Pediatric EM Morsels

JULY 28, 2023

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. 2002 Dec;141(6):793-7. Lesson = treat early! PMID: 12461495.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

RebelEM

MAY 29, 2023

Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e.

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

RebelEM

MAY 25, 2023

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2] NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

EMDocs

MAY 15, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Hypervolemia – leads to pulmonary edema: Consider diuresis If euvolemic – start maintenance fluids of D5 in 0.45%NS Causes and outcomes of the acute chest syndrome in sickle cell disease. Published January 2002.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS Causes and outcomes of the acute chest syndrome in sickle cell disease. Clinical Guide for the Management of Sickle Cell Disease, 2002. Published January 2002.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

EMDocs

DECEMBER 16, 2023

Clinical characteristics and outcome of thyroid storm: a case series and review of neuropsychiatric derangements in thyrotoxicosis. Outcome and risk factors associated with extent of central nervous system injury due to exertional heat stroke. Temps greater than 41.5C BMC research notes , 8 , 758. link] Swee, duS., L., & Lim, A.

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68