PEM CHATT

Episode Summary In this special adult EM edition recorded at the AAENP conference in Nashville, Toni sits down with Jill Ogg-Gress, DNP, APRN-NP, FNP-C, ENP-C, who presented "The Silent Emergency: Managing Fever in the Immunocompromised Population." Jill explains why immunocompromised patients can look deceptively well, why a "low-grade" temperature should still trigger a full workup, and why these patients shouldn't wait in the waiting room. The conversation covers the four high-risk patient groups, the initial lab workup, how procalcitonin fits in, when to consider an LP, empiric antibiotic choices, and the value of the ED pharmacist. Biggest Take-Home Recognize who these patients are and don't delay the evaluation. Get them back, get labs going, and start antibiotics within the first hour so they have better outcomes down the road. Timestamps 00:00 – Intro: special adult EM edition from AAENP Nashville 00:17 – Welcome Jill Ogg Russ and "The Silent Emergency" lecture 00:48 – The four high-risk immunocompromised groups 01:28 – Why 100.4 (or less) and subtle symptoms should trigger a workup 02:11 – Protocols ("Code 60") and getting patients out of the waiting room 03:00 – Initial workup: CBC/ANC, cultures, lactate, ESR/CRP 03:23 – Procalcitonin thresholds and the procal of 112 04:20 – When to consider an LP 04:43 – Biggest take-home: don't delay, antibiotics in the first hour 05:08 – Empiric antibiotics: cefepime, vancomycin, antifungals 05:42 – The value of ED pharmacists 06:40 – Wrap-up and disclaimer Disclaimer Any opinions expressed on this podcast are solely those of the speakers and do not reflect the opinions or policies of any employer or hospital system. In many states, advanced practice providers work collaboratively with physicians; always consult your physician leader when appropriate. Any cases discussed have been de-identified, and details have been changed or omitted to protect patient privacy. Some cases may represent composites of clinical experiences, and any resemblance to a specific individual beyond the educational context is unintentional. This podcast is designed for medical education purposes only. The speakers have made every effort to provide current, evidence-based information; however, this should never replace your own effort to validate current evidence-based practice before implementing a plan of care. Any pathway or algorithm discussed may not reflect those of your healthcare system and may vary by geographic location or employer. This podcast is not intended to provide medical advice or treatment plans for patients and their families. If you have a medical concern or an emergency, please be seen by a local medical provider or call 911.

Title: When Ear Pain Is a Red Flag: Recognizing Necrotizing Otitis Externa Episode Description: What happens when a routine ear infection becomes a potentially life-threatening diagnosis? In this episode of PEM CHATT, recorded at the AAENP conference in Nashville, we welcome Jill Ogg-Gress to discuss a memorable case of necrotizing otitis externa. An older, immunocompromised patient initially diagnosed with otitis externa returned to the emergency department just three days later with worsening symptoms, hearing loss, and facial droop. What initially raised concern for stroke ultimately led to the diagnosis of necrotizing otitis externa with early osteomyelitis. Jill shares the clinical clues that prompted further investigation, the importance of recognizing cranial nerve involvement, and why early imaging findings may not tell the whole story. In This Episode: Recognizing red flags in patients with persistent or worsening otitis externa Why severe nocturnal ear pain deserves additional attention Hearing loss and facial nerve dysfunction as concerning neurologic findings The limitations of CT imaging in early disease When to escalate care, involve ENT, and consider advanced imaging Avoiding diagnostic anchoring when a patient's clinical course doesn't fit the initial diagnosis Clinical Pearl: A patient with otitis externa who develops disproportionate pain, hearing loss, or cranial nerve abnormalities needs reassessment for invasive infection. A CT without obvious bony erosion does not necessarily exclude early necrotizing otitis externa. The Takeaway: Sometimes the most important diagnostic skill is recognizing when the initial explanation no longer fits. Listen to PEM CHATT for practical conversations and clinical insights from emergency medicine professionals. Disclaimer: This podcast is intended for healthcare professional education and does not replace clinical judgment, institutional protocols, or specialist consultation.

