This EM Basic podcast episode features a rebroadcast of a Pediatric Emergency Playbook episode by Dr. Tim Horeczko, focusing on the undifferentiated sick infant. Dr. Horeczko emphasizes a structured approach to assessing and managing these critical cases, advocating for a broad differential diagnosis beyond just sepsis. He introduces the Pediatric Assessment Triangle (PAT) and the "Misfits" mnemonic as tools to aid in the evaluation, urging listeners to consider trauma, heart disease, endocrine emergencies, metabolic issues, inborn errors of metabolism, seizures, formula problems, intestinal disasters, and toxins before settling on sepsis as the primary diagnosis. The episode includes a case study of a neonate with hypoplastic left heart syndrome to illustrate the importance of considering congenital heart disease and the use of the hyperoxia test and prostaglandin E1 (alprostadil) in management. The podcast also touches on the availability heuristic and how cognitive biases can affect diagnostic accuracy.
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