Author: Brandon Ho

Case by Kala Frye Bourque MD, CNH PEM Fellow A 6-year-old male presents to the ED with pain and swelling to the left neck that started this morning. His symptoms began with pain in the left gums the prior evening, with swelling noted after awakening. He denies fevers, chest pain, shortness of breath, or drooling. […]

This week’s case focuses on a child with decreased neck movement. The initial presentation of decreased neck movement in a 12-month-old male prompted consideration of torticollis, atlantoaxial rotary subluxation (AARS), and deep neck space infections. The distinction between subluxation, which typically presents with a fixed neck position rather than pain-limited range of motion, is helpful […]

Case by Kammeron Brissett MD, CNH PEM Fellow 12 month old male presents with 3 days of left-sided neck stiffness and increased fussiness.  Neck stiffness was first noticed after waking up from a nap 3 days ago. Mom states he appears to be reluctant to turn his neck to the left. He continues to maintain oral […]

This case highlights the complexity of managing a pediatric patient presenting with hypertensive emergency. Hypertensive emergency is characterized by stage II hypertension with signs of end-organ damage. In this case, the patient presented with signs of CNS dysfunction (seizure and altered mental status). Most learners were also concerned for some other intracranial pathology (ie abscess, […]

This week’s case focuses on a 5-year-old who presents with eye pain. The crux of the discussion centers on strategies to examine an eye in an uncooperative patient. Pediatric cooperation is a key barrier to detailed exams. Strategies such as distraction, anxiolytics, and, if needed, procedural sedation can be employed. Before considering procedural sedation, topical […]