An Emergency Medicine Broadsheet
·Phoenix·
Est. MMXXVI
Blue Fish Med · Today's Topic
Children with Special Needs: Transplants
A child with a transplant may deteriorate from sepsis, rejection, drug toxicity, obstruction, or adrenal suppression while showing few inflammatory signs. Early consultation and protection of perfusion can preserve both life and graft.
A 9-year-old kidney-transplant recipient arrives pale and quiet, clutching a half-empty water bottle. His mother says he has vomited twice, has had fewer wet diapers today, and “just isn’t acting like himself”; the medication list is folded inside a plastic sandwich bag. His temperature is 38.7°C, heart rate 142, and the next dose of his immunosuppressant is due in 20 minutes. The question is what must happen before the medication clock runs out.
— What’s your move? Read on.
Before you read
How do you protect the graft while resuscitating the child?
Which medications and infections require special attention in an immunosuppressed patient?
When to Think of It
Fever, hypotension, vomiting/diarrhea, oliguria, altered behavior, respiratory symptoms, abdominal pain over the graft, new edema, hypertension, or missed immunosuppressants in any transplant recipient should trigger a transplant-emergency pathway. Assume serious infection until proven otherwise; immunosuppression may blunt fever and leukocytosis.
Sick or Not Sick
The pivotal call is shock, threatened airway, altered mental status, or rapidly declining graft function versus physiologic stability. Shock or organ dysfunction mandates resuscitation and ICU-level consultation while diagnostic workup proceeds.
The First Fifteen Minutes
ABCs, cardiac monitoring, two IVs or IO access, bedside glucose, temperature, urine output, and immediate contact with the transplant center. Obtain CBC, CMP, magnesium, phosphorus, lactate, blood cultures, urinalysis/culture, drug levels when relevant, and viral testing without delaying treatment.
Hypoglycemia: dextrose 10% 5 mL/kg IV (0.5 g/kg; maximum commonly 250 mL), because glucose rapidly reverses neuroglycopenia. Recheck in 10–15 minutes; dosing varies by age and institutional protocol.
Suspected septic shock with poor perfusion: balanced crystalloid 10–20 mL/kg IV bolus, reassessing after each bolus, because it restores preload; use smaller aliquots if cardiac or renal dysfunction is present.
Persistent shock after fluid or concern for myocardial dysfunction: epinephrine infusion 0.05–0.3 mcg/kg/min IV, titrated to perfusion, because it provides inotropy and vasoconstriction. Norepinephrine 0.05–0.3 mcg/kg/min IV is reasonable when vasodilatory shock predominates; check institutional pediatric infusion guidance.
Suspected bacterial sepsis: ceftriaxone 75–100 mg/kg IV/IO once, maximum 2 g, plus vancomycin 15 mg/kg IV, because broad early coverage is essential; tailor to local resistance, renal function, allergies, and transplant-center guidance. If hospital-acquired infection, neutropenia, or severe immunosuppression is present, cefepime 50 mg/kg IV, maximum 2 g, or piperacillin-tazobactam 100 mg/kg of the piperacillin component IV, maximum 4.5 g, may be preferred.
Chronic steroid user with shock: hydrocortisone 2 mg/kg IV, maximum 100 mg, because stress-dose steroid restores catecholamine responsiveness; confirm the home regimen and involve the transplant team.
Do not independently stop, double, or substitute tacrolimus, cyclosporine, sirolimus, mycophenolate, or prednisone; obtain urgent transplant advice. Vomiting, diarrhea, AKI, and interacting drugs can make tacrolimus levels toxic.
Definitive Care & Disposition
Admit any ill or potentially infected transplant child, generally to a monitored bed or PICU if shock, respiratory failure, altered mental status, severe electrolyte abnormality, or rising creatinine is present. Ultrasound with Doppler evaluates graft perfusion, hydronephrosis, collections, and vascular complications; biopsy is usually specialist-directed for suspected rejection. Treat identified infection, obstruction, thrombosis, rejection, or drug toxicity with the transplant service. Avoid NSAIDs, nephrotoxins, and iodinated contrast unless the diagnostic benefit clearly outweighs risk.
How This One Kills
The lethal error is labeling oliguria, vomiting, or lethargy as a medication side effect and delaying sepsis treatment or graft imaging. Immunosuppression can make a child appear deceptively well until shock or graft loss is advanced.
The Differential — What Else Looks Like This
Acute rejection — rising creatinine, hypertension, graft tenderness, or reduced urine without a clear infectious source; confusing it with dehydration delays specialist therapy.
Calcineurin-inhibitor toxicity — tremor, hypertension, AKI, hyperkalemia, or neurologic symptoms with an elevated level; escalating immunosuppression worsens toxicity.
Graft obstruction or vascular compromise — abrupt oliguria/anuria and abnormal Doppler findings; delay can cause irreversible graft loss.
Ordinary viral gastroenteritis — may cause vomiting and poor intake but can produce dangerous tacrolimus level changes and dehydration in this population.
The Second-Day Story
An immunosuppressed child may have no fever, leukocytosis, or focal tenderness. A caregiver may report only fatigue, reduced interaction, poor intake, new hypertension, or fewer wet diapers. The reliable signals are trend changes—weight, creatinine, urine output, blood pressure, medication tolerance, and drug exposure—so compare with baseline and involve the transplant team early.
Back to Our Patient
Back to the 9-year-old kidney-transplant recipient: his fever, tachycardia, vomiting, and reduced urine output represent a high-risk presentation, so the team recognizes possible sepsis with threatened graft function rather than simple gastroenteritis. He is placed on monitors, receives IV access, cultures and labs, cautious balanced-crystalloid boluses with reassessment, and prompt broad-spectrum antibiotics; because perfusion remains poor, a vasoactive infusion and stress-dose hydrocortisone are considered while the transplant service is contacted. Doppler ultrasound shows preserved flow without obstruction, and cultures later grow urinary E. coli. He is admitted to the PICU, with immunosuppressant dosing adjusted by the transplant team and graft function monitored closely.
