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Approach to Shock

Pediatric Emergency Playbook

Do we recognize shock early enough? World wide, shock is a leading cause of morbidity and mortality in children, mostly for failure to recognize or to treat adequately. So, what is shock? Simply put, shock is the inadequate delivery of oxygen to your tissues. How do we prioritize our interventions? Pericardial Effusion?

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Vasopressor Nonresponse

Northwestern EM Blog

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

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Necrotising Enterocolitis

Mind The Bleep

Common signs and symptoms include: Abdominal distention with prominent veins and discolouration Umbilical flaring Poor feeding Bilious vomiting Abdominal tenderness Bowel changes, including diarrhoea, blood and mucus Lethargy, apnoea, bradycardia Sepsis Risk factors of low birth rate, prematurity and formula feeding. (1, Updated 2022 Aug 8].

Sepsis 52
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The Pediatric Surgical Abdomen

Pediatric Emergency Playbook

2007; 16:27-33. 2007; 298(4):438-451. 2007; 25:1009-1040. Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. J Pediatr Surg 2014; 49:1619. Pyloric Stenosis Aspelund G, Langer JC. Current management of hypertrophic pyloric stenosis. Semin Pedaitr Surg. Dias SC et al.

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Neonatal Jaundice

Pediatric Emergency Playbook

He will be dehydrated – possibly in shock. Check the bilirubin in any neonate you are working up for sepsis. 2007 Nov;25(4):1117-35, vii. 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. 2012; 129(4). Gamaleldin R et al.

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Episode 29 - Assessing Abdominal Pain in Adults: A Rational, Cost-Effective, and Evidence-Based Strategy

EB Medicine

However, it can also be due to hypoxia, sepsis, anemia, PE, or metabolic acidosis, so consider all of those also in your differential. Nachi: Moving on to blood pressure: frank hypotension should make you immediately think of a ruptured AAA or septic shock 2/2 an intra abd infection. was sensitive for 28-day mortality in sepsis.

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IV fluids in the ED: When do we really need them?

EMDocs

Sepsis There has been much controversy over the last two decades around the various nuances of volume resuscitation in ED patients with suspected sepsis, much of which goes beyond the scope of this limited review. Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. Inwald et al.