The "upgoing thumb sign" can be used as part of a comprehensive neurological evaluation to help distinguish stroke mimic from actual stroke. It won't replace MRI, but it can be part of the neurological exam, just like we use the Babinski sign. One editorial from 1993 suggested calling it the Hachinski-Babinski, after the discover. Here's how to do it.
This large multi-center prospective study of pediatric sedation found adverse events occurred in 12%, most mild desaturation or vomiting. Severe adverse events occurred in 1%. Ketamine given alone was the safest drug. Propofol alone, ketamine + fentanyl, or ketamine + propofol were associated with greater risk for severe adverse events.
No clinical criteria were powerful diagnostic discriminators of the presence or absence of pneumonia in children, though some were fair. When in doubt, a CXR is probably warranted, with the exceptions of obvious bronchiolitis or asthma. Low SpO2 (</= 95 to 96%) or increased work of breathing were the best predictors of radiographic pneumonia in children; auscultatory findings and tachypnea were poor. You don't need a CXR if no cough, no fever, no tachypnea, and normal SpO2.
I couldn't state it better than the author's conclusion: "In adult patients, the presence of whooping or posttussive vomiting should rule in a possible diagnosis of pertussis, whereas the lack of a paroxysmal cough or the presence of fever should rule it out. In children, posttussive vomiting is much less helpful as a clinical diagnostic test."