Patient Presentation to Attending
How you’d present this patient on the floor — tight, pertinent positives and negatives, no rambling
“This is a 9-year-old kidney-transplant recipient with fever, two episodes of vomiting, decreased urine output, and acute lethargy since this morning. He is febrile to 38.7°C, tachycardic at 142, pale, and has delayed capillary refill, without respiratory distress or focal peritoneal signs. His glucose is normal, but lactate is elevated and creatinine is above his baseline; cultures are pending. I’m concerned for sepsis with early graft dysfunction, while rejection, tacrolimus toxicity, and obstruction remain in the differential. I’ve obtained access and cultures, started cautious weight-based crystalloid with reassessment, given empiric broad-spectrum antibiotics, and called the transplant service; he needs PICU monitoring, vasoactive support if perfusion does not improve, and urgent graft Doppler imaging.”
Study Directive
Draw a transplant-emergency algorithm from memory: shock, infection, rejection, toxicity, obstruction, and vascular compromise.
Memorize empiric sepsis doses for ceftriaxone, vancomycin, cefepime, and hydrocortisone.
Review one institutional pediatric transplant guideline and identify its transplant-center contact process.
Practice calculating maintenance immunosuppressant timing, weight-based fluid boluses, and vasoactive infusion rates for a 20-kg child.
Complete three cases involving oliguria after transplant and state the next test, medication hazard, and disposition for each.
More in Today's Issue
5 additional topics
2 of 6
Diphtheria
Respiratory diphtheria can create a mechanically obstructing pseudomembrane and release toxin that causes myocarditis and neuropathy. Antitoxin is...
Also known asmembranous pharyngitis · croup · Corynebacterium diphtheriae
A 7-year-old boy sits upright on his mother’s lap, breathing through an open mouth as a gray-white sheet clings to his tonsil. His voice has become thick over two days, and a sweet, foul odor follows each breath. His neck is visibly fuller, and when the triage nurse reaches toward his throat, he pulls away. The airway decision has not yet been made.
Before You Read
When should you stop examining the throat and secure the airway?
What must be given before laboratory confirmation?
Which complications require monitoring after the membrane is gone?
Why It Matters
Respiratory diphtheria can create a mechanically obstructing pseudomembrane and release toxin that causes myocarditis and neuropathy. Antitoxin is time-sensitive and should not wait for culture or PCR.
When to Think of It
Gradual sore throat, low-grade fever, malaise, dysphonia, cervical adenopathy, and an adherent gray pharyngeal membrane—especially in an incompletely immunized child or after travel/exposure. The membrane bleeds when forcibly removed; do not scrape it.
Sick or Not Sick
The key call is impending airway compromise or systemic toxicity. Stridor, retractions, drooling, hypoxia, rapidly progressive neck swelling, altered mental status, or exhaustion requires early controlled airway planning with anesthesia/ENT and transfer to a PICU-capable setting.
The First Fifteen Minutes
Place the child in a calm, upright position; minimize agitation and avoid repeated throat instrumentation. Give humidified oxygen if tolerated, because agitation can convert partial obstruction to complete obstruction.
If hypoxemic or tiring: high-flow oxygen by the best-tolerated interface, while preparing expert airway management; do not force a mask onto a distressed child.
If severe airway edema is contributing and the child is stable enough to tolerate therapy: dexamethasone 0.6 mg/kg IV/IM, maximum 16 mg, because it reduces inflammatory airway swelling; it does not neutralize diphtheria toxin or replace airway control.
Once suspected, obtain nasopharyngeal and throat swabs from the edge/beneath the membrane if safe, but do not delay antitoxin. Contact public health and infectious disease immediately. Diphtheria antitoxin dosing is exposure/severity-based and product-specific; obtain it urgently through public health and verify dosing with the product protocol or infectious-disease consultant.
Give antibiotic eradication therapy after cultures: erythromycin 40–50 mg/kg/day PO or IV divided q6h, maximum 2 g/day, because it stops bacterial toxin production and transmission; penicillin G 50,000 units/kg/day IV divided q4–6h, maximum 4 million units/day, is an alternative. Verify local guidance and allergy management.
If anaphylaxis occurs after antitoxin: epinephrine 0.01 mg/kg IM of 1 mg/mL solution, maximum 0.5 mg, because rapid alpha/beta agonism reverses airway edema and shock; repeat every 5–15 minutes as needed.
Definitive Care & Disposition
Secure the airway early with the most experienced team; surgical airway backup should be present because distorted anatomy and a friable membrane make repeated attempts hazardous. Admit to PICU with continuous cardiac monitoring, serial ECG/troponin assessment, and neurologic examination. Maintain droplet and contact precautions, identify and prophylax close contacts, and document clearance cultures after therapy according to public health guidance. Immunize during recovery if not fully vaccinated; disease does not reliably confer immunity.
How This One Kills
The classic failure is repeatedly swabbing or scraping the membrane until edema, bleeding, and agitation produce a suddenly impossible airway. The second major miss is waiting for a positive culture before antitoxin.
The Atypical Presentation
Vaccinated or partially treated patients may have only sore throat, hoarseness, fatigue, or a small nasal membrane. Fever can be modest, and the throat may not look dramatic before toxin injury appears. Ask about vaccination, travel, household illness, and adherence; inspect the neck and voice, and treat a credible clinical syndrome before tests return.
Back to Our Patient
Back to the 7-year-old with the gray membrane and enlarging neck: the adherent bleeding pseudomembrane, muffled voice, and cervical swelling make suspected respiratory diphtheria the working diagnosis. He is kept calm and upright, receives oxygen as tolerated, and ENT/anesthesia prepare a controlled airway with surgical backup; the team obtains safe swabs but does not scrape the membrane. Public health supplies diphtheria antitoxin, and IV erythromycin is started immediately. He is admitted to the PICU for airway and cardiac monitoring, with contact tracing, prophylaxis, and vaccination planning initiated.
