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Bullous Skin Lesions, Meet Emergency Medicine

Taming the SRU

This differential is broad and reflects the clinical diversity of their presentations - in this post we will parse through the specifics of bullous lesions as well as what there is to do for them acutely. There is typically no mucous membrane involvement, however children will also have poor feeding resulting in fluid loss and dehydration.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. 2004 Jul;15(4):248-250. C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

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Don’t Forget the Orbeez!

Don't Forget the Bubbles

Closer to home, the New South Wales Poisons Information Centre (NSWPIC) reported 129 incidents involving water-absorbing beads since 2004. Other symptoms, such as constipation, abdominal pain and dehydration, were also be seen. The vast majority were managed at home, with no adverse events reported. Zamora et al., From Mullens et al.,

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Failure to thrive

Don't Forget the Bubbles

Susan had issues initially with ensuring the correct latch, but after a review with a lactation consultant, feeding is going well. Though it has been hard, they have been coping well and enjoying parenthood. First and foremost, do they look well or unwell? Are there signs of significant dehydration or malnutrition?

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Neonatal Jaundice

Pediatric Emergency Playbook

They may get a little dehydrated, especially if mother’s milk is late to come in. Home care The neonate who is safe to go home is well appearing, and not dehydrated. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. Their livers are immature. Bhutani et al.

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Bubble Wrap PLUS – July ’23

Don't Forget the Bubbles

Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study. 2023 Jun 14;46:8-23 One-year survival and outcomes of infants born at 22 and 23 weeks of gestation in Sweden 2004-2007, 2014-2016 and 2017-2019. 2023 Jun;257:113325. Selvaratnam RJ, et al. J Paediatr Child Health. 2023 Jun 9.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Also consider non-hemorrhagic volume depletion, dehydration : orthostatic vitals may uncover this [see Mendu et al. (3)]. Premonitory symptoms (Nausea, pallor, diaphoresis, flushing), or triggers (Valsalva, Pain, Emotion, Prolonged Standing, Dehydration) are very useful in making the diagnosis. Vasovagal syncope is generally benign.