Hello, med students. My name is Zach Olson, and thank you for downloading this week's episode of the EM Clerkship podcast.

One of the single scariest patient presentations that you will get as a medical student or even as a resident or doctor, especially if you're in a community hospital like

mine where you see kids every day is literally anything pediatrics. Because even though kids

kind of look like little adults in a lot of ways they are, as they get smaller and smaller

the nerves just go up and up and up. And when you get that little limp baby dumped into your

lap with a distended out

stomach and blue lips and the parents are crying and there's 10 nurses trying to get a baby IV, but they

can't. And you're thinking, do I need to drop an I.O? Just blow the growth plate on a bone that's the size

of my finger. Your heart rate goes up because kids are scary and weird and small and just kind of funny

looking sometimes and you need to have your core pediatric template your core approach down

cold for when these types of situations occur and we're going to build up to that over the next

few months that sick child. But first,

we need to start with the approach to not sick appearing kids. By far, the more common

situation, the approach to a normal sick child. Or if you don't see kids in your ED to your

friend's kids. This is my personal

method and the method I would advocate that you use as well. It's simple, it's efficient,

it's easy to remember, and it still gets you all of the info that you need. So let's discuss

the core approach to the pediatric evaluation in the emergency department today.

Five extra steps that you do in addition to taking a good HPI. Those five things are the core bodily function status or the PIS status, as I call it,

PEDs history, immunization status, vitals, and then last, an alphabetical organized ABCDEF

PEDs exam. Pist status, history, immunizations, vitals, ABCD-E-F exam. Now let's go through

each of these. First, you've taken your HPI. Now, usually in adults, we start taking our pertinent positives here, fever, vomiting, difficulty breathing. You can still do that to a small extent with these little kiddos. But to be honest, kids are horrible historians if they can talk at all.

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