Patient Presentation to Attending
“This is a 7-year-old incompletely immunized boy with two days of sore throat and progressive muffled voice, now with a firmly adherent gray pharyngeal membrane and cervical swelling. He has low-grade fever and no rash, but is increasingly anxious with mild inspiratory noise and has not tolerated throat examination. I have not attempted to remove the membrane because it bleeds and could worsen obstruction. I’m concerned for respiratory diphtheria with impending airway compromise and toxin-mediated myocarditis risk. I’m keeping him upright and calm, involving ENT, anesthesia, infectious disease, and public health, obtaining safe cultures without delaying antitoxin, and starting IV erythromycin with PICU admission.”
Study Directive
Memorize the “membrane + neck swelling + low fever” recognition pattern and the no-scraping rule.
Review your local public-health pathway for obtaining diphtheria antitoxin and managing contacts.
Practice an airway plan aloud, including when to call ENT/anesthesia and why repeated laryngoscopy is dangerous.
Draw a timeline of diphtheria complications: local disease, myocarditis, and neuropathy.
Complete two cases: one stable membrane case and one impending-airway case, stating treatment before test results.
Key Medications
Diphtheria antitoxin: dose varies by site, duration, and severity; obtain through public health and verify product-specific protocol/ID guidance.
Erythromycin: 40–50 mg/kg/day PO/IV divided q6h; max 2 g/day.
Penicillin G: 50,000 units/kg/day IV divided q4–6h; max 4 million units/day.
Dexamethasone: 0.6 mg/kg IV/IM; max 16 mg for significant upper-airway edema.
Epinephrine for anaphylaxis: 0.01 mg/kg IM of 1 mg/mL; max 0.5 mg, repeat q5–15 min.
Pediatric antibiotic dosing and antitoxin selection vary; check Lexicomp, UpToDate, or institutional/public-health protocol if uncertain.
High-Yield Pearls
A stable airway can become unstable during examination; calm positioning and early expert airway planning are treatment.
Myocarditis often appears after the local throat disease and may be detected by ECG, conduction abnormalities, or troponin elevation.
Clinical recovery does not prove immunity; vaccination and clearance testing remain necessary.
The Mimics
Streptococcal pharyngitis — exudate is usually removable and does not form a firmly adherent bleeding membrane; confusing it delays antitoxin and isolation.
Epiglottitis — drooling, tripod positioning, and abrupt toxicity predominate without a tonsillar pseudomembrane; throat manipulation can precipitate collapse.
Peritonsillar abscess — unilateral swelling, uvular deviation, and trismus are focal; treating it as diphtheria alone misses drainage.
Candidiasis — plaques scrape off more easily and occur in immunocompromised hosts; failure to recognize diphtheria risks toxin-mediated myocarditis.
Board Question
A 6-year-old with incomplete immunization has an adherent gray pharyngeal membrane and cervical adenopathy. He is hemodynamically stable and oxygenating normally. Which intervention should occur next?
AForcefully remove the membrane for culture
BWait for culture confirmation before treatment
CAdminister diphtheria antitoxin and begin antibiotic therapy
DPerform immediate needle aspiration of the tonsil
Reveal answer
Correct: C
Antitoxin neutralizes circulating toxin and is most effective when given promptly; treatment is clinical and should not await laboratory confirmation. Antibiotics eradicate the organism and reduce transmission.
A comprehensive reference for recognizing respiratory and cutaneous diphtheria and initiating immediate isolation, antitoxin, antibiotics, and contact management without awaiting confirmation.
A contemporary European outbreak highlights the need to consider diphtheria in migrant populations and rapidly coordinate diagnostic testing, isolation, treatment, and public-health response.
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Pediatric Analgesia
Undertreated pain causes fear, tachycardia, and immobility; overtreated pain can cause respiratory depression and obscure deterioration. Safe pediatric...
Also known aspain control · pediatric pain management · analgesia dosing
A 4-year-old girl lies rigid on the stretcher after falling from a playground platform, her knees pulled toward her chest. She watches every gloved hand, then cries “no” before anyone touches her abdomen. Her father says she has not vomited and can wiggle both feet, but her pain has made examination nearly impossible. The team must decide how to relieve suffering without losing the clues to serious injury.
Before You Read
Which analgesic fits this child’s physiology and suspected injury?
How do you measure pain when a child cannot provide a number?
What monitoring is required after opioid or sedative analgesia?
Why It Matters
Undertreated pain causes fear, tachycardia, and immobility; overtreated pain can cause respiratory depression and obscure deterioration. Safe pediatric analgesia is repeated assessment plus titration—not withholding medication until diagnosis is complete.
When to Think of It
Pain should be treated whenever it is reported, behaviorally evident, or limiting examination, movement, breathing, or procedures. Use developmentally appropriate tools: FLACC for young/nonverbal children, Wong-Baker Faces for many preschool and school-age children, and a numeric scale for developmentally capable older children.
Sick or Not Sick
The central call is isolated pain in a physiologically stable child versus pain with shock, respiratory compromise, altered mental status, or possible raised intracranial pressure. The latter requires simultaneous resuscitation, glucose assessment, focused trauma evaluation, and carefully titrated analgesia—not analgesic delay.
The First Fifteen Minutes
Reassess airway, breathing, circulation, neurologic status, glucose when indicated, weight, allergies, last oral intake, and prior analgesics. Use splinting, positioning, ice, distraction, and caregiver presence because nonpharmacologic measures reduce medication requirements.
Mild pain, able to take oral medication: acetaminophen 15 mg/kg PO, because central prostaglandin modulation reduces pain and fever; maximum 75 mg/kg/day or 4 g/day, whichever is lower.
Mild-to-moderate musculoskeletal pain with adequate hydration and no renal disease, GI bleeding, coagulopathy, or NSAID-sensitive asthma: ibuprofen 10 mg/kg PO, maximum 400 mg per dose, because peripheral prostaglandin inhibition treats inflammatory pain. Avoid in significant dehydration, kidney injury, or bleeding risk.
