Pediatric Emergency Playbook

AUGUST 1, 2017

Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. J Pediatr Surg 2014; 49:1619. 2014; 8(5):533-541. Hirschsprung disease, associated syndromes and genetics: a review.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

RebelEM

JANUARY 25, 2023

Emery Med J 2014; 31(3): 248-9. Small bowel obstruction: Outcome and cost implications of admitting service. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 PMID: 24532357 Oyasiji T et al.

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

The Skeptics' Guide to EM

DECEMBER 16, 2017

You quickly assess him in the resuscitation room, the team attempts intravenous (IV) access and collects labs while you give 10mg of midazolam intramuscularly and the seizures seem to stop. There was no statistical difference in the primary outcome between 33C vs. 36C ( SGEM#82 ). He then has another seizure in the department.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 40

Pediatric Emergency Playbook

APRIL 1, 2016

We could use it to track treatment , and see if we can clear the lactate; decreased lactate levels are associated with a better outcome in adults. Myopericarditis in Children: Elevated Troponin I Level Does Not Predict Outcome. 2014; 14:83. The confusion and frustration with lactate is that we often test the wrong people for it.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified. As a result — cardiac cath was not performed — since results of a cath would not have altered the unfortunate outcome. Knotts RJ, Wilson JM, Kim E, Huang HD, Birnbaum Y.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

EB Medicine

JULY 8, 2019

Jeff: A 2014 study even showed an up to 80% reduction in the likelihood of developing DM2 postoperatively at the 7-year mark. overall, these surgeries are relatively safe with one 2014 review publishing a 10-17% overall complication rate and a perioperative 30 day mortality of less than 1%. 2014(8):CD003641. Am J Emerg Med.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Don't Forget the Bubbles

NOVEMBER 29, 2023

Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. 2014 May;32(5):452-6. Epub 2014 Jan 15. 2014 Oct;113(4):549-59.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

EMDocs

DECEMBER 18, 2023

8 Based on multiple randomized controlled trials (RCTs), SSC 2021 guidelines suggest against using procalcitonin as a screening method to guide initiation of antibiotic therapy, as no difference in clinical outcomes was appreciated. 15 Two changes were elucidated in the 2021 SSC guidelines for fluid resuscitation.

Sepsis 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

RebelEM

MAY 15, 2024

2014 Aug 21;124(8):1251-8; quiz 1378. doi: 10.1182/blood-2014-02-482612. Epub 2014 May 28. Changing aetiology, clinical features, antimicrobial resistance, and outcomes of bloodstream infection in neutropenic cancer patients. Time to antibiotics and outcomes in cancer patients with febrile neutropenia. 2014;14:162.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Northwestern EM Blog

APRIL 15, 2024

“Tracheostomy: Epidemiology, Indications, Timing, Technique, and Outcomes.” Respiratory Care 59 (2014): 895 - 919. Tracheotomy outcomes and complications: a national perspective. As with any high stress situation in resuscitation, it helps to fall back onto our ABCs, airway being of principle importance here.

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

ACEP Now

OCTOBER 10, 2023

Both INTERACT-2 and ATACH-2 showed no statistical difference in their primary outcome between intensively lowering the BP and a less-intensive strategy. Background There have been a couple of large and influential trials published on BP management after an intracranial hemorrhage (ICH). Reference Ma LM, Hu X, Song L, et.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. They looked at 119 adult patients from an (unspecified) number of trauma centres. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Taming the SRU

MAY 5, 2023

2014, Hjortrup, Haase et al. The CLASSIC trial is a randomized controlled trial conducted in the ICU setting which compared restrictive versus standard fluid strategies with a primary outcome of death by 90 days in patients with septic shock. Safety outcomes Serious adverse event occurrences were similar in both groups.

Sepsis 52

Sepsis Shock Administration 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. The association between hyperoxia and patient outcomes after cardiac arrest: analysis of a high-resolution database.

Resuscitation 40

Resuscitation Pediatrics Administration Emergency Nursing 40

Don't Forget the Bubbles

MAY 3, 2023

Results of this study showed that the use of low-dose insulin infusion led to similar clinical outcomes and fewer adverse events compared to the standard-dose insulin infusion. The effect of hand position on chest compression quality during CPR in young children: Findings from the Videography in Pediatric Resuscitation (VIPER) collaborative.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

PHEM Cast

FEBRUARY 25, 2021

Prognostication Better outcomes: Rescued and BLS commenced < 5-10 min Children Those who have not aspirated Water temperature < 10 o C, core body temperature 33-35 o C Neurologically intact on arrival at hospital Minimum blood pH > 7.1, Resuscitation. New Engl J Med. 366: 2102–10. Tipton & Golden (2011). 82: 819-824.

