Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.


Peds M&M

Mike Preis, MD

  • Centor Criteria (Strep Throat):
    Tonsillar exudates, Tender anterior cervical adenopathy, Absence of cough, History of fever
    Each criteria = 1 point; 3 or 4 points often considered “diagnostic”
    Centor Criteria with 3 or 4 criteria has a Positive Predictive Value of ~40%, but there is a Negative Predictive Value of ~81% if all 4 are negative
  • Consider caustic ingestion and esophageal injury with complaint of sore throat, anorexia, and vomiting even if there are no oral lesions. If two of the three symptoms of vomiting, drooling, or stridor are present the likelihood of GI burns is increased with vomiting being the most powerful predictor.
  • Pediatric inguinal hernia reduction entails an anterior to posterior directed milking motion of the herniated bowel towards the inguinal ring and should result in a pop or feeling of the bowel sliding out of your hand and through the ring. If the hernia does not reduce easily, obtain immediate pediatric surgery evaluation and consider observation.
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