Moderate-to-severe pain or inability to tolerate oral medication: fentanyl 1 mcg/kg intranasal or IV, then 0.5 mcg/kg IV q5 minutes as needed, because rapid mu-opioid analgesia has minimal hemodynamic effect; monitor ventilation and sedation continuously.
Severe pain with IV access and need for titration: morphine 0.05–0.1 mg/kg IV slowly, reassessing every 5–10 minutes; it reduces central nociception but can cause hypotension, vomiting, and respiratory depression. Use a lower initial dose in shock, frailty, or respiratory disease.
Opioid-induced respiratory depression with inadequate breathing: naloxone 0.1 mg/kg IV/IM/IN, maximum 2 mg per dose, titrated to adequate ventilation rather than complete arousal; it reverses opioid effect but may precipitate severe pain and withdrawal.
Procedural pain requiring dissociation is a separate decision: ketamine 1–2 mg/kg IV or 4–5 mg/kg IM, with airway-capable monitoring and institutional protocol, because it provides analgesia and dissociation while usually preserving spontaneous respiration.
Definitive Care & Disposition
Treat the cause—reduction, splinting, wound repair, antiemetic therapy, imaging, or surgery—while documenting pre- and post-analgesia neurovascular findings. Reassess pain, respiratory rate, oxygenation, sedation, and blood pressure after each dose. Discharge only when the child is comfortable on a safe oral plan, caregivers understand dosing and return precautions, and serious injury has been excluded.
How This One Kills
The dangerous error is treating pain as a diagnostic obstacle and withholding analgesia until after examination, allowing fear and guarding to obscure evolving shock or abdominal injury. The medication-specific miss is giving repeated opioid doses without reassessing ventilation.
The Atypical Presentation
Children with autism, developmental delay, communication impairment, or chronic pain may express distress as withdrawal, agitation, aggression, sleepiness, or refusal to move rather than verbal pain. Ask caregivers what is abnormal for that child, observe function, and use a behavioral scale. A quiet child is not necessarily comfortable; repeated physiologic and functional reassessment is essential.
Back to Our Patient
Back to the 4-year-old after the fall: her rigid posture and inability to tolerate examination identify clinically important pain, while stable breathing, perfusion, and neurologic findings allow analgesia alongside evaluation. After weight confirmation, she receives intranasal fentanyl because access is not yet established, plus positioning and caregiver distraction; pain and guarding improve enough for a focused abdominal and extremity examination. Imaging reveals a forearm fracture without abdominal injury, which is splinted. After repeat neurovascular examination and transition to oral acetaminophen/ibuprofen, she is discharged with follow-up and return precautions.
Patient Presentation to Attending
“This is a 4-year-old girl who fell from a playground platform and has severe left arm pain with generalized guarding from distress. She is alert, breathing comfortably, has normal perfusion, no vomiting or loss of consciousness, and moves all extremities with intact distal pulses. Her pain is preventing a reliable examination. I’m treating significant traumatic pain while continuing evaluation, using weight-based intranasal fentanyl now with continuous respiratory monitoring, then reassessing for focal abdominal findings and neurovascular status. I’ll obtain targeted imaging, splint any fracture, and discharge only if pain is controlled orally and repeat examinations remain reassuring.”
Study Directive
Memorize acetaminophen, ibuprofen, fentanyl, morphine, naloxone, and ketamine doses using a 15-kg and 30-kg child.
Practice selecting FLACC, Faces, or numeric scoring for five developmental scenarios.
Perform a medication safety check: weight, concentration, maximum dose, route, prior analgesics, contraindications, and reassessment interval.
Review opioid monitoring and naloxone titration in your institutional pediatric sedation policy.
Work through three trauma cases and document pre- and post-analgesia neurovascular examinations.
Key Medications
Acetaminophen: 15 mg/kg PO/IV q4–6h; max 75 mg/kg/day or 4 g/day; reduce/avoid in significant hepatic disease.
Ibuprofen: 10 mg/kg PO q6–8h; max 400 mg/dose; avoid renal injury, dehydration, GI bleeding, and significant coagulopathy.
Fentanyl: 1 mcg/kg IN or IV, repeat IV 0.5 mcg/kg q5 min; verify concentration and institutional maximum.
Morphine: 0.05–0.1 mg/kg IV slowly, titrated; lower doses may be needed in high-risk children.
Naloxone: 0.1 mg/kg IV/IM/IN; max 2 mg, titrate to ventilation.
Ketamine: 1–2 mg/kg IV or 4–5 mg/kg IM for procedural dissociation; dosing and repeat intervals vary—check institutional protocol.
Pediatric dosing must be weight-based; confirm maximum doses in Lexicomp, UpToDate, or local protocol.
High-Yield Pearls
A successful analgesic dose improves examination reliability; it does not invalidate the examination.
Pain out of proportion or with passive stretch demands serial compartment assessments even after opioids.
In a nonverbal child, function and caregiver-observed behavior may be more informative than a numeric pain score.
The Mimics
Anxiety or behavioral distress — improves with reassurance but persistent focal pain or guarding remains; dismissing pain delays injury diagnosis.
Occult compartment syndrome — pain out of proportion or with passive stretch; opioids may reduce the signal but do not eliminate the need for serial exams.
Intracranial injury — headache/vomiting with altered behavior or focal findings; analgesia is appropriate, but sedation must not replace neurologic reassessment.
Sickle-cell vaso-occlusive pain — recurrent severe pain with a familiar pattern and no trauma; undertreatment prolongs crisis and damages trust.
Board Question
A 3-year-old with a closed forearm fracture is crying intensely but has normal perfusion and respiratory status. IV access is not yet available. Which is the most appropriate initial analgesic?
AWithhold analgesia until radiographs are completed
BIntranasal fentanyl 1 mcg/kg
COral aspirin 10 mg/kg
DIntramuscular morphine 1 mg/kg
Reveal answer
Correct: B
Intranasal fentanyl provides rapid, effective analgesia without requiring IV access and has relatively limited hemodynamic effect. Analgesia should not be delayed for imaging; aspirin is inappropriate in children, and the morphine dose is excessive.
