PEM Rules
Yaron Ivan
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PEM Rules is a dedicated Pediatric Emergency Medicine Podcast designed to help students, residents, physicians and anyone who takes care of children in the acute setting.
Find out more and www.pemrules.com
Contents does not constitute medical advice
Available episodes
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Oldest first
20 hours ago
Episode 59: Interview with Noah Makovsky, Primary Care Pediatrician in Denver, Colorado
It is the General Pediatricians that often sends the child to the Pediatric ED. How the PCP and PEM doctor better communicate to help their patients.
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Mar 13, 2023
Episode 58: Clinical Care Tips – Ketamine Sedation, The Doctor and The Parent Perspective.
I don’t know what I would do without Ketamine. My favorite drug to use for procedures. Here is how I use it and what I tell the parents…
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Mar 6, 2023
Helping a PEM Fellow With a Research Project
Dear Listener,
If you are a PEM provider in the US in a Pediatric ER that has rotating residents and/or fellows please take a moment and click on the link below and help Sophia Wang (a PEM fellow in the University of Mississippi Medical Center) with her research project regarding patient handoff during transition of care.
Sophia is an active contributor to PEM Rules who has produced several episodes of the podcast (coming up this summer).
Thank you in advance,
Yaron Ivan, PEM Rules
Link to PEM Rules and the survey below
https://pemrules.com/news/
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Feb 27, 2023
Episode 57: Clinical Care Tips – All About My Favorite Procedure. Suturing Those Lacerations
Probably the most common procedure I perform in the Pediatric ER and one I particularly like. Suturing. Which rules do I use and what is my anticipatory guidance for these parents.
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Feb 13, 2023
Episode 56: Interview With My Favorite Pediatric Dermatologist, Dr. Tace Rico
Rashes always makes us, none dermatologist worry and maybe a bit anxious. Which rashes are worrisome? and what should we look for as the red flags of pediatric rashes. I discuss this and more With Dr. Tace Rico our Pediatric Dermatologist.
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Jan 30, 2023
Episode 55: The Art of Talking To Consultants
Talking to a consultant so your patient can benefit the most is an art and a science. Here are some rules I have already discussed (and some new ones) that help me make the best of those contestations on the phone.
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Jan 16, 2023
Episode 54: Clinical Care Tips – Documentation, Important S&S and Communicating with Parents and Trainees
There is a certain art to how to document to your advantage? And what s&s should scare you more. Are Bilateral complaints really worse? Most importantly, how to speak to parents and trainees.
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Jan 2, 2023
Episode 53: Interview with My Favorite Pediatric Anesthesiologist Adam Adler
What is the best approach to the patient with the difficult airway? and how can we improve our sedations? I discuss these topics (and others) with Dr. Adam Adler, a pediatric Anesthesiologist and a friend.
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Nov 28, 2022
Quick Announcement - Thank You For All Your Support
PEM Rules will be taking a short winter vacation for the month of December. Really appreciate everyone's support over the last 2 years. Will see you again in the new year.
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Nov 21, 2022
Episode 52: Clinical Care Tips – Some More Rules About Vomiting and PO Challenge, and Having a Good Backup Plan
Does every child who is vomiting need Zofran? What is the “best” thing to do for a vomiting child and how do we set our PO challenge for success? What do we do when things don’t go as planned?
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Nov 7, 2022
Episode 51: EBM Review with Victoria. All about Bronchiolitis
Despite so much research and evidence there are still so many questions and uncertainties. Victoria and I review the clinical presentation, diagnosis, current and future treatment.
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Oct 24, 2022
Episode 50: Clinical Care Tips – Talking About True Emergencies, Hypoglycemia, and Importance of Knowing the Epidemiology.
As a PEM physician I must worry (and therefore rule out and treat) the true emergencies first. That is why I first check for what is emergent and what I can fix. Since my patient population varies greatly with regards to age I find it very important to know the epidemiology, in other words, what is the most common cause of X based on the patient’s age.
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Oct 10, 2022
Episode 49: PEM Research. Why, How, What and When...
Research is one of the most intimidating aspects of medicine for us clinicians. Why is that ? and where is a good place to start? I discuss these topics and much more with Dr. Bob Hickey from the Children's Hospital of Pittsburgh
Please consider contributing to PEM Rules on
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Sep 26, 2022
Episode 48- Clinical Care Tips – More About Mistakes, Smiling Children and the Precious IV access
What is the best way to view mistakes and how to reap some benefits from them. How I go about "working up" smiling children and what to do first with that IV access.
Please consider contributing to PEM Rules on
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Sep 12, 2022
Episode 47: Interview With My Favorite Pediatric Nephrologist, Dr. Craig Woda.