25 | The Untrustworthy Normal with Rachel Cody, DNP, AGACNP-BC, FNP-BC, ENP-C   Recorded live at the AANP Conference, Nashville, Tennessee Host: Toni Dobson | Guest: Rachel Cody Run time: about 6 minutes   A normal lab can feel like permission to relax. Sometimes it is. Sometimes it is the most dangerous result on the chart. In this conference episode, Toni sits down with Rachel Cody to recap her AANP lecture, "The Untrustworthy Normal." They talk about why labs often lag behind pathology, why every test you order should answer a specific question on your differential, and why a clinician's gut is real clinical data. Rachel walks through a sepsis case where a normal white count and a normal lactate gave false reassurance, and she explains why some diagnoses, like necrotizing fasciitis, will never be made by a lab. The bottom line: treat the patient, not the numbers. Clinical Pearls Before you order, ask: "What will I do with this result?" Match every lab to a diagnosis on your differential. A normal result outside the right time window is not a normal result. It is a missing result. Look at the medication list for anything that can blunt the body's response (immunosuppressants, steroids, beta-blockers). Put your hands on the patient. The exam finds what the labs can't. Early-career APPs: trusting your instincts and escalating is good practice, not a weakness. Timestamps 00:00 — Introduction 00:20 — The Untrustworthy Normal: lecture overview 00:50 — Key take-homes: labs lag pathology, D-dimer, CT timing for SAH 01:30 — Treating the patient, not the numbers 02:00 — Clinical intuition is data: talking to consultants when studies are normal 03:00 — Case study: the sepsis patient on methotrexate 04:10 — Matching diagnostics to differentials; necrotizing fasciitis vs. cellulitis 05:00 — "Lay your hands on your patients" 05:15 — Closing and disclaimer Disclaimer Any opinions expressed on this podcast are solely those of the speakers and do not reflect the opinions or policies of any employer or hospital system. In many states, advanced practice providers work collaboratively with physicians; always consult your physician leader when appropriate. Cases discussed have been de-identified, and details have been changed or omitted to protect patient privacy. Some cases may be composites of clinical experiences. This podcast is for medical education only and does not replace your own review of current evidence-based practice. Pathways or algorithms discussed may not reflect those of your healthcare system. This podcast does not provide medical advice. If you have a medical concern or emergency, see a local medical provider or call 911.

24 | Tick Paralysis: Easy to treat but easy to miss with Toni Dobson, DNP, FNP-C, ENP-C ⏱️ Runtime: about 13 minutes 📝 Episode Summary In this conference-series episode, Toni steps into the role of both host and guest to share her AAENP presentation on tick paralysis. It's a rare neurologic presentation in the emergency department and one that ED clinicians often miss. Toni explains why: she had it on her differential, searched the patient for a tick and still missed it. The episode covers how tick paralysis develops and who's most at risk. Toni walks through a pediatric case of acute-onset ataxia, builds a differential and shows how to tell tick paralysis from Guillain-Barré syndrome (GBS). She also shares a practical ED algorithm that starts with a thorough skin exam. LINK to algorithm: https://drive.google.com/file/d/1Ld-3mh1m89_dVaFo82CtCS-oqQa3xll7/view?usp=sharing ⏰ Timestamps 00:00 Intro 00:18 Welcome and the AAENP conference series 00:39 Why tick paralysis, and why it gets missed 01:24 What tick paralysis is: the tick, the toxin and the timeline 02:25 Ascending paralysis, mortality and treatment 02:59 Who's at risk 03:23 Why ED clinicians miss it 04:15 The case: a 3-year-old with acute ataxia 05:53 Building the differential 07:19 Tick paralysis vs. GBS 09:31 The ED algorithm 10:14 The skin exam and the flea comb 11:00 After the tick is removed: observe, then discharge or admit 11:32 When symptoms don't improve 12:13 Take-home points 13:05 Disclaimer ⚖️ Disclaimer Any opinions expressed on today's podcast are solely those of the speaker and do not reflect the opinions or policies of any employer or hospital system. In many states, advanced practice providers work collaboratively with physicians. Always consult your physician leader when appropriate. Any cases discussed on this podcast have been de-identified, and details have been changed or omitted to protect patient privacy. Some cases may also represent composites of our clinical experiences, and any resemblance to a specific individual beyond the educational context is unintentional. This podcast was designed for medical education purposes only. Its speakers have made every effort to provide the most current and evidence-based information. However, that should never replace one's own effort to validate current evidence-based practice before implementing a plan of care. Any pathway or algorithm that we may have discussed may not reflect those of your healthcare system. Please be aware that there may be changes based on your geographic location or current employer site. This podcast was not designed in any way to provide medical advice or treatment plans for patients and their families. If you have a medical concern or an emergency, please be seen by a local medical provider or call nine one one for assistance.

