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Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. 2004 Jul;27(7):1541-6. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. The mortality rate for cerebral edema is 21%–24%.

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Adjunctive Methylene Blue in Septic Shock?

RebelEM

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. 95% CI 15.4

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Peri-Intubation Hypotension – Dose Induction Dose Matter?

RebelEM

This approach has been shown to benefit patients when agents like propofol and midazolam are used. ( Russotto 2022 , Choi 2004 ). Outcomes: Primary: Postintubation hypotension (SBP < 100 mm Hg) 15 minutes post-intubation. However, there is scant evidence on the more common induction agents ketamine and etomidate. mg/kg 1.33

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SGEM#450: Try Again – Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage

The Skeptics' Guide to EM

Background: In hemorrhagic stroke, the ABCs for resuscitation remain the same, but can also be categorized as: Airway Management: This is an important aspect for patients with a poor neurologic exam or those who are not protecting their airways. Reversal of Warfarin: Freeman et al. Reversal of Warfarin: Freeman et al.

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Blood Pressure Management in Neurologic Emergencies: What Does the Evidence Say?

EMDocs

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. Lowering the MAP may mitigate these risks and possibly improve outcomes. doi: 10.1161/01.str.0000014509.11540.66.

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Intubation

PHEM Cast

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. 2004 Aug;99(2):607-13, Hasegawa K et al. Resuscitation. Resuscitation. Click here to hear what our friends over at the Resus Room think about Airways 2 References (kindly shared by Rich) Davis DP et al.

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The Pediatric Surgical Abdomen

Pediatric Emergency Playbook

2004; 199(4):628-635. Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. Intestinal Malrotation in Children: A Problem-Solving Approach to the Upper Gastrointestinal Series. Lee HC et al.