Pediatric Emergency Playbook

AUGUST 1, 2020

2008 Nov;36(11):2226-37. In: Pediatric Emergency Medicine, Baren JM, Rothrock SG, Brennan JA, Brown L (Eds), Saunders Elsevier, Philadelphia 2008. J Athl Train. 2013 Jul-Aug; 48(4): 546–553. DeFranco MJ et al. Environmental issues for team physicians. Am J Sports Med. Ishimine P. Hyperthermia. Jardine DS. Heat illness and heat stroke.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Stroke Burns Pediatrics 52

PulmCCM

FEBRUARY 12, 2024

SCCM Guideline Update: Steroids for Community-Acquired Pneumonia, ARDS, Septic Shock Steroids are good medicine in the ICU, U.S. SCCM made its statement unilaterally, without the European Society of Intensive Care Medicine (ESICM), its partner on the 2008 and 2017 updates, or the American Thoracic Society (ATS).

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Northwestern EM Blog

FEBRUARY 14, 2022

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. 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.

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EMDocs

NOVEMBER 4, 2023

Published 2008 Sep 19. 2008) ISBN:0521871123. J Emerg Trauma Shock. Scrotal abscess as a complication of perforated appendicitis: A case report and review of the literature. 2008;1(1):165. Cureus 12(7): e8991. doi:10.7759/cureus.8991 8991 ​​Schlossberg D. Clinical Infectious Disease. Cambridge Univ Pr. Insights Imaging.

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PHEM Cast

APRIL 16, 2018

The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Use of CPR in hemorrhagic shock, a dog model. 2008; 64: 9-14/ The heart of the matter: utility of ultrasound of cardiac activity during traumatic arrest. 2012; 73: 102-10. EMJ 2017; 34: 860-900.

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PHEM Cast

JULY 14, 2016

British Orthopaedic Association Standards for Trauma (BOAST); 2008. 2008 Apr 15;5(3):214–9. Journal of Emergencies, Trauma, and Shock. 2008 Apr 22;178(9):1141–52. BOAST2: SPINAL CLEARANCE IN THE TRAUMA PATIENT. Hauswald M, Ong G, Tandberg D, Omar Z. Out-of-hospital spinal immobilization: its effect on neurologic injury.

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Dr. Smith's ECG Blog

NOVEMBER 3, 2023

The notes now refer to the patient being in cardiogenic shock, on pressors. hours from presentation, where he was found to have an acute thrombotic LAD occlusion which was stented with resulting TIMI 3 flow, but still the patient was in severe cardiogenic shock. Time = 3 hours: the next troponin returns at 60 ng/L.

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EMDocs

JANUARY 4, 2024

Cardiogenic shock and hypotension can occur (systolic heart failure with reduced ejection fraction.) 10,12 Refractory shock or malignant arrhythmias occur in < 5% of patients. 2008 Apr;51(4):412-5, 415.e1. Cardiotoxicity: Overdose can cause prolonged QRS and QTc intervals. Ann Emerg Med. doi: 10.1016/j.annemergmed.2007.06.004.

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Emergency Medicine Ireland

OCTOBER 30, 2023

First up is the VASST trial, (Russel et al 2008 NEJM). Vasopressin versus norepinephrine infusion in patients with septic shock. New Engl J Medicine 358 , 877–87 (2008). Effect of Early Vasopressin vs Norepinephrine on Kidney Failure in Patients With Septic Shock: The VANISH Randomized Clinical Trial. Gordon, A.

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EMDocs

APRIL 22, 2024

However, as shock resolved and hemodynamic stability improved, RV strain and underfilling of the LV remained apparent 30 minutes after ROSC (Vid 4). Rockville (MD): Office of the Surgeon General (US); 2008. 2008 Mar;28(3):370-2. A thin wall (diameter <5mm) is suggestive of an acute etiology”. RV pressures > LV pressures.

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PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

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Pediatric Emergency Playbook

AUGUST 1, 2017

J Med Genet 2008; 45:1. J Pediatr Gastroenterol Nutr 2008; 46:13. 2008; 15-21. 2008; 22-28. 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. J Pediatr Surg.

Pediatrics 52

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ACEP Now

MAY 8, 2023

Question I was shocked to see bank runs in March 2023. Homeowners doing this en masse with adjustable-rate mortgages contributed to the Global Financial Crisis of 2008. I thought those went away after regulatory changes in the Great Depression.

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Thinking Critical Care

MAY 18, 2023

In 1983 I was an Englishman abroad, the London anaesthetist who was appointed to be the English anaesthetist on the Shock Team only because the outstanding candidate from Oxford had preferred to take up a job doing muscle relaxant research with Kitz and Katz in the USA. 4] The research agenda at the time was broad.

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ACEP Now

SEPTEMBER 3, 2024

billion dollars in one of the largest leveraged buyouts since the 2008 financial crisis, of which over 7 billion dollars was new debt obligation.18 He was shocked when the hospital CEO took him up on it, but a year later, volumes increased 30 percent with his emphasis on quality rather than cost-cutting.

