Episode 19 Part 1: Pediatric Abdominal Pain and Appendicitis

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 8 December 2011

⏱️ 81 minutes

🔗️ Recording | iTunes | RSS

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Summary

In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis, "the mother of pediatric emergency medicine" & Dr. Stephen Freedman, one of the world's pre-eminent pediatric EM researchers, discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows.

Transcript

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0:00.0	Welcome to Emergency Medicine Cases.com.
0:04.6	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC Studios in Toronto.
0:14.1	On this episode number 19 on pediatric abdominal pain, we have with us Dr. Anna Jarvis and Dr. Stephen Friedman.
0:20.4	Dr. Jarvis was an emergency
0:21.5	physician at the Hospital for Sick Children in Toronto from 1997 to 2010. She's a full
0:26.3	professor at the University of Toronto and the Associate Dean of the Office of Health
0:29.8	Professions Student Affairs. She also created, implemented, and supervised the Department of
0:34.1	Pediatrics Clinical Fellowship Program in Pediatric Emergency Medicine for 13 years.
0:38.8	Dr. Stephen Friedman is an emergency physician at the Hospital for Sick Children in Toronto and an assistant professor at the University of Toronto.
0:45.2	He completed his pediatric emergency medicine fellowship in Children's Memorial Hospital in Chicago and a Master of Science and Clinical Investigation in Northwestern University.
0:53.5	He's a clinician investigator in the Division of Emergency Medicine at UFT and
0:56.9	an associate scientist and child health evaluative sciences.
1:01.0	With the gastro season upon us here in Canada, you'll be seeing oodles of kids with GI
1:05.6	symptoms, and so we need to develop our eagle eye perspective for picking out those kids with
1:10.5	belly pain,
1:11.0	vomiting, and or diarrhea who have an alternate, more serious diagnosis such as a surgically
1:16.0	correctable lesion.
1:18.0	Searching for a surgically correctable lesion in kids who present to the ED with abdominal
1:21.7	pain is like searching for a needle in a haystack.
1:24.9	Only 1 to 2% of kids who present with abdominal pain have a surgical diagnosis,
1:29.5	yet these conditions are the ones that if not picked up and managed appropriately in the ED
1:33.5	can lead to significant morbidity and mortality. Children with so-called classic gastroenteritis
	...

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