PEM Rules

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 thi...

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 DISCLAIM...

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/pemrule...

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

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  

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.

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?    

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.  

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 med...

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 P...

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 medi...

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?

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.  

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:...

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.

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?

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 Col...

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 ?

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 Ped...

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.

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 listeni...

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   D...

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.

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.

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 po...