23 | Delivering Difficult News with Cory Edgar, DMSc, PA-C Host: Toni Dobson Guest: Corey Edgar DMSc, PA-C 🩺 — oncology and bone marrow transplant clinician, born and raised in Florida, whose doctoral work focused on delivering difficult messages 📝 Episode Summary Delivering bad news is not a "soft skill" — it is a core clinical skill that can be learned, practiced, and improved. In this episode, Toni sits down with Corey Edgar to walk through the SPIKES protocol, a structured framework for difficult conversations. Corey breaks down each step with practical ED examples, explains why the warning shot and the pause matter so much, and reminds us that bad news is not only cancer or death. Anything that changes a patient's or family's anticipated future counts — which means most of us deliver bad news on every shift. 🔑 Key Takeaways 💪 Communication is a learnable skill. Practice it and let others watch and give you feedback. 🎯 "Warning shot, then be quiet." If you remember one thing, remember this. ⏳ Silence will feel longer than it is. Five seconds of quiet with emotional tension feels like forever — give your patient that space anyway. 🛑 When emotion rises, the information download stops. The visit and the engagement continue, but the data dump does not. 🤔 Not knowing everything is okay. Name what is known, what is unknown, and what comes next. 🧩 Bad news is defined by the recipient, not by us. A new type 1 diabetes or celiac diagnosis may be very manageable medically, but it still changes a family's anticipated future. ⏰ Timestamps 00:00 — Intro 00:16 — Meet Corey Edgar 00:36 — Why "soft skills" are actually core clinical skills 01:05 — The data: malpractice, satisfaction, adherence, and outcomes 01:56 — Communication as a learnable skill and an introduction to SPIKES 02:22 — S: Setting 02:54 — P: Perception 04:06 — I: Invitation 05:30 — SPIKES as a procedure: the prep work 05:51 — K: Knowledge and the warning shot 06:56 — Example: the abdominal pain case 07:48 — The power of the pause 09:03 — E: Emotion and empathy 10:30 — S: Summary and strategy — naming uncertainty 11:38 — Toni's "too calm" story and the missed warning shot 12:00 — "Warning shot, then be quiet" 12:32 — What counts as bad news 13:29 — Wrap-up 13:38 — Disclaimer ⚖️ Disclaimer Any opinions expressed on today's podcast are solely those of the speaker and do not reflect the opinions or policies of any employer or hospital system. In many states, advanced practice providers work collaboratively with physicians. Always consult your physician leader when appropriate. Any cases discussed on this podcast have been de-identified, and details have been changed or omitted to protect patient privacy. Some cases may also represent composites of our clinical experiences, and any resemblance to a specific individual beyond the educational context is unintentional. This podcast was designed for medical education purposes only. Its speakers have made every effort to provide the most current and evidence-based information. However, that should never replace one's own effort to validate current evidence-based practice before implementing a plan of care. Any pathway or algorithm that we may have discussed may not reflect those of your healthcare system. Please be aware that there may be changes based on your geographic location or current employer site. This podcast was not designed in any way to provide medical advice or treatment plans for patients and their families. If you have a medical concern or an emergency, please be seen by a local medical provider or call 911 for assistance.

🎙️ PEM CHATT Podcast: SCAPE (Sympathetic Crashing Acute Pulmonary Edema) 📍 Special Adult EM Edition, Live from the AAENP Conference in Nashville, Tennessee 🎧 Host: Toni Dobson 🩺 Guest: Brandy Ganatra, DNP, AGACNP-BC, an acute care/ICU nurse practitioner who now works in emergency medicine in Nebraska ⏱️ Runtime: About 6 minutes 📝 Episode Summary In this special adult emergency medicine edition of PEM CHATT, Toni talks with Brandy Ganatra at the AAENP conference about SCAPE, or sympathetic crashing acute pulmonary edema. This is the patient many of us learned to call "flash pulmonary edema." Brandy covers the pathophysiology behind the newer name, how to recognize these patients quickly, why high-dose nitroglycerin is the mainstay of treatment, and why early, aggressive management in the ED can turn a crashing patient around in minutes. 