ABEM Peds EM key terms

Viral inflammation of the subglottic airway, most often parainfluenza, causing a barking cough, hoarse voice, and inspiratory stridor that worsens at night. Treated with dexamethasone and nebulized epinephrine for moderate to severe distress.

Narrowing of the subglottic trachea on an anteroposterior neck radiograph that resembles a church steeple. It supports a diagnosis of croup but is neither required nor exclusionary, since clinical findings drive management.

Bacterial inflammation of the epiglottis, classically Haemophilus influenzae type b, producing abrupt high fever, drooling, muffled voice, and tripod positioning. Airway management takes priority and the throat should not be examined with a tongue blade.

Enlargement of the epiglottis on a lateral neck radiograph that looks like a thumbprint. It suggests epiglottitis, though a normal film does not exclude the diagnosis and imaging must never delay airway control.

A harsh, high-pitched inspiratory sound produced by turbulent airflow through a narrowed upper airway. Its timing and character help localize obstruction, and new stridor with drooling or distress signals an airway emergency.

Viral lower respiratory infection of infants, usually respiratory syncytial virus, causing tachypnea, wheeze, crackles, and feeding difficulty. Management is supportive; routine bronchodilators, steroids, and antibiotics are not recommended.

A pause in breathing lasting 20 seconds or more, or a shorter pause with bradycardia or desaturation, in an infant born before 37 weeks. It may recur during respiratory illness and influences disposition decisions in the emergency department.

Deep, rapid, sighing respirations that compensate for metabolic acidosis by blowing off carbon dioxide. In children it is a classic sign of diabetic ketoacidosis and warrants immediate glucose and ketone testing.

A metabolic crisis of insulin deficiency with hyperglycemia, ketonemia, and acidosis. In children it can present with abdominal pain and vomiting, and treatment requires careful fluid and insulin titration to avoid cerebral edema.

Brain swelling from fluid shifts during treatment of pediatric diabetic ketoacidosis, causing headache, altered mental status, bradycardia, and hypertension. It is treated urgently with mannitol or hypertonic saline and slowed fluid administration.

The difference between measured cations and anions, calculated as sodium minus chloride minus bicarbonate. An elevated gap narrows the differential to causes such as ketoacidosis, lactic acidosis, and toxic ingestions.

Poisoning from aspirin or oil of wintergreen causing vomiting, tachypnea, tinnitus, and mixed respiratory alkalosis with metabolic acidosis. Alkalinization of serum and urine with sodium bicarbonate enhances elimination and is first-line therapy.

Telescoping of proximal bowel into distal bowel, usually ileocolic, in infants aged 6 to 36 months. It causes episodic colicky pain, vomiting, and currant-jelly stool, and is reduced with air or contrast enema when stable.

Concentric rings of bowel wall seen on ultrasound or computed tomography in intussusception. It reflects the layers of the intussusceptum within the intussuscipiens and supports prompt enema reduction.

Bloody, mucoid stool passed by some children with intussusception after mucosal ischemia. Its presence is a late finding, so its absence should not lower suspicion when the history and examination are typical.

Hypertrophy of the pyloric muscle in young infants causing nonbilious projectile vomiting, hunger, and weight loss. Examination may reveal an olive-shaped mass, and ultrasound confirms the diagnosis before surgical correction.

A laboratory pattern of low chloride and high bicarbonate caused by prolonged vomiting with loss of gastric acid. It is typical of pyloric stenosis and must be corrected with saline before anesthesia.

Abnormal intestinal rotation allowing the midgut to twist on its blood supply, causing bilious vomiting and rapid ischemic injury. It is a surgical emergency requiring immediate imaging and operative detorsion.

Vomiting that is green or yellow-green, indicating intestinal obstruction distal to the ampulla of Vater. In a neonate it is a surgical emergency until malrotation with volvulus is excluded.

A remnant of the omphalomesenteric duct on the antimesenteric ileum that may contain ectopic gastric mucosa. It can cause painless lower gastrointestinal bleeding, obstruction, or diverticulitis in children.

An acute medium-vessel vasculitis of young children marked by prolonged fever, conjunctivitis, rash, mucosal changes, and extremity swelling. Prompt intravenous immunoglobulin and aspirin reduce the risk of coronary artery aneurysms.

Dilatation of the coronary arteries caused by untreated Kawasaki disease, detectable by echocardiography. It is the main source of long-term morbidity and drives the urgency of timely immunoglobulin therapy.

A seizure occurring with fever in a child aged 6 months to 5 years without central nervous system infection or prior unprovoked seizures. Simple episodes are brief and generalized, and most children need no further testing.

Continuous seizure activity or recurrent seizures without recovery lasting 5 minutes or longer. It requires immediate benzodiazepine dosing, airway support, and a search for hypoglycemia, infection, and toxic causes.

Resistance to passive knee extension when the hip is flexed to 90 degrees, indicating meningeal irritation. It is one of several meningeal signs whose absence does not reliably exclude meningitis in young children.

Involuntary flexion of the hips and knees when the neck is passively flexed, suggesting meningeal irritation. Like other meningeal signs, it is insensitive in infants and cannot replace cerebrospinal fluid analysis when suspicion is high.

Infection and inflammation of the meninges presenting with fever, headache, neck stiffness, and altered mental status. Infants may show only irritability and poor feeding, and treatment should not be delayed for imaging or lumbar puncture.

Life-threatening organ dysfunction from a dysregulated response to infection. In children it may appear as tachycardia, poor perfusion, and altered mentation, and early antibiotics and fluid resuscitation improve outcomes.

The seconds required for color to return to a blanched fingertip or nail bed after pressure. Prolonged refill suggests poor peripheral perfusion and is used in pediatric shock assessment, though it is affected by ambient temperature.

Hypertension with bradycardia and irregular respirations, a late sign of raised intracranial pressure. Its appearance in a head-injured child signals impending herniation and demands immediate intervention.

A scored assessment of eye opening, verbal response, and motor response used to grade level of consciousness. Pediatric versions adjust verbal scoring for preverbal children and trends guide imaging and disposition.

A validated decision tool that identifies children with minor blunt head trauma who are at very low risk of clinically important traumatic brain injury. It supports selective rather than routine computed tomography.

Radial head subluxation from a longitudinal pull on a child's outstretched arm, causing pain and refusal to use the limb. Reduction by flexion and supination or hyperpronation usually restores function immediately.

A fracture of the distal humerus above the condyles, most common in children after a fall on an outstretched hand. It risks brachial artery and median nerve injury, and displaced fractures need urgent orthopedic evaluation.

Elevated pressure within a closed fascial space that compromises tissue perfusion. In children it presents with pain out of proportion, pain on passive stretch, and tense swelling, and it requires urgent fasciotomy.

A five-type system describing fractures that involve the physis, ranging from separation through the growth plate to crush injury of the plate. Higher types and intra-articular extension carry greater risk of growth disturbance.

Intentional injury of a child, often signaled by injuries inconsistent with the stated history, delayed presentation, or patterned bruising. Recognition requires a thorough examination, appropriate imaging, and mandatory reporting.

Bleeding within the retina, seen with trauma, coagulopathy, or abusive head trauma. Extensive hemorrhages of differing ages in an infant without a credible mechanism raise strong concern for inflicted injury.

A noninvasive estimate of arterial oxygen saturation using light absorption through skin. It is a core vital sign in pediatric emergencies but can be inaccurate with poor perfusion, motion, or abnormal hemoglobin.