Identifies modifiable barriers and facilitators to timely prehospital pain assessment and treatment, helping emergency systems improve pediatric analgesia protocols and handoffs.
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Pediatric Intranasal Analgesia
Intranasal analgesia can deliver rapid opioid analgesia without IV access, reducing distress and facilitating examination or splinting. It is a route, not a...
Also known asintranasal fentanyl · intranasal ketamine · IN analgesia
A 6-year-old boy with a bent wrist presses his cheek into his mother’s shoulder as the nurse approaches with an IV catheter. His skin is sweaty, his nostrils are wet with blood from the fall, and he keeps repeating that he does not want a needle. The radiology slot is open now, but the stretcher-side struggle is escalating. The team must decide whether the nose can provide the fastest safe route.
Before You Read
When is intranasal fentanyl a good first route—and when will it fail?
What dose and volume maximize absorption?
What monitoring and rescue plan must accompany it?
Why It Matters
Intranasal analgesia can deliver rapid opioid analgesia without IV access, reducing distress and facilitating examination or splinting. It is a route, not a substitute for airway assessment, monitoring, or definitive care.
When to Think of It
Use intranasal analgesia for moderate-to-severe acute pain when IV access is delayed or distressing, especially in stable children with trauma, burns, lacerations, or painful procedures. It is less reliable with active epistaxis, copious secretions, severe nasal obstruction, major midface trauma, or a child unable to cooperate.
Sick or Not Sick
The decisive call is a spontaneously breathing, hemodynamically stable child with an accessible nasal mucosa versus a child with respiratory compromise, shock, altered mental status, or major facial/nasal injury. In the latter group, prioritize airway and circulation, use an alternate route, and prepare for opioid-related respiratory depression.
The First Fifteen Minutes
Confirm weight, allergies, prior opioids, respiratory history, mental status, and nasal patency. Apply pulse oximetry and have suction, oxygen, bag-mask ventilation, and naloxone available.
Moderate-to-severe pain with usable nasal mucosa: fentanyl 1.5–2 mcg/kg intranasally, commonly divided between nostrils; because it is lipophilic, it crosses nasal mucosa rapidly into systemic circulation. Many protocols use 1 mcg/kg initially; maximum single doses and repeat intervals vary—check institutional guidance.
Reassess pain, respiratory rate, chest excursion, oxygen saturation, and sedation after 5–10 minutes. If inadequate analgesia and ventilation remains normal, repeat 0.5–1 mcg/kg intranasally according to local protocol; avoid automatic stacking.
If nasal absorption is unreliable or the child deteriorates: obtain IV/IO access and use fentanyl 0.5–1 mcg/kg IV slowly, titrated, because IV delivery is more predictable.
If opioid-induced hypoventilation occurs: open the airway, provide oxygen and assisted ventilation, and give naloxone 0.1 mg/kg IV/IM/IN, maximum 2 mg, titrated to adequate breathing, because it reverses opioid respiratory depression.
For severe pain with shock or respiratory compromise, do not rely on intranasal medication; use resuscitation and controlled IV/IO analgesia with senior support.
Definitive Care & Disposition
Proceed with splinting, wound care, reduction, imaging, or surgery after analgesia. Document dose, concentration, nostril(s), response, sedation score, and respiratory status. Children requiring repeated opioid doses, ongoing pain, procedural sedation, respiratory monitoring, or treatment of serious injury need observation or admission; discharge requires stable ventilation, age-appropriate behavior, controlled pain, and a safe oral regimen.
How This One Kills
The common failure is giving a large volume into a bloody or obstructed nose, assuming absorption occurred, and then repeating the dose—producing delayed opioid toxicity when the child swallows or absorbs the cumulative medication. The opposite failure is dismissing intranasal analgesia after a single poorly delivered dose and leaving severe pain untreated.
The Atypical Presentation
A child may become quiet rather than visibly sedated, particularly after distress resolves. A caregiver may report “he is finally calm,” while the child is actually hypoventilating. In children with autism or communication impairment, assess respiratory effort, arousability, color, and baseline behavior—not just the apparent reduction in crying.
Back to Our Patient
Back to the 6-year-old with the bent wrist: he is stable, spontaneously breathing, and has no major facial injury, but his bloodied nostril makes absorption potentially unreliable. The team first clears visible blood, monitors him continuously, and gives a carefully measured intranasal fentanyl dose divided between nostrils with rescue equipment ready. At 10 minutes he is comfortable, awake, and ventilating normally; the wrist is examined, neurovascular status is documented, and a fracture is splinted. He needs no further opioid, transitions to oral medication, and is discharged after observation with orthopedic follow-up and return precautions.
Patient Presentation to Attending
“This is a 6-year-old boy with an obvious wrist deformity after a fall and severe pain preventing examination or IV placement. He is alert with normal breathing, perfusion, and distal pulses, and has no major midface injury, although there was a small anterior nosebleed. I’m concerned for a forearm fracture but currently see no airway or shock features. I’ve placed him on continuous pulse oximetry, given weight-based intranasal fentanyl divided between nostrils after clearing blood, and will reassess pain, sedation, and ventilation in 5–10 minutes. We’ll obtain radiographs, splint with repeat neurovascular documentation, and observe before discharge if he remains comfortable and physiologically normal.”
Study Directive
Calculate intranasal fentanyl doses for 10-, 20-, and 35-kg children using your department’s chosen protocol.
Practice converting dose to volume for the available fentanyl concentration and dividing it between nostrils.
Create a bedside checklist: weight, nasal patency, monitoring, rescue equipment, dose, reassessment time, and redosing threshold.
Review three contraindication scenarios—epistaxis, midface trauma, and bronchiolitis—and select an alternate route.
Demonstrate naloxone preparation and pediatric dose calculation with your resuscitation team.
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Key Medications
Fentanyl intranasal: 1–2 mcg/kg, often 1.5–2 mcg/kg, divided between nostrils; concentration and maximum dose vary—check institutional protocol.
Naloxone: 0.1 mg/kg IV/IM/IN; max 2 mg, titrate to adequate ventilation.
