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EM@3AM: Hyperthermia

EMDocs

As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. Clinical decision making in seizures and status epilepticus. Gronert, G.

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Big Labs, Little People

Pediatric Emergency Playbook

There are two main reasons for an elevated lactate: the stress state and the shock state. The shock state is due to tissue hypoxia, seen in septic shock. We should use lactate to detect occult shock. Children compensate so well for shock, that subtle tissue hypoxia may not be detected until later. Pediatrics.

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The Undifferentiated Sick Infant

Pediatric Emergency Playbook

The combination of abnormalities determines the category of pathophysiology: respiratory distress, respiratory failure, CNS or metabolic problem, shock, or cardiopulmonary failure. Does this child look volume depleted? Endocrine Emergencies - Could this be congenital adrenal hyperplasia with low sodium, high potassium, and shock?

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Neonatal Jaundice

Pediatric Emergency Playbook

He will be dehydrated – possibly in shock. Acute bilirubin encephalopathy may progress to an abnormal neurologic exam, seizures, apnea, or coma. 2006 Jun;11(3):214-24. My take away: we now have some evidence basis for using filtered sunlight as an adjunct for babies well enough to go home. He will be irritable. Pediatrics.

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MI in Children

Pediatric Emergency Playbook

The infant in shock after a ‘cold’: myocarditis Beware of the poor feeding, tachycardic, ill appearing infant who “has a cold” because everyone else around him has a ‘cold’. 2006; 87:e168-e171. Viral myocarditis Presenting with Seizure and Electrocardiographic Findings of Acute Myocardial Infarction in a 14-Month-Old Child.

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Sickle Cell Disease Module

Don't Forget the Bubbles

It has been routine practice in the UK since 2006. Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. Do not use pethidine since it can cause seizures and CNS hyperexcitability. How is sickle cell disease diagnosed?