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EM Clerkship

Pediatrics History

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5795 Ratings

🗓️ 19 November 2017

⏱️ 9 minutes

🧾️ Download transcript

Summary

Always ask about pediatric patient’s ‘P-I-S-S’ status!!! Core Function Questions (P-I-S-S Status) Peeing Evaluates for dehydration Number of wet diapers per day? Same number as usual? Intake Rule of 3s Estimates how much milk/formula an average infant should be taking 3oz of milk or formula every 3 hours Sleeping Is the patient sleeping MORE than […]

Transcript

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0:00.0

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

0:11.0

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

0:21.1

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

0:28.1

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

0:32.3

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

0:36.9

lap with a distended out

0:38.4

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

0:44.2

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

0:49.0

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

0:56.5

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

1:03.5

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

1:10.5

few months that sick child. But first,

1:14.2

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

1:21.0

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

1:27.1

friend's kids. This is my personal

1:29.1

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

1:33.6

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

1:39.2

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

1:48.9

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,

1:55.1

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

2:04.8

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

2:15.1

each of these. First, you've taken your HPI. Now, usually in adults,

...

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