Intranasal medication volumes should generally be kept low and divided between nostrils; use a concentrated formulation when available.
Pediatric route-specific dosing varies meaningfully by protocol; check Lexicomp, UpToDate, or institutional guidance when uncertain.
High-Yield Pearls
A bloody or obstructed nose predicts unreliable delivery; change the route rather than repeatedly escalating intranasal doses.
Reassess ventilation and arousability, not just crying—calmness may be the first sign of opioid toxicity.
Intranasal fentanyl is especially useful before splinting or IV placement, but it does not provide procedural dissociation.
The Mimics
Nasal obstruction or epistaxis — poor mucosal contact and unreliable absorption; repeated dosing can cause delayed overdose.
Opioid-naive respiratory illness — bronchiolitis or sleep-disordered breathing increases vulnerability to hypoventilation; choose a lower threshold for monitored alternate-route dosing.
Major midface trauma — possible skull-base or airway injury; intranasal administration may be inappropriate and distract from airway control.
Procedural distress without significant pain — anxiety may require behavioral support rather than escalating opioid doses, avoiding unnecessary respiratory risk.
Board Question
A 5-year-old with a closed tibial fracture has severe pain and no IV access. He is alert, breathing normally, and has no nasal obstruction or facial trauma. Which statement about intranasal fentanyl is most accurate?
AIt should be avoided because analgesia will obscure the examination
BIt is appropriate at a weight-based dose with respiratory monitoring and rescue equipment available
CIt must be delivered as a large volume into one nostril
DA second full dose should be given immediately if crying continues at 2 minutes
Reveal answer
Correct: B
Intranasal fentanyl is appropriate in a stable child when IV access is delayed, but it requires weight-based dosing, reassessment, and monitoring for opioid toxicity. Absorption is optimized with small divided volumes; early crying does not justify immediate redosing.
Synthesizes efficacy and safety data for intranasal ketamine as a needle-free option for acute pediatric pain when IV access is unavailable or undesirable.
Cooperative or adequately restrained child with a visible, nonpenetrating nasal foreign body that is difficult to grasp but can plausibly be expelled...
Also known aspositive pressure technique · mother's kiss · parent's kiss
0:00 / –:––AI‑generated audio
Indications
Cooperative or adequately restrained child with a visible, nonpenetrating nasal foreign body that is difficult to grasp but can plausibly be expelled through the involved nare.
Best suited to a smooth, mobile object in the anterior nasal cavity.
Consider after appropriate analgesia and topical vasoconstriction when direct removal is not immediately successful.
Contraindications
Button battery, magnet, caustic material, sharp or penetrating object, significant epistaxis, suspected septal injury, or object impacted posteriorly.
Respiratory distress, inability to maintain the airway, or concern for aspiration—stabilize first and involve ENT.
Uncooperative patient in whom a mask seal or safe restraint cannot be achieved.
Do not use repeated forceful insufflations or delay urgent specialist removal.
Otoscope or headlight, nasal speculum if available, bayonet forceps/suction catheter for backup, gauze, and emesis basin.
Analgesia and topical vasoconstrictor according to local practice; use age-appropriate dosing references.
Explain the maneuver, position the child upright or slightly forward, and have an assistant stabilize the head and occlude the unaffected nare.
Ensure the object is visible and identify the involved side before attempting expulsion.
Steps
Position the child upright with the head supported and the face slightly forward to allow expelled material to fall outward rather than posteriorly.
Select a mask that seals over the mouth and nose without excessive pressure on the involved nostril; place it over the mouth and the affected side of the nose.
Occlude the unaffected nostril firmly with a finger, while maintaining a complete mask seal around the mouth and involved nare.
Ask the child to close the mouth if able. If cooperation is inadequate, use a brief, controlled bag squeeze to deliver a short pulse of positive pressure—not a full ventilation.
Inspect the nostril and mouth immediately. Suction expelled secretions or the object, and stop after one or two appropriately performed attempts.
If unsuccessful, abandon the maneuver and proceed to direct visualization, another suitable technique, procedural sedation, or ENT consultation rather than escalating pressure.
Confirmation & Success Criteria
Foreign body is visibly expelled and recovered or clearly identified in the basin/gauze.
Reinspect both nasal passages and the oropharynx for retained material, mucosal trauma, or bleeding.
Confirm unobstructed nasal airflow, stable oxygen saturation, comfortable breathing, and absence of coughing or choking.
If the object is not recovered, do not assume success; obtain specialist assessment or imaging when clinically indicated.
Complications & Rescue
Aspiration or posterior displacement: stop, suction, assess the airway, provide oxygen, and manage as an airway emergency if needed.
Epistaxis or mucosal injury: direct pressure, gentle suction, and topical vasoconstrictor when appropriate; avoid further instrumentation.
Barotrauma or discomfort: use only brief, low-volume pulses and discontinue if resistance or distress occurs.
Failure or worsening distress: stop attempts, provide standard airway support, and involve ENT/anesthesia; procedural sedation may be required.
Suspected button battery or magnet: do not attempt positive-pressure expulsion; obtain urgent ENT removal.
Aftercare & Documentation
Document the side, object type and location, visualization, analgesia/topical agents, number and type of attempts, technique, outcome, and complications.
Reexamine the mucosa for abrasions, septal injury, retained fragments, and ongoing bleeding.
Give return precautions for persistent unilateral discharge, foul odor, fever, facial swelling, recurrent bleeding, breathing difficulty, or concern that material remains.
Arrange ENT follow-up for failed removal, mucosal injury, button battery/magnet exposure, posterior objects, or suspected retained fragments.
6 of 6 · Procedure Corner
Ear Foreign Body Removal with Skin Glue
Visible, dry, smooth or irregular foreign body in the external auditory canal that is difficult to grasp with forceps but can be contacted safely with a...
0:00 / –:––AI‑generated audio
Indications
Visible, dry, smooth or irregular foreign body in the external auditory canal that is difficult to grasp with forceps but can be contacted safely with a glue-tipped applicator.