🔑 Key Takeaways 🫁 What Is SCAPE? SCAPE is sympathetic crashing acute pulmonary edema, the presentation many clinicians know as "flash pulmonary edema." The term is fairly new. Cardiology often calls it acute decompensated heart failure, but critical care and ED literature increasingly use "SCAPE." The name points to the pathophysiology, and the pathophysiology points to the treatment. Think bigger than "the lungs are full of fluid." ⚡ The Pathophysiology A sympathetic surge causes marked peripheral vasoconstriction and a sharp rise in systemic vascular resistance (SVR), which is the afterload the left ventricle has to pump against. The core need is afterload reduction. 🚨 Recognition: What Does It Look Like? Extremely tachypneic and tachycardic Profoundly hypertensive Hypoxic and tripoding, with severe respiratory distress Pink, frothy sputum from acute pulmonary congestion Onset is sudden. "It happens in an instant." Common history: heart failure or hypertension, sometimes with missed medications 💊 Management: High-Dose Nitroglycerin + Non-Invasive Ventilation 💊 Nitroglycerin is the mainstay of therapy. Lower doses mostly cause venous dilation, which is why nitro is used for angina and ischemia. SCAPE calls for high doses. Brandy starts IV nitro at 100 mcg/min and may titrate up to 400 mcg/min. One sublingual nitro tablet is roughly equal to 80 mcg/min, which puts the IV dosing in perspective. "It's not as scary as we think." Nitro has a short half-life (about 2–5 minutes). Titrate down instead of turning the drip on and off. 😮‍💨 Support breathing at the same time. Use non-invasive ventilation (CPAP/BiPAP) for the high work of breathing, with the goal of avoiding intubation. 🔀 Do things in parallel, not one at a time. We like our ABCs, but here several interventions need to start together. 📋 A practical sequence: Give sublingual nitroglycerin. While you do that, set up non-invasive ventilation. While you do that, prepare to start IV nitroglycerin, then titrate. With timely afterload reduction, restored cardiac output, and breathing support, these patients can turn around in 15–20 minutes. 🔄 💎 Final Pearls 👀 Recognize it early, monitor closely, and treat aggressively. Timing and the right management are critical. 🤝 Teamwork is essential. 🚫 Don't get stuck on diagnostics. Don't wait for a chest X-ray to confirm it. Put the POCUS probe on 🔍 and look for volume overload. 💪 Act quickly and with confidence. Current literature supports high-dose nitroglycerin as safe and effective in the ED. ⏰ Episode Timestamps [00:00] Intro: special adult EM edition from the AAENP conference [00:18] Meet guest Brandy Ganatra [00:39] What is SCAPE, and why the new name? [01:28] How bedside management has changed: getting comfortable with high-dose nitro [02:41] Recognition: what these patients look like [03:17] Nitroglycerin dosing: low vs. high dose, starting at 100 mcg/min [04:00] Nitro safety: short half-life, and sublingual compared with IV [04:50] Turning patients around in 15–20 minutes [05:12] Take-home points: teamwork, POCUS, and acting with confidence [05:44] Closing and disclaimer ⚖️ Disclaimer Any opinions expressed on today's podcast are solely those of the speaker and do not reflect the opinions or policies of any employer or hospital system. In many states, advanced practice providers work collaboratively with physicians. One should always be careful to consult with their physician leader when appropriate. Any cases discussed on this podcast have been de-identified, and details have been changed or omitted to protect patient privacy. Some cases may also represent composites of our clinical experiences, and any resemblance to a specific individual beyond the educational context is unintentional. This podcast was designed for medical education purposes only. Its speakers have made every effort to provide the most current and evidence-based information. However, that should never replace one's own effort to validate current evidence-based practice before implementing a plan of care. Any pathway or algorithm that we may discuss may not reflect those of your healthcare system. Please be aware that there may be changes based on your geographic location or current employer site. This podcast was not designed in any way to provide medical advice or treatment plans for patients and their families. If you have a medical concern or an emergency, please be seen by a local medical provider or call 911 for assistance.

