Pediatric Emergency Playbook

JUNE 1, 2017

The previously well child now decompensated: undiagnosed thrombophilia Asymptomatic patent foramen ovale (PFO) is the cause of some cases of cryptogenic vascular disease, such as stroke and MI. 2007; 2:2-11. 2007; 5(3):172-176. However, the presence of PFO alone does not connote higher risk. Congenit Heart Dis. Aliku TO et al.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Pediatric Emergency Playbook

JUNE 1, 2016

Conversely, is the heart rate too slow – even if the stroke volume is sufficient, if there is severe bradycardia, then cardiac output -- which is in liters/min – is decreased. 2007; 35:64-8. Could this be a supraventricular tachycardia that does not allow for enough diastolic filling, leading to poor cardiac output? mg/kg up to 0.5

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

EMDocs

MAY 11, 2024

Answer : Brainstem stroke specifically in the pons resulting in locked in syndrome. CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis?

Stroke 101

Stroke EMS EKG/ECG Radiology 101

EMDocs

OCTOBER 21, 2023

Answer : Basilar Artery Occlusion Epidemiology:  Basilar artery occlusion (BAO) is a subset of the posterior circulation strokes. Posterior circulation strokes are estimated to account for 20% of all strokes, with BAO accounting for ~1% of all strokes. Symptoms may range from days to months prior to stroke onset.

EMS 86

EMS Stroke Outcomes Hospitals 86

EMDocs

JANUARY 29, 2024

This article will discuss blood pressure goals and preferred pharmacotherapy for non-traumatic ischemic and hemorrhagic strokes. Ischemic Strokes: Ischemic stroke is characterized by a blockage of a blood vessel in the brain. The BP targets for patients with ischemic strokes depend on the available therapeutic options.

Stroke 83

Stroke Outcomes EMS Seizures 83

EB Medicine

DECEMBER 1, 2018

In 2007-2008, an oseltamivir-resistant H1N1 strain emerged globally. J: Also, for our NP and PA listeners, we have a special offer this month: You can get a full year of access to Emergency Medicine Practice for just $199--including lots of pharmacology, stroke, and trauma CME--and so much more! Again, that’s www.ebmedicine.net/APP.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

Emergency Medicine Ireland

NOVEMBER 30, 2020

Just to be clear up front we’re going to be talking about taking the lid off for stroke, NOT taking the lid off for TBI. Just to be clear up front we’re going to be talking about taking the lid off for stroke, NOT taking the lid off for TBI. I will get to TBI. I will get to TBI but they are really quite different topics.

Stroke 40

Stroke Outcomes EMS 40

Sensible Medicine

APRIL 29, 2024

Say blueberries and rates of stroke. Then they applied the specification curve analysis to one specific database—the NHANES (National Health and Nutrition Examination Survey) from 2007 to 2014. This time in nutritional epidemiology. Take a moment and think about the methods section of a standard association study.

Stroke 135

Stroke Documentation/Coding Shock Research 135

Pediatric EM Morsels

JULY 21, 2023

[Simpson 1991] No one system universally accepted like adult standard GCS [Simpson 1991, Jain 2022] “There is an evident need for valid standards of paediatric head injury severity, to permit comparisons of different methods of treatment.” PubMed: 29631516] van Heuven AW, Dorhout Mees SM, Algra A, Rinkel GJ. 2008 Apr;39(4):1347-8. 107.498345.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

ACEP Now

OCTOBER 29, 2024

Passively, I watch another clinician’s cursory examination of a critically ill patient to determine how they deem a patient “toxic-appearing” or their bedside neurological assessment to activate a code stroke. Actively, I ask them on their patients that we both had the opportunity to see: What abscesses would they prefer to pack?

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

Pediatric Emergency Playbook

JANUARY 1, 2017

Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. Surgical pain is not “erased” by opioids ( Thomas 2003 , Poonai 2014 ); treating pain improves specificity to certain surgical emergencies with retained diagnostic accuracy ( Manterola 2007 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

ACEP Now

DECEMBER 11, 2023

These included oral and nasal spray formulations of these two decongestants, but a third, phenylpropanolamine, was excluded due to safety concerns relating to hemorrhagic strokes. These changes are of note because data regarding limited efficacy were presented to the FDA in 2007 and 2015.

Administration 64

Administration Outcomes Research Stroke 64

Don't Forget the Bubbles

AUGUST 21, 2023

Stimulation of baroreceptors results in a catecholamine-mediated increase in heart rate , stroke volume, contractility, and systemic vascular resistance (SVR). The LV dysfunction is often asymptomatic in the early stages of the disease. A range of adaptive processes occurs to compensate for falling cardiac output. 24; 15-25 Fenton M.,

Pediatrics 98

Pediatrics Outcomes Research Sepsis 98

Critical Care Now

MAY 12, 2022

The Pre-brief When we think of lysing things in the emergency department (ED), we think of alteplase busting up a blood clot in either ischemic stroke or in patients experiencing a massive pulmonary embolism. 2007; 75: 1523 – 28. Interests include trauma, toxicology, and infectious diseases. Cerumen Impaction. Am Fam Physician.

Infectious Diseases 52

Infectious Diseases Stroke Administration Emergency Department 52

EB Medicine

MAY 3, 2019

Nachi: Just as telestroke has changed stroke care forever, as technology advances, telepsychiatry may provide a solution to easily expand access to outpatient services and consultation in a cost effective manner - offering quick psychiatric care to those that never had access. Jeff: The last cutting-edge topic to discuss is telepsychiatry.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EMDocs

DECEMBER 16, 2023

Both can result in heat exhaustion and heat stroke and have many overlapping symptoms. Patients with heat stroke have hot, dry skin and altered mental status (e.g., C, and heat stroke occurs at a core temperature > 40°C. C, and heat stroke occurs at a core temperature > 40°C. Temps greater than 41.5C Bendall, J.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia EMS Stroke Seizures 80

Don't Forget the Bubbles

FEBRUARY 7, 2024

“Time is brain” urges us to think about thrombolysis or clot retrieval in acute strokes. The cremasteric reflex The cremasteric reflex is a superficial reflex in males, triggered by lightly stroking the inner part of the thigh. The cremaster muscle contracts, elevating the testicle on that side. Soyer, T.U.T.K.U.,

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Dr. Smith's ECG Blog

APRIL 8, 2015

2007 Oct; 33(3): 233–239. to 1.45) for fatal or nonfatal stroke. Of the 67 patients who underwent targeted tests, suspected diagnoses were confirmed in 49 (73%) patients: aortic stenosis (n = 8, 1%), pulmonary embolism (n = 8, 1%), seizures/stroke (n = 30, 5%), and other diseases (n = 3). g/dL —Hypotension (obviously!)

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52