide in adolescents is a daunting concept for the occassional player. Last time, we discussed the HEADSS assessment tool for communicating with adolescent patients, and this is a great place to start. In this episode we explore some of the elements of a structured mental health assessment.

The challenges of being an adolescent, and of caring for adolescents! We have a good look at the HEEADSSS assessment tool, which will help you to structure your interaction with teenage patients in an open-minded and non-judgemental way.

Treating the wrong children with fluids will cause harm... as a recent NEJM paper about fluid boluses in very sick African children showed. We thought we'd get in on the discussion, before everyone goes throwing the baby out with the bathwater. In this PEMcast we try to appraise the Maitland paper in a rational, unemotional way... and almost manage!

So, a well-looking child turns up to triage and gets given a high triage priority, simply because they have a Congenital Metabolic Disorder. Do we really have to jump to it, put in an IV cannula, and call the specialist? There are individual subtleties in managing these children with Inborn Errors of Metabolism, but a few common principles apply. This short tour of a few commoner conditions should give you a handle on this important group of patients.

Most 'flat' babies with acidosis will be septic, some might have another condition, but occasionally we will have the opportunity to diagnose and treat a congenital metabolic condition. Individually these conditions are rare, but as a group they are collectively common enough that we will encounter them in our Emergency Departments. Classifying these conditions is an ever-changing minefield, but fortunately, understanding the basic principles is not too bad... especially with a bit of expert guidance from our guest brain.

Treatment Options in Neonatal Jaundice

It takes a long time and a lot of exposure to become comfortable with jaundiced newborns. Maybe we just become less cautious or less thorough over time... Most of us feel the need to slow down and consider all the possibilities, before jumping to a benign diagnosis.

Fortunately, serious injuries to the cervical spine, whether bony, ligamentous, or spinal cord injury, are uncommon in the really young... which is lucky for us, because these youngsters are also more difficult to assess, and some clinicians feel uncomfortable trying to apply the NEXUS decision instrument in the under 3 year old age group. Join us as we explore the evidence...

No-one wants to miss a broken neck... The assessment of a potential cervical spine injury in a child is a bit different when compared to adults, due to the anatomical, physiological and behavioural differences. In this PEMcast we walk through a suggested method of assessing and managing the cervical spine in children... and discuss itchy teeth.

Septic Arthritis: scary and dangerous. Transient Synovitis: bit of a limp for a few days... So how do we risk stratify children when these conditions look the same in the first couple of days? What clinical features, and what blood tests can we use to help us - without over-investigating every minor limp? We turn to the medical literature and try to sort this out - join us on our hippy mission...

Watchful waiting or invasive investigations? A limping child may have transient synovitis, or something more serious such as septic arthritis, osteomyelitis, or Perthes Disease.