21 | Submersion Injuries with Dr. Sarah Lazarus In this episode of PEM CHATT, host Toni Dobson is joined by pediatric emergency physician Dr. Sarah Lazarus to break down the critical topic of pediatric drowning and submersion injuries. Together, they explore real-world clinical scenarios, debunk common myths, and provide practical guidance for both clinicians and caregivers. Drowning remains one of the leading causes of death in children, particularly ages 1–4, and even non-fatal events can result in devastating long-term consequences. This episode emphasizes both clinical management and prevention strategies—highlighting how quickly these events occur and how often they happen despite close supervision.   🔑 Key Takeaways Drowning is fast and silent Often occurs in seconds with little to no splashing or noise Terminology matters “Dry drowning” and “secondary drowning” are outdated and misleading Pathophysiology is respiratory Water aspiration → surfactant washout → impaired gas exchange → hypoxia Observation is critical True aspiration events should be monitored for ~6 hours from the time of incident Imaging isn’t always helpful Chest X-rays can lead to unnecessary admissions without changing outcomes Management is symptom-driven Asymptomatic → observe Symptomatic → oxygen support, VBG, imaging, admission Cardiac arrest cases are severe Focus on oxygenation, ventilation, rewarming, and consider ECMO early Prevention requires layers No single strategy (including swim lessons) is sufficient ⚠️ Clinical Pearls Drowning is an evolving process, not a single moment event Patients should be observed for 6 hours after the event Symptoms appearing days later are NOT due to drowning Pediatric arrests are often respiratory in origin → prioritize ventilation Antibiotics and steroids are not routinely indicated Most toddler submersion injuries do NOT require C-spine immobilization 🧠 Myth Busting “Dry drowning” isn’t real. This term originated from outdated medical concepts but is no longer used. If a child had a true submersion injury, symptoms will present within 6 hours—not days later. 🛟 Prevention Insights Use “arms reach, eyes reach” supervision Perform a home swim test (can the child swim 2 pool lengths?) Understand that: Swim lessons ≠ drowning proof Life jackets ≠ guaranteed safety Drowning prevention requires multiple overlapping layers of safety Resources and references: Brenner’s article: https://pubmed.ncbi.nlm.nih.gov/19255386/ CHOA Algorithm: https://www.choa.org/-/media/Files/Childrens/medical-professionals/clinical-practice-guidelines/submersion-event-ed.pdf NEJM Article: https://www.nejm.org/doi/full/10.1056/NEJMra1013317#figures_media Timeline 00:00 Welcome to PEM CHATT 00:19 Why Drowning Matters 01:12 Meet Dr. Sarah Lazarus 02:14 Bread Pudding is my favorite 03:34 Drowning Terminology 04:38 Who Is Most at Risk 06:08 Silent Drowning Explained 09:15 Systemic Effects Checklist 11:03 Fresh vs Salt vs Cold 11:46 Three Patient Categories 12:36 Case One Asymptomatic Kid 14:12 Avoiding Unneeded X-Rays 16:12 Case Two Symptomatic Infant 18:40 Imaging and Labs Strategy 18:58 When to Skip Antibiotics 20:02 Arrest Scenario Walkthrough 20:30 Resuscitation Priorities And ECMO 21:54 When Resuscitation Is Futile 22:40 C-Spine Immobilization Debate 23:24 Drowning CPR Starts with Breaths 25:29 Injury Prevention Work and Stats 27:14 Layers of Drowning Prevention 30:01 Dry Drowning Myth Busting 33:16 Key Pearls and Closing    

In this “Rewind” episode, Toni sits down with retired pediatrician Dr. Margaret “Meg” Wang, who trained and practiced through the pre-vaccine and early-vaccine eras of pediatrics, including the 1989–1990 measles epidemic in New York City. Together, they walk us through what pediatrics looked like before Hib, pneumococcal, varicella, and rotavirus vaccines and what we might face again as vaccination rates fall and herd immunity wanes. You’ll hear vivid, frontline stories of: Hib meningitis, occult bacteremia, and epiglottitis in infants and toddlers, when full sepsis workups (blood, urine, CSF, IV antibiotics, 72-hr admissions) were standard for many febrile children through 36 months of age. “Old-school” periorbital and buccal cellulitis from Hib—bright red with a violaceous hue, toxic kids, high fevers, and automatic LP + admission. Measles in an actual epidemic: the prodrome with the “three Cs” (cough, coryza, conjunctivitis), Koplik spots, and that classic confluent, head-to-toe rash, plus why measles is not a mild illness. Varicella beyond the “nuisance rash”: super-itchy multi-stage lesions, serious skin infections, and a child who developed Staph aureus bacteremia and tricuspid valve endocarditis requiring open-heart surgery—all from chickenpox in an unvaccinated child. Rotavirus winters: the green, watery, diaper-filling diarrhea, relentless fluid losses, metabolic acidosis, hypoglycemia in infants, and frequent admissions—versus the near-disappearance of severe rotavirus disease after the vaccine. Clinically, Toni and Dr. Wang dig into: How fever protocols for 0–36 month-olds have evolved from routine full sepsis workups to today’s more nuanced approach with viral testing and inflammatory markers like CRP and procalcitonin. Bedside pattern recognition for epiglottitis (toxic, drooling, tripod positioning, chin thrust, neck extension) and why you never upset these kids or put a tongue blade in their mouth—just get them upright and straight to controlled intubation with anesthesia. The role of parental gut instinct and why “this is not my kid” should always make you pause and reassess. 