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Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage. Don’t await for fancy meds to arrive from pharmacy. Load gauze onto Magill forceps. Well… sometimes it starts again.

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EM@3AM: Stercoral Colitis

EMDocs

Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation.

EMS 94
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ToxCard: Iron

EMDocs

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Published 2012 Jul 1.

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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). Pediatric Emergency Care 28(11): p 1129-1131, November 2012. |

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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. 2012 PMID: 21893125.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 93
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Policy Playbook: Labor Actions and Unionization in Healthcare

EMDocs

3 Increasing Strikes and Unions Labor actions in healthcare can disrupt normal hospital operations, potentially impacting costs and threatening patient quality of care. 2012 Feb 1;4(1):127-57. Despite a plateau in overall union membership of around 10% in 2023 1 , major labor actions shook the U.S. Why does it matter? 5 January 2023.