Dr. Jay Fisher is back on PEM Rules to discuss his experience with Bacterial Meningitis, a rare (and terrible) condition that is high on my list of "I Never Want to Miss It".

Here are the articles Jay discussed:

References

Clinical Features Suggestive of Meningitis in Children:A Systematic Review of Prospective Data. Pediatrics 2010;126(5);952-960.

https://pubmed.ncbi.nlm.nih.gov/20974781/

Bulging fontanelle in febrile infants as a predictorof bacterial meningitis. European Journal of Pediatrics (2021) 180:1243–1248.

https://pubmed.ncbi.nlm.nih.gov/33169238/

Here is the link to the picture of the CSF of the patient discussed in the episode.

https://pemrules.com/wp-content/uploads/2024/12/csf.png

As a PEM physician I am fairly good (and confident) about intubating children and passing that ET tube beyond the vocal cords. Managing the vent, however is a whole different ballgame. That is why I asked Jared to come and teach us some basic vent setting for our children.

Many PEM physicians I meet have some rules of their own or interesting interpretations of my PEM Rules. Here are some of Carla Laos's (a PEM Physician and medical director in Las Vegas) rules she uses in her practice.

As a leader it is important to take responsibility for anything that happened "under your watch". Yes, you can check many things but do you actually need to? And what should you think about when you initiate treatment with antibiotics on an admitted patient.

With the concerning rise of antibiotic resistance I asked Dr. Fatima Levent to come back to PEM Rules and review with us the appropriate choice of antibiotics for our patients.

Pediatric Gastroenterological Chief Complaints is something we do in the Pediatric Emergency Department a considerable part of our time. That is why I invited Howard Baron to come on the show and talk about his advice for investigating and treating common GI conditions.

PEM Rules will take a short summer break for the months of July and August and will be back in September again with (hopefully) more exciting episodes. Thank you for all the support.

Please check out the PEM Rules store at

https://www.redbubble.com/shop/ap/164385928

at the Facebook page

https://www.facebook.com/PEMRules

And please keep in touch.

Like many other "adult diagnosis" Cannabinoid hyperemesis syndrome is something we see in the Pediatric ER more and more of. That is why I invited Biren to come on the show and talk to us about this condition.

What is fever? and do we always have to treat it? how much attendant should the triage level get and what can we do to learn (and teach) better?

What happens when you are a "general practitioner" but are passionate about Emergency Medicine or PEM. Listen to Dr. Allen Herman's story on practicing Emergency Medicine despite completing his training in Family Medicine.