My Nephrology professor in Medical school used to say that “The kidney is an easy organ to master, but you truly need to understand it”. My friend Craig Woda (an astute Pediatric Nephrologist) helps me better understand how we can do a better job identify nephrological issues in children.
As usual, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
And make sure to check out www.pemrules.com
Copyright PEM Rules LLC
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Sep 5, 2022
Special Announcement: Research Article Published and Some More
Hope you like the news I have to share and check out the link below. As usual please check out www.pemrules.com and consider contributing by clicking below.
https://ko-fi.com/pemrules
Best,
Yaron Ivan PEM Rules LLC.
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Aug 29, 2022
Episode 46: Applying The Rules - Thank you Jaron Smith
Jaron Smith is a PEM Fellow in Dallas Texas who applied the PEM Rules and wanted to share his story. Thank you Jaron for sharing your thoughts and thank you for your music request.
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Aug 15, 2022
Episode 45: Interview with My Favorite Pediatric Cardiologist Dr. Kelvin Lee
What are the red flags for cardiological presentations and how can we better identify children with cardiological issues in the Pediatric Emergency Department. I discuss that and more with my good friend and colleague, Dr. Kelvin Lee.
As always, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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Aug 1, 2022
Episode 44: Clinical Care Tips - Words of Wisdom From Dr. Bob Hickey.
Some words of wisdom I learned from Dr. Bob Hickey, one of my favorite Attendings in fellowship. A clinician and avid researcher.
As always, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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Jul 18, 2022
Episode 43: My Approach to the Ill Appearing Baby
Not particularly based on any evidence-base study I am aware of, but this is how I approach the Ill-appearing (previously well) newborn / baby in the Pediatric Emergency Department
Check out the following video I created to help you remember the EKG changes of hyperkalemia
https://pemrules.com/hk/
As always, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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Jul 4, 2022
Episode 42: Interview with My Favorite Pediatric Intensivist, Dr. Barry
What makes a good PEM physician? (from a PICU standpoint) and how can we all work better together to benefit our patients? My former co resident, and now PICU attending Suzie Barry and I break it down.
As always, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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Jun 20, 2022
Episode 41: Clinical Care Tips – Some More Tips About Resuscitations and “Partially Treated Disasters”
My nurses and my team often appreciate some of these rules and they are also the right thing to do for our patients.
As always, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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Jun 6, 2022
Episode 40: Child Life in the Pediatric ER
Sometimes the people who help me the most in the ER are not even clinicians. They are the child life specialists who help my patients (and therefore me) have a better / easier experience. Jessie is one of our child life specialists who helps me be a more compassionate physician.
As always, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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May 23, 2022
Episode 39: Clinical Care Tips – All About Premature Closure and the Rule I Have for It
Premature closure is something that all clinician deal with. This rule helped me avoid it in the past. In the end, it all boils down to rule number 47 (see episode 11).
As always, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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May 9, 2022
Episode 38: PEM Nursing in the Pediatric ED
What is the role of the PEM nurses in the Pediatric ED? and how do they help me do a better job? Who is the ideal PEM attending? I discuss this and other topics with one of our fantastic Pediatric EM nurses, Elizabeth
As usual, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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Apr 25, 2022
Episode 37: Clinical Care Tips -Who to Monitor, Pin-pointing Problems, and How to Have Better Outcome In Resuscitations
This episode is about knowing who (not what) to monitor, helping your team by pin-pointing and naming the problem and how to (hopefully) have good outcome in resuscitations by having the parents present.
As usual, Please consider supporting PEM Rules by clicking below
https://ko-fi.com/pemrules
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Apr 18, 2022
Special Announcement - PEM Rules Is Also a Monthly Column
Thank you all for listening to the podcast in the last 15 months. I am excited to announce that PEM Rules is now a column in the journal EP monthly. Please check out the link below to read the "PEM Rules Philosophy".
http://epmonthly.com/article/you-dont-have-to-win-just-dont-lose/
Also please consider supporting PEM Rules by clicking on the link below.
https://ko-fi.com/pemrules
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Apr 11, 2022
Episode 36: Clinical Care Tips – About You, Part 6
How to give yourself credit for all the work you do, what to “look at” during your shift and how to manage your time
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Mar 28, 2022
Episode 35: Physician Assistants, Nurse practitioners (AKA APP’s) in the Pediatric Emergency Department.
APP’s are the people I can’t do without. They are helpful, motivated and often teach me more than I teach them. I love having them around.
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Mar 14, 2022
Episode 34: Clinical Care Tips – How to Be Ready For Intubation, How To Use Your Resources Well And Why You Should Do Things Step By Step
It is not very often that I intubate an asthmatic but when I do I always think about PEM rule number 91. Rule Number 92 is meant to help me be more efficient and do what is right for my patients and rule number 93 helps me to things one step at a time.