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ETM Course

MAY 3, 2017

2008 Feb;64(2 Suppl):S38-49 Tourniquet use for civilian extremity trauma. Ft Detrick, Maryland: Borden Institute; 2012. Practical use of emergency tourniquets to stop bleeding in major limb trauma. Kragh JF Jr, Walters TJ, Baer DG, Fox CJ, Wade CE, Salinas J, Holcomb JB. J Trauma Acute Care Surg. 2015 Aug;79(2):232-7

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Taming the SRU

AUGUST 30, 2023

A 2008 review in the International Journal of Medicine on spinal epidural abscess (SEA) agreed that inflammatory markers (specifically ESR and CRP) are generally sensitive in the diagnosis of SEA, but are not specific. 2008 Aug;75(8):557-66. Notably, up to 40% of patients with native vertebral osteomyelitis had a normal WBC [33-34].

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Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Dr. Smith's ECG Blog

OCTOBER 6, 2023

His included cardiogenic shock, V Tach, AV block. de Winter et al in N Engl J Med 359:2071-2073, 2008. This poor echo can be seen even after very good reperfusion because myocardium that is still viable can be "stunned" and take weeks to recover. But the ECG is telling us that the myocardium will probably not recover.

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Pediatric Emergency Playbook

OCTOBER 1, 2015

He is in compensated shock. Pediatr Clin N Am 55 (2008) 1343–1358 Garton HJ. Pediatr Clin N Am 55 (2008) 1299–1314 Munck A et al. The Huber needle is not a resuscitative line. Obtain proper access to give fluids -- do not rely on the port-a-cath. Vascular devices are notoriously troublesome. Hydrocephalus. J Am Coll Surg.

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ACEP Now

SEPTEMBER 13, 2023

Dr. Prescott, currently retired, was Chief Academic Officer of the Association of American Medical Colleges from 2008-2021 where he says he worked with “every single school of medicine in the U.S.,” There was no center at the NIH that looks at emergency care as a specialty.” Washington (DC): National Academies Press (US); 1966.

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Pediatric Emergency Playbook

DECEMBER 1, 2015

It’s a high-flow artery to the face, and if disrupted, the child may have significant bleeding and possibly hemorrhagic shock. 2008; 15:988-994. Electrical Injuries: Shocking or Subtle?” The labial artery is just deep to the burn, and as the eschar sloughs off, it can be exposed. J Pediatr Surg. 2004;39(8):1233-1237. Horeczko T.

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PulmCCM

OCTOBER 16, 2023

For example, a patient who presented with shock and mitral regurgitation, received a central line for vasopressors on day 0, and was found to have bacteremia from blood cultures drawn on day 3 due to endocarditis would have a CLABSI, but not a CRBSI. Many states have instituted mandatory reporting of CLABSI.

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EB Medicine

JULY 8, 2019

From the 80’s to 2008, the worldwide prevalence of obesity nearly doubled! Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause. From the 80’s to 2008, the worldwide prevalence of obesity nearly doubled! Additionally, back in 2010, it was estimated that 6.6% million adults!!

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EB Medicine

MAY 3, 2019

Jeff: If those figures seem a bit high, another CDC study found that in a general population survey of a quarter million people between 2006-2008, 9% met the criteria for major depression. Jeff: And while it seems crass to even mention the financial impact, the number is shocking - suicide has an estimated economic burden of $5.4

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EMDocs

JANUARY 20, 2024

Symptoms of heart failure and cardiogenic shock may develop in more severe cases. Patients with features of shock may require vasopressors, and the decision on the specific drug hinges on the presence or absence of left ventricular outflow tract (LVOT) obstruction.

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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.

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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 ). Unexplained tachycardia may be the early signs of shock.

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Pediatrics Soft Tissue Injuries Burns Emergency Department 40

ALiEM

JUNE 5, 2023

Glucocorticoid therapy should be considered in anthrax meningitis, cutaneous anthrax with extensive tissue edema involving the head and neck, or anthrax with vasopressor-resistant shock [9]. Geneva: World Health Organization; 2008. When should you administer post-exposure prophylaxis (PEP)? Emerg Infect Dis. 2014;20(2):e130687.

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EMDocs

JANUARY 20, 2025

Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. 13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear. Inwald et al.

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RebelEM

FEBRUARY 7, 2024

Chorioamnionitis is a bacterial infection of fetal amnion and chorion membranes. Triple antibiotic coverage is recommended. Suggested regimens include: Ampicillin AND Gentamicin AND Clindamycin OR Metronidazole Update tetanus vaccination Usually requires dilation and curettage to remove any retained products of conception or foreign bodies.

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Advanced Emergency Nursing from AENJ

SEPTEMBER 13, 2015

The weight of the fetus upon the aorta and IVC, especially when supine, embarrasses return circulation, contributes to shock, and O 2 delivery to the fetus may be sluggish. Use the NODESAT technique. Monitor oximetry and capnography. Chandrasekhar, S., Bulich, L. Topulos, G. P., & Datta, S. Airway Changes during Labor and Delivery.

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EMDocs

MARCH 11, 2024

The clinical picture of this patient was consistent with hypovolemic shock secondary to acute cholera infection. 18 Patients with signs and symptoms of severe dehydration or shock, including stupor, coma, uncontrollable vomiting, extreme fatigue that prevents drinking, and unstable vital signs should receive IV fluid resuscitation.

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