Pediatric Urologic Emergencies

In this blog, we’re going to dive into the topic of  pediatric urologic emergencies. We’re going to focus on some of the more uncommon emergencies such as:  phimosis, paraphimosis, priapism, entrapment injuries, testicular torsion, epididymitis, varicocele, and hydrocele. It’s important to note that UTI’s and Kidney stones are also common in peds, and often require additional work-up as often indicate abnormal anatomy or disease processes.

The Limping Child

Background

Most children begin walking between 12 and 18 months. Their initial gait starts broad-based, often with short asymmetric steps. At faster speeds, they often develop foot slapping and asymmetric arm swinging. By ages 3-5 years-old, children start to walk with more fluidity and symmetric strides. By ages 5-7 years-old, their gait begins to resemble the same pattern as an adult.

Journal: PECARN Head CT Rule

PECARN Head CT Rule

Dr. Brian Yu did a great 5-minute summary on the PECARN head CT Rule that was published in 2009. It’s an ambitious study that involved 25 emergency departments and included 42,412 patients under the age of 18 years who presented with blunt head trauma. It further risk stratified these patients into 2 major cohorts of <2 years of age and 2-18 years of age. It excluded patients with trivial injury, penetrating trauma, neurologic history, and those with prior imaging. The outcomes this study aimed for were clinically important findings including death, need for neurosurgical intervention, intubation >24 hours, and admission >2 nights. 

PALS 2010

Kleinman et al, “Part 14: Pediatric Advanced Resuscitation.” Circulation. November 2, 2010. (Supplement). It’s available free online, go grab a copy and enjoy with a nice cup of coffee. Introduction Airway Monitoring and Access Drugs (part 1) Drugs (part 2) Pulseless Arrest Bradycardias Tachycardias