Object is lateral or mid-canal, stable, and clearly separated from the tympanic membrane.
Patient can remain still, or appropriate analgesia, restraint, or procedural sedation is available.
Contraindications
Suspected or confirmed tympanic membrane perforation, object abutting the tympanic membrane, or inability to visualize the object and canal wall.
Button battery, magnet, sharp/penetrating object, live insect, wet or friable material, or object embedded in tissue.
Active otitis externa, significant canal edema or bleeding, or an uncooperative patient at risk for sudden movement.
Avoid cyanoacrylate contact with the canal wall, tympanic membrane, hair, skin, or moisture; do not use if the applicator cannot be controlled precisely.
Equipment & Prep
Otoscope or preferably an operating microscope, appropriate ear specula, headlight, and suction.
Small wooden applicator or cotton-tipped applicator with a clean, controllable tip; medical-grade cyanoacrylate adhesive.
Analgesia or topical anesthetic when appropriate; use dosing references for the child’s age and weight.
Direct lighting, restraint or an assistant, gauze, and backup tools such as alligator forceps or a right-angle hook.
Explain that the applicator must remain still for several seconds; position the child securely with the affected ear accessible.
Steps
Inspect the canal and tympanic membrane, determine the object’s size and depth, and confirm a safe gap between the object and the tympanic membrane.
Remove only enough adhesive to make a tiny controlled droplet on the applicator tip; avoid a wet or excessive coating.
Under direct visualization, advance the applicator along the canal without touching the canal wall or tympanic membrane.
Touch the adhesive tip to the foreign body’s most accessible surface, avoiding surrounding skin and hair.
Hold the applicator motionless until the adhesive sets firmly—typically several seconds, according to the product—then withdraw the object in line with the canal.
If the object does not adhere immediately, withdraw without dragging, reassess, and select another technique or obtain ENT assistance; do not reapply uncontrolled adhesive.
Confirmation & Success Criteria
Foreign body is removed intact with no residual adhesive or fragments in the canal.
Reinspect the entire canal and tympanic membrane for retained material, abrasion, bleeding, or perforation.
Confirm improved hearing and absence of severe pain, vertigo, or persistent foreign-body sensation when developmentally assessable.
If visualization remains incomplete or the object fragments, arrange microscopy/ENT evaluation rather than repeated blind attempts.
Complications & Rescue
Adhesive contact with canal skin or tympanic membrane: do not forcibly peel it away; stop manipulation and obtain urgent otolaryngology guidance.
Canal laceration or bleeding: stop, apply gentle pressure or suction as appropriate, and reassess the tympanic membrane.
Object pushed medially or tympanic membrane injury: stop further attempts, keep the ear dry, provide analgesia, and arrange urgent ENT assessment.
Pain, vertigo, vomiting, or sudden hearing change suggests deeper injury; discontinue and evaluate for tympanic membrane or middle-ear trauma.
Failed attempt, retained fragments, button battery, magnet, or sharp object warrants prompt ENT removal, often with microscopy and procedural sedation.
Yesterday’s Differential
The daily puzzle — from editions past
A quick test of recall from prior editions. Commit to an answer before you check.
From yesterday's edition
A 62-year-old woman on chronic furosemide presents with palpitations and generalized weakness after a week of vomiting. Heart rate is 96, blood pressure normal. What’s the diagnosis, and the first move?
Check your answer
Hypokalemia. Check potassium and magnesium together. Replace potassium to >=4.0 mmol/L and magnesium to >=1.0 mmol/L to stabilize the myocardium; put the patient on a monitor for ectopy and torsades, and treat sustained polymorphic VT with IV magnesium.
From the August 22 edition
Today, three days ago: Fomepizole. What’s the adult ED dose, and the contraindication you’d most regret missing?
Check your answer
15 mg/kg IV load, then 10 mg/kg IV q12h for 4 doses, then 15 mg/kg q12h until toxic alcohol level/clinical criteria resolved. Dose more frequently during hemodialysis per protocol. Hypersensitivity to fomepizole/pyrazoles.
From the August 15 edition
A 32-year-old woman 2 weeks postpartum develops progressive headache, papilledema, and a focal seizure. CT shows a small hemorrhagic venous infarct; CT venography confirms superior sagittal sinus thrombosis. Which is the best next treatment?
AAspirin only
BTherapeutic anticoagulation
CThrombolysis before anticoagulation in all cases
DLumbar puncture before treatment
Reveal answer
Correct · B
Therapeutic anticoagulation. Anticoagulation is indicated in CVT, including when venous infarction contains intracranial hemorrhage, because it prevents thrombus propagation and promotes recanalization. Endovascular therapy is reserved for selected patients who deteriorate despite anticoagulation.
Journal Watch
From the FOAMed wire
Notable posts and reviews from the last week, ranked by relevance to today’s lead and source trust.
Is there any moderate or high-level evidence that SEP-1 compliance and/or implementation is associated with improvement in sepsis mortality? The post Effect of Sepsis Bundle (SEP-1) Compliance and Implementation on Mortality appeared first on REBEL EM - Emergency Medicine Blog .
Learn how ED physicians can preserve physiologic reserve and protect long-term health through active mitigation. The post Night Shift Is an Occupational Exposure. Treat It Like One appeared first on ACEP Now .
In this episode, Sam Ashoo, MD and Dr. Syeda Maria Muzammil, MD discuss the August 2026 Emergency Medicine Practice article, Emergency Department Management of Postthrombolysis Intracranial Hemorrhage. 0:25 – Intro & sponsor message 1:18 – Guest introduction: Dr. Maria Muzammil 2:24 – Timeframe for post-thrombolysis hemorrhage & ED/ICU boarding...
We kick off July with pieces on sepsis from Haney, peds fingertip injuries from Ilene, and a case of a cranky consult with Jan and Swami. Megan and Mel work through last month’s EMA papers 1. Mel's July Update 2....
UMEM Pearl
Matched to today’s topics
A clinical pearl from the University of Maryland EM group’s Educational Pearls, tied to today’s differential.