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Feb 28, 2022
Episode 33: Clinical Care Tips – What to Do With “Problems”, How Often to Evaluate Your Patients and Remembering That Sometimes You Just Can’t Go Wrong.
When you are faced with a problem try to keep it small, remember your patients are yours as long as they are in the department. And keep in mind, During the initial stages of resuscitations, you simply can’t go wrong
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Feb 21, 2022
Special Announcement And Request
Thank you for listening to PEM Rules and for the emails and support. Please check out www.pemrules.com and consider supporting my educational project using the link below (or on the website) and sign up for the newsletter which is (finally) up and running.
https://ko-fi.com/pemrules
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Feb 14, 2022
Episode 32: Fever in Children. Is It Good, Bad and Should It Be Treated or Left Alone?
Fever is one of the most common chief complaint in the Pediatric Emergency Department and tends to scare many parents, myself included. My previous scribe (and now an astute medical student) Victoria, researched what fever is? what it does? and answered the ultimate question, to treat or not to treat??
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Jan 31, 2022
Episode 31: Clinical Care Tips – About You Part 6 - Some Rules About Worrying, Teaching and How to Be More Than Just an Emergency Medicine Doctor
Worrying about you or your patients is usually just a bad idea that does not serve us well, but what about just being concerned? What does PGY really mean? and why you should sometime be more than just an Emergency Medicine Physician.
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Jan 24, 2022
Special Announcement / Request
It has been over a year since I started PEM Rules and I would love to have some feedback. Have you used the rules in your practice? check out www.pemrules.com and submit any feedback you wish.
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Jan 17, 2022
Episode 30: Clinical Care Tips – How To Go About Hydration, Document Your Encounters, And What To Do With That EpiPen In Your Hand.
We all know rule number 82 but sometimes forget to use it. Practicing protective medicine is something we all do but hopefully we keep it to a minimum and how to be a step ahead during the most crucial times.
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Jan 3, 2022
Episode 29: Interview With My Great Mentor and The Man Behind So Many of The Rules Dr. Richard Saladino
I had the privilege to work with Dr. Rick Saladino when I was a fellow at the Children’s Hospital of Pittsburgh when he served as the division chief. Rick taught me a lot of clinical medicine, research methods and most importantly he is the man behind many of the rules I now teach my residents and discuss in this podcast.
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Dec 20, 2021
Episode 28: Clinical Care Tips - More on MSK Chief Complaints, Improving Your Skills and Thinking Outside the Box
Some good rules about musculoskeletal chief complaints, how they relate to previous rules, how to always improve your skills and a reminder to think outside the box.
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Dec 6, 2021
Episode 27: Interview with My Favorite Pediatric Orthopedist Dr. Sean Keyes
Pediatric Orthopedics is probably the subspecialty I consult most often and Dr. Sean Keyes is one of my favorites consultants to talk to. In this discussion I pick his brain about some important Pediatric Ortho principles.
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Nov 22, 2021
Episode 26: Clinical Care Tips – About You, Part 5
Why I don’t recommend you ever run in the ER. How to spend your money during your training and how a doctor should really worry.
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Nov 8, 2021
Episode 25: Peds ID, In The ED
Though Infectious Diseases is not a very common subspecialty I consult from the ED, it is still one of my favorites. Great discussion with Dr. Levent about vaccination, fever and when antibiotics is truly needed.
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Oct 25, 2021
Episode 24: Clinical Care Tips - About You, Part 4
Sometimes there is just nothing to lose, so why not try? What do you do when you make mistakes? And how do you deal with the chaos of the ED?
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Oct 11, 2021
Episode 23: Clinical Care Tips – Abdominal Pain, Bronchiolitis and How to Find the Right Size Endotracheal Tube
This is how I make sure the abdomen is not surgical, what helps me with the disposition of children with bronchiolitis and how do I decide what ET tube size I need.
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Sep 27, 2021
Episode 22: My Newborn Talk to Young Parents in the ED
Some of my favorite patients are those newborns with new parents who have many questions and concerns. I try to address the acute concerns of that encounter and take care of the issue (whatever it may be) but I always take the 10 minutes to give those parents my “Newborn Talk”.
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Sep 13, 2021
Episode 21: Clinical Care Tips - Ventilation, Sedation and Breaking Some Rules
Talking about ventilating a child using bag and mask, the way I go about conscious sedations and how I get ready, and recognizing the fact that some rules were meant to be broken.
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Aug 30, 2021
Episode 20: EBM Review with Victoria – Approach to the Child with Anaphylactic Reaction
My former scribe, Victoria, who is now an astute medical student and I discuss an evidence based approach to the treatment and management of anaphylactic reaction.
