Pediatric DDx

Pediatric Emergency Department Differential Diagnosis

Adult
Common ED Complaints
Common Pediatric ED Complaints
Overview & quick triage
Crying / Inconsolable Infant
IT CRIES mnemonic
Dehydration (Pediatric)
% loss → fluid plan
Failure to Thrive (FTT)
Inadequate intake vs ↑ losses vs ↑ demand
Neurologic
Altered Mental Status (Pediatric)
AEIOU-TIPS, hypoglycemia first
GI / Feeding
👶 Abdominal Pain — DDx by Age
Age-stratified pediatric abdominal pain workup
Constipation
Functional vs organic
Diarrhea (Pediatric)
Hydrate first, dx after
Feeding Difficulties
Mechanical, neuro, GI, cardiac
Intestinal Colic
Rule of 3s, exclude red flags
Reflux / Regurgitation
GER vs GERD vs alarm signs
Vomiting (Pediatric)
Bilious = surgical until proven
Neonatal
Cyanosis & Blue Spells (Neonate)
Cardiac vs pulmonary, hyperoxia test
Hyperbilirubinemia / Jaundice
Direct vs indirect, AAP 2022 thresholds
Infectious / Fever
Fever (Pediatric)
Age-stratified workup
Sepsis (Pediatric)
Phoenix criteria, 1-hr bundle
Meningitis (Pediatric)
LP, empiric abx, dex
Oral Thrush (Candidiasis)
Nystatin first-line
Respiratory
Stridor & Pediatric Respiratory Emergencies
Croup, epiglottitis, FB, RTA, anaphylaxis
Dermatologic
Diaper Rash
Irritant vs candida vs bacterial
Pediatric Rash
Morbilliform / vesicular / petechial / urticarial
Scabies
Permethrin, treat household
Endocrine / Environmental
Heat-Related Illness
Cramps → exhaustion → stroke
Lead Poisoning
BLL thresholds & chelation
Genitourinary
Undescended Testes (Cryptorchidism)
Refer by 6 mo, surgery by 1 y
Musculoskeletal
Knee Pain (Pediatric)
Age-stratified DDx; don't miss SCFE & septic joint
Hip Pain (Pediatric)
Limp child — septic hip, SCFE, Perthes, transient synovitis
Wrist Pain (Pediatric)
FOOSH injuries — don't miss scaphoid & physeal fractures
Elbow Pain (Pediatric)
Supracondylar, nursemaid's, lateral condyle — neurovascular checks
Ankle Pain (Pediatric)
Salter-Harris before sprain; Tillaux & triplane in adolescents
Shoulder Pain (Pediatric)
Clavicle fx, AC injury, dislocation, SCFE-equivalent (SCFP)
Back Pain (Pediatric)
Red flags strong — discitis, tumor, spondylolysis, abuse
Neck Pain (Pediatric)
Trauma vs infection vs inflammatory — when to image
Hand & Finger Pain (Pediatric)
Finger fx, tendon injuries, scaphoid-adjacent pitfalls
Foot Pain (Pediatric)
Midfoot/forefoot/toe injuries, osteomyelitis, return precautions