Pediatric transplant recipients are children with special health care needs; prehospital programs such as STARS can bridge care gaps before they reach the ED.
The STARS (Special Needs Tracking and Response System) program was started in 2014 to bridge gaps in caring for children with special health care needs in the prehospital setting.
Pharmacology Corner
Two drugs for the shift
One antimicrobial and one other ED workhorse — selected daily, with sources and last-reviewed dates so every dose is cross-checkable.
Antimicrobial of the Day
Cefuroxime
Second-generation cephalosporin (oral and IV)
Indication
Community-acquired pneumonia, otitis media/sinusitis, SSTI, early Lyme disease, uncomplicated UTI, and surgical prophylaxis.
What’s your dose? — reveal dosing & cautions
ED Dose
PO: 250–500 mg q12h. IV: 750 mg–1.5 g q8h. Early Lyme: 500 mg PO q12h x14–21 days. Pediatric oral: 20–30 mg/kg/day divided q12h.
Renal Adjustment
Reduce IV frequency in CrCl < 20 mL/min; HD: dose after dialysis.
ED Pearl
One of the few oral cephalosporins with reliable activity in early Lyme disease — a useful alternative to doxycycline in pregnancy and young children.
First-line vasopressor for septic shock; cardiogenic shock; vasodilatory shock from any cause.
What’s your dose? — reveal dosing & cautions
ED Dose
Start 0.05–0.1 mcg/kg/min (≈ 5–8 mcg/min in adult); titrate q2–5 min to MAP ≥ 65 mmHg. Typical max 1–2 mcg/kg/min before adding a second agent.
Renal Adjustment
Titrate to effect; no specific renal dose change.
Contraindications
Profound hypovolemia (treat volume deficit first or simultaneously) and mesenteric/peripheral vascular thrombosis are relative.
Interactions
MAO inhibitors and tricyclic antidepressants (potentiated pressor response); beta-blockers (blunted beta effects, exaggerated alpha).
Monitoring
Arterial line ideal but do not delay starting through a peripheral large-bore IV; check the IV q15min for extravasation, and have phentolamine available.
ED Pearl
You can — and should — start norepi peripherally in septic shock while central access is being obtained. Waiting for a central line is the most common avoidable cause of delayed pressor initiation.
For educational use only. Verify dosing against the FDA label and your institution’s pharmacy resources before administering.
ECG of the Day
Pacing
Normal Pacemaker Function
Vertical pacing spikes before P waves or QRS complexes, each followed by a captured beat with appropriate discordance, define a normally functioning pacemaker.
The Tracing
An 82-year-old man with a dual-chamber device comes in for a fall. Vitals are stable. On his 12-lead you see, before each beat, a pair of sharp vertical spikes of very short duration — one preceding a small P wave, a second preceding the QRS. Each atrial spike is followed by a P wave and each ventricular spike by a broad QRS, beat after beat. The QRS complexes are wide with a left bundle branch look, and the ST segments and T waves point in the opposite direction to the main QRS deflection. A couple of complexes in the middle of the strip are narrower and shaped differently, without the same relationship to the spikes. The rhythm is regular and the rate is adequate.
Pacing spikes — vertical deflections of short duration (~2 ms); smaller with bipolar and epicardial leads than with unipolar/endocardial leads
Atrial pacing: spike precedes the P wave; ventricular pacing: spike precedes the QRS
RV-paced QRS shows an LBBB morphology (left epicardial lead placement produces an RBBB morphology)
Appropriate discordance — ST segments and T waves opposite the terminal QRS
AV-sequential (dual-chamber) pacing: both atrial and ventricular spikes with 100% capture, a P after each atrial spike and a QRS after each ventricular spike
Pearls
The absence of paced complexes does not mean pacemaker failure — it often just means the patient's own conduction is adequate and the device is appropriately inhibited.
Fusion and capture beats (narrower complexes with different morphology interspersed among paced beats) are normal findings when native impulses coincide with or outrun pacing, not malfunction.
A magnet forces asynchronous pacing (AOO/VOO/DOO) in a pacemaker, but on an ICD a magnet instead deactivates the defibrillator — do not confuse the two responses.
Pitfalls
RV-paced LBBB-morphology beats look like native LBBB; the pacing spikes are what identify them — and the same discordance rules (Sgarbossa) apply when hunting for ischemia.
Atrially paced patients often show 1st-degree AV block or Wenckebach that isn't present at their native rate — this reflects AV-node fatigue from pacing above its capacity, not a new pathologic block, provided output isn't compromised.
Asynchronous ventricular pacing (e.g., magnet mode) carries a risk of pacemaker-induced ventricular tachycardia — don't apply a magnet reflexively without understanding the device.
At the Bedside
Confirm capture and appropriate inhibition before calling a device problem: verify each spike is followed by a P wave or QRS, recognize fusion/capture beats and appropriate discordance as normal, and reserve interrogation and electrophysiology involvement for genuine failure to capture, sense, or pace.
For educational use only. Verify ECG interpretation against the LITFL entry and your institution’s practice before clinical decision-making.
Case of the Day
From the lead · Children with Special Needs: Transplants
Self-Examination
Test Your Understanding
A 12-year-old liver-transplant recipient presents with fever, mild tachycardia, and new confusion. Blood pressure is 78/42 mm Hg after an initial 20 mL/kg balanced-crystalloid bolus. Which is the best next step?
AWait for tacrolimus and blood culture results
BGive ibuprofen and observe urine output
CStart a vasoactive infusion and broad-spectrum IV antibiotics while contacting the transplant center
DStop all immunosuppressants immediately
Reveal answer
Correct answer · C
Shock in an immunosuppressed transplant recipient requires immediate hemodynamic support and empiric antimicrobials; diagnostic results must not delay treatment. Immunosuppression changes should be directed by the transplant team because abrupt withdrawal can worsen rejection or precipitate complications.
Study Pace4 topics today; Issue 42 of 94 — Pediatrics (Week 23 A)Deadline · June 1, 2026