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Aug 16, 2021
Episode 19: Clinical Care Tips – Life, Career, And The Patients We See Often
I love my job but rule number 64 is so important as a person, father and husband. I also discuss the importance of listening and paying attention to the PMH and HPI and why a chest x ray is a good idea on that child who had Pneumonia so many times
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Aug 2, 2021
Episode 18: Lower Airway Obstruction – Bronchiolitis
Probably one of the most researched diseases in Pediatrics. Bronchiolitis is an issue for us PEM physicians every winter. Here is my approach to the wheezing child with bronchiolitis.
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Jul 19, 2021
Episode 17: Upper Airway Obstruction – Viral Croup
As an Emergency Physician, my biggest concern (and the first thing I need to address) is the airway. I like to think of the Pediatric airway as simple. Upper and lower. Viral croup is a very common upper airway obstruction.
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Jul 5, 2021
Episode 16: Communication Tips and Tricks – Part 3
We all want to work in an ED that is running smoothly. We all want to have good relationships with our consultants and none of us want to see the same patient two days in a row. These rules help with all those issues.
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Jun 21, 2021
Episode 15: Communication Tips and Tricks – Part 2
Some more helpful rules to help you communicate to worried parents, consultants and trainees. I use these every day with great success, Most of the time
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Jun 7, 2021
Episode 14: Communication Tips and Tricks – Part 1
Communicating effectively to your colleagues, trainees, consultants and patients is a key element of what I do. Effective communication drives better patient care, patient satisfaction and simply makes the day better
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May 24, 2021
Episode 13: Approach to The Child with a Rash In The Pediatric Emergency Department
My personal experience is that rashes often intimidate us EM providers. I know that because I often work with trainees who get a bit nervous when they see a child with a rash. I encourage them to think of a child with a rash the way they think of any other patient. This episode is all about my approach to a child with a rash in the Peds ED.
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May 10, 2021
Episode 12: Clinical Care Tips - About You, Part 3
What is the right thing to do? When does a leader take “time off” Here are some more PEM rules, about you (the provider). These have to do with how I lead my team, mentor my trainees and treat my patients.
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Apr 26, 2021
Episode 11: Clinical Care Tips - About You, Part 2
These are some more rules that helped me make better career choices and working in a team as a team leader
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Apr 12, 2021
Episode 10: Clinical Care Tips - About You, Part 1
Some More PEM rules, about you (or me, the provider). These have to do with how I try to act as a leader and communicate to my patients and colleagues. One may call it professionalism.
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Mar 29, 2021
Episode 9: Clinical Care Tips - Assessment and Plan Part 2
These are some rules that help me with the assessment and plan of my patients and the most appropriate disposition for them.
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Mar 15, 2021
Episode 8: How I Approach Patients
Taking a break from the Rules. Here I share my personal approach to the pediatric patient including how I obtain history, perform physical exam and work up my patients.
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Mar 1, 2021
Episode 7: Clinical Care Tips - Assessment and Plan Part 1
Here are some rules that help with the assessment of patients, their plan of care and disposition. Remember, every patient needs an assessment and every patient needs a plan (that is actually one of the rules).
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Feb 15, 2021
Episode 6: Clinical Care Tips - Procedures
Procedures are some of my favorite things to do and teach as a PEM physician. These rules are about approaching and performing procedures in the Pediatric ED.
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Feb 1, 2021
Episode 5: Clinical Care Tips Part 4 - Musculoskeletal Complaints and Vomiting
Some more rules in the Clinical Care category that help with the assessment and plan of patients with musculoskeletal complaints and vomiting. These are two very common presentations to the Pediatric ED
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Jan 18, 2021
Episode 4: Clinical Care Tips Part 3 - Intensive Care and Shock
Despite being an emergency physician, it is uncommon for me to actually encounter true emergencies. As mentioned in previous episodes most of what I do is not emergent or even urgent and many times less is more. However, every once in a while, I do encounter true emergencies and find myself managing shock cardiac arrest as well as other emergent conditions. The next set of rules provide some advice when encountering such situations.
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Jan 16, 2021
Episode 3: Clinical Care Tips Part 2 - Newborns
What constitutes constipation in a newborn? When is spitting up a concern? What is the most important detail to obtain in a newborn history? listen now and find out.
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Jan 4, 2021
Episode 2: Clinical Care Tips Part 1
Here are the first five rules in the first category (Clinical Care Tips) starting with the most important of them all "Its not the patient's job to prove that they are sick, it is your job to prove they are not"
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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Jan 4, 2021
Episode 1: Introduction To the PEM Rules Podcast
What is PEM Rules? what is it all about and what will come in the future? Let's get started.
Please consider contributing to PEM Rules at
https://ko-fi.com/pemrules
And check out www.pemrules.com
Copyright PEM Rules LLC
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