Pediatric Emergency Playbook

AUGUST 1, 2017

J Med Genet 2008; 45:1. J Pediatr Gastroenterol Nutr 2008; 46:13. 2008; 15-21. 2010; 149(3):386-391. Hirschprung Disease Amiel J, Sproat-Emison E, Garcia-Barcelo M, et al. Hirschsprung disease, associated syndromes and genetics: a review. Arshad A, Powell C, Tighe MP. Hirschsprung's disease. BMJ 2012; 345:e5521. J Pediatr Surg.

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Pediatrics Ultrasounds Resuscitation Sepsis 52

Northwestern EM Blog

FEBRUARY 14, 2022

Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation. Interestingly, when vasopressin was studied in 2008, it similarly did not show a mortality benefit when added to norepinephrine infusion in septic shock2.

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Shock Resuscitation Fluid Resuscitation Sepsis 52

EMDocs

JANUARY 4, 2024

Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. 2008 Apr;51(4):412-5, 415.e1. Comparison of Resuscitative Protocols for Bupropion Overdose Using Lipid Emulsion in a Swine Model. Ann Emerg Med. doi: 10.1016/j.annemergmed.2007.06.004.

Seizures 92

Seizures EKG/ECG Poisoning Shock 92

EMDocs

APRIL 22, 2024

During this resuscitation two different ultrasound machines were used to capture images due to a malfunction with the first machine after initial images were captured. Rockville (MD): Office of the Surgeon General (US); 2008. 2008 Mar;28(3):370-2. Upon arrival, our 25-year-old patient was in PEA arrest. Am J Prev Med.

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Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations. 2008 Jan;26(1):31–8. Li Y, editor.

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Emergency Department Ultrasounds Administration Burns 92

RebelEM

MARCH 13, 2023

However, we might expect on-scene advanced trauma resuscitation to prolong prehospital time sizably. Many studies suggest that increased time spent on scene correlates with worse outcomes for trauma (Stiell 2008) and all-cause incidence (Isenberg 2005) across all levels of prehospital care. 2008 Apr 22;178(9):1141-52.

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Basic Life Support EMS Outcomes Resuscitation 52

Advanced Emergency Nursing from AENJ

APRIL 29, 2015

Every five years, a conference determines the current state of the art for resuscitation recommendations. For babies born at term, it is best to begin resuscitation with room air rather than 100% oxygen. Resuscitation, 85(9), 1142-1148. The optimal Fio2 during the immediate period after cardiac arrest is still debated.

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Resuscitation Pediatrics Administration Emergency Nursing 40

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Guest Skeptic: Dr. Rory Spiegel (@EMNerd_) is a clinical instructor at University of Maryland, a recent graduate of Stony Brook’s Resuscitation Fellowship, and a current Critical Care fellow at University of Maryland. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. NEJM January 2018. NEJM January 2018.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

EMDocs

JANUARY 29, 2024

Case Resolution: In addition to standard measures for resuscitation, the patient is started on a nicardipine drip to target an SBP < 160 mmHg and neurosurgery is urgently consulted. 2008 Jul;26(7):1446-52. Neurosurgery takes the patient to surgery after the CT angiogram suggests aneurysmal rupture. 2019 Aug;50(8):2023-2029.

Stroke 99

Stroke Outcomes EMS Seizures 99

Pediatric Emergency Playbook

OCTOBER 1, 2015

The Huber needle is not a resuscitative line. Vascular Devices: assume the line is not functional, and use another to resuscitate, especially in port-a-caths. Pediatr Clin N Am 55 (2008) 1343–1358 Garton HJ. Pediatr Clin N Am 55 (2008) 1299–1314 Munck A et al. He is in compensated shock. Hydrocephalus. J Am Coll Surg.

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Pediatrics Fractures Resuscitation Burns 40

Advanced Emergency Nursing from AENJ

JULY 9, 2015

ü With foresight, plan for your alternatives based upon what you have now , until the patient can be brought safely to conventional resuscitation room settings. Resuscitation, 56(1), 83-89. NREMT (2008). December 2008 JEMS Vol. SGAs and some methods of intubation can be placed in the prone position. McClusky, S.,

Airway Management 40

Airway Management Pediatrics Resuscitation Emergency Nursing 40

Sensible Medicine

SEPTEMBER 29, 2023

2008 Feb;117(6):743-53. Resuscitation. General Cardiovascular Risk Profile for Use in Primary Care. Circulation. Available from: [link] [2] Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PW. The impact of the use of the Early Warning Score (EWS) on patient outcomes: a systematic review.

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Research Hospitals Academics Emergency Department 60

Thinking Critical Care

MAY 18, 2023

This hypovolaemic shock state was to be maintained for one or two hours before the shed blood was retransfused and the effect of experimental drugs on resuscitation could be tested. [11] I do not recall one experiment getting as far as the resuscitation stage. The reason became clear. 12] N Engl J Med 1984 Nov 01. 311:1137-43.

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Shock Research Sepsis Resuscitation 40

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. 4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy. She appears pale and dehydrated , and her level of alertness fluctuates. She is apyrexial, tachycardic and normotensive. What causes haematuria in children? Pediatr Nephrol.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Sensible Medicine

SEPTEMBER 29, 2023

2008 Feb;117(6):743-53. Resuscitation. General Cardiovascular Risk Profile for Use in Primary Care. Circulation. Available from: [link] [2] Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PW. The impact of the use of the Early Warning Score (EWS) on patient outcomes: a systematic review.