🔑 Key Takeaways: Vaccines didn’t just reduce visit volumes; they completely changed inpatient and ED workflows, procedure rates (LPs!), and long-term morbidity (e.g., deafness after meningitis). As coverage declines, we won’t just see “more fevers”—we’ll see sicker kids, more invasive procedures, more admissions, and more preventable complications. Your vaccine counseling today is part of preventing tomorrow’s “Rewind” from becoming reality again. 📌 Call to Action: Hit play, then share this episode with a colleague, resident, or trainee who has never seen these diseases and thinks of measles or chickenpox as “mild.” Their future patients are counting on it. 💉🧠

Fever Management in Children 3-36 Months: An Evidence-Based Approach Join host Toni Dobson and guest Andrea Perkins, PA-C, as they dive deep into the evidence-based management of fever in otherwise healthy children aged 3-36 months. This comprehensive episode covers everything from basic fever physiology to algorithmic approaches for both vaccinated and unvaccinated children. Key Topics Covered: Defining fever and understanding the pathophysiology The critical difference between fever and hyperthermia Vaccination status and risk stratification Comprehensive physical exam pearls Evidence-based algorithms for immunized vs. unimmunized children UTI risk assessment and when to obtain urine samples Laboratory workup guidelines based on vaccination status Fever management strategies and parent education Addressing fever phobia in families Resources: UTI Calculator: www.uticalc.com UpToDate management guidelines: UpToDate Link Andrea's algorithm: Link to Algorithm Next Episode: Dr. Margaret Wang joins us to discuss the return of vaccine-preventable illnesses and how we can prepare. 📺YouTube: https://www.youtube.com/@PEMChatt 🟢Spotify: https://open.spotify.com/show/6oaYDeq5AXIZGxBvEIxaTs 🍎 Apple Podcasts: https://podcasts.apple.com/us/podcast/pem-chatt/id1806882767

In this episode of PEM CHATT, the focus is on febrile neonates, the first part of a two-part series on pediatric fever management. Host Toni speaks with Dr. Lindsay McHale, a pediatric emergency medicine physician, to discuss how historical protocols for managing febrile neonates have evolved with advances in vaccines, PCR testing, and maternal surveillance. The discussion covers the 2021 AAP guidelines for managing febrile neonates, the essential components of a fever workup, interpretation of test results, and the nuances of decision-making across neonatal age groups. Practical insights on performing lumbar punctures, antibiotic selection, and interpreting potentially confounding results, such as bloody CSF taps, are shared, along with real-life case examples that illustrate the complexities involved. The conversation aims to equip clinicians with an evidence-based approach to improve patient outcomes in various clinical settings. #PEM #NP #APP #PA #pediatrics #emergencymedicine #emergencynursepractitioner #fellowship #medicaleducation #podcast #children #nursepractitioner #clinicalpharmacists #febrileneonate #sickbabies #lumbarpuncture 00:00 Introduction to Febrile Neonates 00:57 Historical Management of Febrile Neonates 01:25 Advancements in Medicine and New Guidelines 02:23 Introducing Dr. Lindsay McHale 03:56 Defining Febrile Neonates 04:54 Managing Febrile Neonates in the ER 05:51 Cold Babies and Controversies 07:45 Treating Fever in Neonates 09:06 Inclusion and Exclusion Criteria for Febrile Neonate Protocol 10:27 Why Neonates Are High-Risk 11:40 Code 60: Rapid Response for Febrile Neonates 12:30 Hypothetical Case Study: Febrile Neonate 14:24 Parental Concerns and Communication 19:57 Detailed Workup and Testing 23:27 Antibiotic Choices for Neonates 25:13 Dosing Nuances in Neonatal Antibiotics 26:49 Tips for Performing Lumbar Punctures 30:25 Interpreting Test Results in Neonates 32:46 AAP Sepsis Protocol for Neonates 40:06 Managing Febrile Infants: Case Studies 44:18 Conclusion and Next Episode Preview   LINKS: AAP Guideline https://publications.aap.org/pediatrics/article/148/2/e2021052228/179783/Evaluation-and-Management-of-Well-Appearing?autologincheck=redirected CHOP Algorithm https://www.chop.edu/clinical-pathway/febrile-infant-emergent-evaluation-clinical-pathway THE MISFITS  https://drive.google.com/file/d/1gpUsQOxMlbuqI-6hBDcZEF5ckpJWhWWb/view?usp=sharing