Resuscitation 52

Resuscitation Hospitals Outcomes Wellness 52

EMDocs

SEPTEMBER 25, 2023

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). Resuscitation 2013; 84(11): 1500 – 4. PLoS One 2014; 9(11): e112779. Epub 2014 Feb 17. PMID: 23911630 Kim WY et al. PMID: 25402500 Forsythe SM et al. PMID: 24536033.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

EMDocs

SEPTEMBER 7, 2023

2,10 Initial stabilization of DEG toxicity includes correcting acid-base abnormalities, electrolyte abnormalities, and volume resuscitation. Volume resuscitation as needed while adjusting for any developing acute kidney injury. Long-Term Renal and Neurologic Outcomes among Survivors of Diethylene Glycol Poisoning.”

Poisoning 92

Poisoning CDC Administration Emergency Department 92

RebelEM

MARCH 13, 2023

Nevertheless, mortality of prehospital traumatic cardiac arrest (TCA), and survivability with good neurologic outcome, remain the gold standards of trauma care in and out of the hospital and are effectively the criterion by which we measure outcomes in the trauma literature. Discussion: Dead On Scene: The 96.2% mortality rate and 43.5%

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

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. Early Volume Expansion and Outcomes of Hemolytic Uremic Syndrome. Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome (HUS). 2014 [Cited June 2020]; 7: 231-239. What causes haematuria in children?

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Don't Forget the Bubbles

JUNE 10, 2024

Despite advancements in neonatal care, NEC remains a significant concern due to its association with adverse outcomes, including prolonged hospitalisation, the need for surgical intervention, and increased mortality rates. What is the pathophysiology of necrotising enterocolitis? How do you treat necrotising enterocolitis? Can we prevent NEC?

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

EB Medicine

OCTOBER 1, 2018

In 2014, the Society of Critical Care Medicine and the European Society of Intensive Care Medicine started a task force, and by 2016, updated definitions were out again! Patient’s need adequate fluid resuscitation. Just a reminder that a history of CHF doesn’t preclude proper fluid resuscitation. Jeff : Yes it has! Sepsis-3!!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

FEBRUARY 12, 2024

Trauma surgeons have traditionally relied on ABGs to assess acid-base status for overall prognostication of trauma injury severity and to screen for occult injury or malperfusion, as this might alter management and aggressive resuscitation. As previously noted, ABGs are not easily obtained (let alone in the critically ill trauma patient).

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

PulmCCM

FEBRUARY 17, 2025

Cardiopulmonary resuscitation (CPR) is performed on more than 250,000 people in U.S. When a patient is failing to recover spontaneous circulation, the clinician in charge must decide whether and when to cease resuscitation efforts. This series will try to help with the last part: ending resuscitation efforts, knowing you did your best.

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CPR Hospitals Resuscitation Documentation/Coding 112

Emergency Medicine Journal

NOVEMBER 21, 2024

Background Because of their young age and lack of known comorbidities, paediatric patients with out-of-hospital cardiac arrest (OHCA) often undergo prolonged cardiopulmonary resuscitation (CPR). We aimed to determine the association between prehospital and in-hospital CPR duration and neurological outcomes.

Hospitals 52

Hospitals Outcomes Resuscitation CPR 52

Broome Docs

DECEMBER 22, 2024

Their primary outcome was survival at 30 days, and there was no difference between the two groups (4.5% Favourable neurologic outcomes were seen in 2.7% The primary outcome here was ROSC, and there was no difference (30% with IO vs 29% with IV, RR 1.06, 95% CI 0.9-1.24). 2018 Nov 22;379(21):2002-2014. of the IV group).

Blood Transfusions 52

Blood Transfusions Hospitals Outcomes Emergency Department 52

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

EMDocs

JUNE 27, 2024

2014 Feb;69(2):144-51. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort.

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

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

EMDocs

JUNE 7, 2023

Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. Iran Red Crescent Med J 16: e5072, 2014. Indira M, Andrews MA, Rakesh TP: Incidence, predictors, and outcome of intermediate syndrome in cholinergic insecticide poisoning: a prospective observational cohort study.

Poisoning 98

Poisoning Airway Management Seizures PPE 98

Taming the SRU

FEBRUARY 3, 2025

Additional Treatments for Severe Electrolyte Derangements Severe Hyperuricemia If uric acid 8 mg/dL or 25% increase from baseline develops, then rasburicase should be administered in addition to IV fluid resuscitation. Academic Press; 2014:39-64. original document created by author of post. Renal Disease in Cancer Patients.

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

Dr. Smith's ECG Blog

MARCH 8, 2025

During the resuscitation, she received amiodarone 450 mg IV, lidocaine 100 mg IV, and magnesium 6 g IV. 3:07 PM, slow atrial fibrillation with electromechanical dissociation At this time, the patient's family terminated resuscitation efforts and the patient was pronounced dead. Was her outcome to be expected for ostial RCA OMI?

EKG/ECG 75

EKG/ECG CPR Resuscitation Wellness 75