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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

It is most helpful to do the ultrasound immediately before needle insertion, as movement of the patient may shift cutaneous landmarks from underlying bony structures. This resource offers additional information on ultrasound assisted LP’s. WHY - Why Not? REFERENCES 1. Zambito Marsala, S., Gioulis, M., & Pistacchi, M. Cabellos, C.,

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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism. A prospective, Single-Arm Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. CHEST 2010.

Stroke 136
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Diagnostics: Inflammatory Markers

Taming the SRU

Bacterial Meningitis: IDSA guidelines for 2004 report that a normal CRP value has a high negative predictive value for bacterial meningitis, but sensitivities and specificities vary between studies [35]. Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45]. days (secondary endpoint) [51].

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Bubble Wrap PLUS – July ’23

Don't Forget the Bubbles

Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. 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. Sethi SK, et al.

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The Pediatric Surgical Abdomen

Pediatric Emergency Playbook

2004; 199(4):628-635. Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. J Ultrasound. Intestinal Malrotation in Children: A Problem-Solving Approach to the Upper Gastrointestinal Series. Radiographics. 2006; 26:1485-1500. Kapfer SA, Rappold JF. J Am Coll Surg. Lee HC et al. J Emerg Med. 2012; 43(1):49-51.

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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

The stay in the cardiac intensive care unit (CICU) was further complicated by sepsis, delirium, GI bleeding, and anuric renal failure with need for renal replacement therapy. Another approach is sympathetic chain (stellate ganglion) blockade if you have the skills to do it: it requires some expertise and ultrasound guidance.

EKG/ECG 122
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The Undifferentiated Sick Infant

Pediatric Emergency Playbook

Was there any prenatal care or ultrasound done? Check a glucose ad drug screen Sepsis - Saved for last - You'll almost always treat the sick neonate empirically for sepsis - think of congenital and acquired etiologies. Before you decide on sepsis, ask yourself, could this be a cardiac problem?* Pediatr Clin N Am.