The Higher Tech Kid in the ED

Cite this article as:
Pascoe, E. The Higher Tech Kid in the ED, Don't Forget the Bubbles, 2018. Available at:

This month’s Podcast of the Month is from the Pediatric Emergency Playbook. In a 30 minute podcast Tim Horeczko (Emergency Physician, and Educator) demystifies vagus nerve stimulators, intrathecal pumps, and ventricular assist devices. Through clinical cases, he provides some useful tips and tricks for what to do when the ‘higher tech kid’ presents to ED…

Infantile botulism

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Davis, T. Infantile botulism, Don't Forget the Bubbles, 2014. Available at:

Milla is a 4 month old girl, brought into ED by her parents.  She’s been quieter than normal for the last couple of days and today seems really weak and not sucking on the breast any more.  On examination she has poor head control and marked hypotonia.  They also mention a history of constipation for…

Status epilepticus

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Partyka, C. Status epilepticus, Don't Forget the Bubbles, 2013. Available at:

The batphone rings at 5am. You are given a 5 minute ‘heads up’ by paramedics regarding a 3 year old child they are rushing to you with lights & sirens. She has a history of seizure disorder and has been actively seizing for 45 minutes….

Do antibiotics affect CSF results?

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Davis, T. Do antibiotics affect CSF results?, Don't Forget the Bubbles, 2013. Available at:

Paediatricians often have to make a decision about whether to just go ahead and give antibiotics in suspected meningitis, or wait for a lumbar puncture (LP) – this could be due to parental refusal, an unstable patient, or a failed attempt. There is often a discussion about repeating the LP later that day, or even…

Traumatic brain injury - helmet

Traumatic brain injury

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Bartlett, A. Traumatic brain injury, Don't Forget the Bubbles, 2013. Available at:

An 8 year old boy is rushed into ED following a fall from a fourth story window.  He landed on concrete and has obvious signs of external damage to his skull and a GCS of 5. He’s clearly sustained a serious traumatic brain injury – how is this best managed?

Ventriculoperitoneal shunts

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Lawton, B. Ventriculoperitoneal shunts, Don't Forget the Bubbles, 2013. Available at:

An 8 yr old boy presents after three vomits at home.  He has a background of spastic diplegic cerebral palsy and has a ventriculo-peritoneal (VP) shunt.  He is usually ambulatory and attends mainstream school. What goes wrong with VP shunts? How can we assess them for failure or infection?

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