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Travel-Related Illnesses in Children

Pediatric EM Morsels

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries. In the 1950’s travel accounted for 25 million international tourists. A study of swiss tourists found they compromised 53.4%

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Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

She had septic shock on presentation and was resuscitated with 60ml/kg of balanced crystalloid solution and escalating vasoactive medications. If the fractional excretion of sodium is <1%, you agree with your consultant that you will also ask the nurses to account for the replacement of 5% dehydration (900ml) over 48h (≈ 19ml/h).

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

2015 May;169(4):492-505. Epub 2015 Mar 30. smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 0.4 Br J Haematol.

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Are we on the right TRACT? 

Don't Forget the Bubbles

These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. Published 2015 Feb 2. Were the study groups similar at the start of the trial? 2015;13:21.

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Episode 30 - Emergency Department Management of Patients With Complications of Bariatric Surgery

EB Medicine

Consider IV access and early IV fluids in those at risk for dehydration and intra-abdominal infections. Jeff: Tachycardic patients should make you concerned for hypovolemia 2/2 dehydration, sepsis, leaks, and blood loss. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause.

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Episode 19 - Cannabinoids: Emerging Evidence in Use and Abuse

EB Medicine

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 Jeff: The hyperemetic phase lasts 24-48 hours and can lead to dehydration, electrolyte abnormalities, and weight loss. Be sure to look for and treat dehydration, acute renal failure, and rhabdo though. Subst Abus.

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Neonatal Jaundice

Pediatric Emergency Playbook

They may get a little dehydrated, especially if mother’s milk is late to come in. Home care The neonate who is safe to go home is well appearing, and not dehydrated. Most babies with hyperbilirubinemia are dehydrated, which just exacerbates the problem. None of them became dehydrated or became sunburned. Bhutani et al.