Research 40

Research Hospitals Academics Emergency Department 40

Don't Forget the Bubbles

JUNE 10, 2024

Initial Management Supportive Care : Initial management involves stabilising the infant, which includes fluid resuscitation, cessation of enteral feeds, and provision of total parenteral nutrition (TPN) to rest the bowel and meet the nutritional needs of the infant. How do you treat necrotising enterocolitis? Clark, R., & Swanson, J.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

EB Medicine

JULY 8, 2019

From the 80’s to 2008, the worldwide prevalence of obesity nearly doubled! Jeff: Resuscitation should be aimed at early fluid replacement with IV crystalloids for hypovolemic patients and packed RBC transfusions for patients presumed to be unstable from hemorrhage. Additionally, back in 2010, it was estimated that 6.6% million adults!!

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Emergency Department Sepsis Operations Dehydration 40

Intensive Blog

MARCH 13, 2024

Everything ECMO 048: History of ECPR evidence and considerations for future research Author: Dr George Walker Peer reviewer: A/Prof Aidan Burrell Introduction The first recorded attempts to resuscitate patients were as early as 1530 where Swiss physician Paracelsus used fireplace bellows to reinflate the lungs of those who had stopped breathing.

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CPR Resuscitation Hospitals Outcomes 130

Don't Forget the Bubbles

JANUARY 27, 2025

Management ED management should focus on appropriate resuscitation of the patient and early referral to the surgical team. Rousseau V, Massicot R, Darwish AA, Sauvat F, Emond S, Thibaud E, Nihoul-Fekete C (2008) Emergency management and conservative surgery of ovarian torsion in children: a report of 40 cases, 21(4):201-6, PMID: 18656074.

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Ultrasounds Emergency Department Pediatrics Dehydration 76

EMDocs

JANUARY 20, 2024

This patient’s recent diarrheal illness raises suspicion for hypovolemia, which would be treated with fluid resuscitation (D) , but her moist oral mucosa and dilated inferior vena cava suggest an eu- or hypervolemic state. 2008 Mar;155(3):408-17. Additional fluids will not improve her condition and may worsen it. Am Heart J.

EMS 101

EMS Fluid Resuscitation Shock EKG/ECG 101

RebelEM

MAY 15, 2024

2008 Sep;1138:329-50. Give appropriate fluids, vasopressors, and antibiotics. Application of the MASCC and CISNE Risk-Stratification Scores to Identify Low-Risk Febrile Neutropenic Patients in the Emergency Department. Ann Emerg Med. 2017 Jun;69(6):755-764. doi: 10.1016/j.annemergmed.2016.11.007. 2016.11.007. Epub 2016 Dec 29. Freifeld, A.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Dr. Smith's ECG Blog

MAY 23, 2022

ERS ( E arly R epolarization " S yndrome" ) in which early repolarization ECG findings are seen in a patient with a history of PMVT ( P oly M orphic VT ) or resuscitated idiopathic VT/VFib. The CHALLENGE: In 2008 Hassaguerre found an increased prevalence of ER in patients with idiopathic VFib ( N Engl J Med 358:2016-2023, 2008 ).

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EKG/ECG Documentation/Coding Hyperthermia / Hypothermia Research 52

Pediatric Emergency Playbook

JANUARY 1, 2017

Topical ethyl chloride vapo-coolant offers transient pain relief due to rapid cooling and may be used just prior to an IV start ( Farion 2008 ). Needleless lidocaine injectors may facilitate IV placement without obscuring the target vein ( Spanos 2008 , Lunoe 2015 ). 2008 Jul 1;179(1):31-6. 2008 Aug;24(8):511-5.

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Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Dr. Smith's ECG Blog

JANUARY 21, 2023

In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. Pacing Clin Electrophysiol 2008 Choi SH, Lee OH, Yoon G-S, et al. The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4. ECG met STEMI criteria and was labeled STEMI by computer interpretation.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

EMDocs

JULY 19, 2023

8 As always, remember to correct electrolyte abnormalities and provide fluid resuscitation as indicated. doi: 10.1186/2008-2231-22-46. In short, there is not a whole lot of evidence to support this, but if patient has had a recent ingestion and is not altered, you can consider gastrointestinal decontamination with AC.

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Poisoning Fluid Resuscitation Administration Seizures 92

Dr. Smith's ECG Blog

JANUARY 31, 2025

al in 2008, and is eponymously named after the main author. Sadly, he could not be resuscitated. From the original description by deWinter et al ( N Engl J Med 359:2071-2073, 2008 ) There is a new ECG pattern without ST elevation that signifies acute occlusion of the proximal LAD ( L eft A nterior D escending ) coronary artery.

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EKG/ECG Ambulance Services Outcomes Wellness 114

EMDocs

JANUARY 20, 2025

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. In lower-resource settings, the evidence is stronger against a liberal approach to volume resuscitation. Andrews et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Her rejoinder was “I didn’t think to blow through the nose, but, boy, did I blow between the teeth! ” The nose in Early Modern Expired Air Resuscitation: Early teaching in expired-air resuscitation was three-fold. Few people now remember that a strong early proposal in the move for expired air resuscitation was Mouth to Nose.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

Advanced Emergency Nursing from AENJ

SEPTEMBER 13, 2015

When: The patient needs airway control for resuscitation of mother or child, emergent surgery for maternal or fetal indications; block cannot be effected or would be unsafe. The concept of post-mortem caesarian delivery is being supplanted by ante -mortem resuscitative uterine extraction to save both mother and child. Chandrasekhar, S.,

Airway Management 40

Airway Management Resuscitation Critical Access Emergency Nursing 40

EMDocs

MARCH 11, 2024

Rehydration therapy for patients with cholera should include volume resuscitation and electrolyte repletion. Patients who cannot tolerate oral intake of fluids should receive intravenous (IV) fluid resuscitation but are encouraged to start drinking ORS as soon as they are able. Trop Med Infect Dis. 2023;8(3):169. Kirk M, ed.

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Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111