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emDOCs Podcast – Episode 93: BRASH Syndrome

EMDocs

An inciting event will typically push them over the edge into BRASH syndrome: Dehydration Hypotension from sepsis or another condition GI illness Dosage increase of a chronic medication (e.g., Published February 15, 2016. The key is a patient who is on an AV nodal blocker and who has some sort of risk factor for renal insufficiency.

Shock 88
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Failure to thrive

Don't Forget the Bubbles

Susan had issues initially with ensuring the correct latch, but after a review with a lactation consultant, feeding is going well. Though it has been hard, they have been coping well and enjoying parenthood. First and foremost, do they look well or unwell? Are there signs of significant dehydration or malnutrition?

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Don’t Forget the Orbeez!

Don't Forget the Bubbles

Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. Other symptoms, such as constipation, abdominal pain and dehydration, were also be seen. Children will swallow almost anything. Why should Orbeez be an exception? Zamora et al., 2016;11:39-43.

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Subcutaneous Rehydration

Pediatric Emergency Playbook

⇒ You have a stable child who just needs fluids, but no laboratory tests ⇒ You’ve tried PO hydration, to no avail, despite anti-emetics ⇒ You’re poking the stable, but dehydrated child repeatedly without success What now? Well, it turns out, what is old is new again. 2016 Jun;30(6):549-57. Sound far-fetched? Palliat Med.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. 2016 Dec;91(12):1185-1190. Epub 2016 Oct 3. C or 100.4 mg/kg, max 0.4

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Bubble Wrap PLUS – July ’23

Don't Forget the Bubbles

Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study. 2023 Jun 14;46:8-23 One-year survival and outcomes of infants born at 22 and 23 weeks of gestation in Sweden 2004-2007, 2014-2016 and 2017-2019. 2023 Jun;257:113325. Selvaratnam RJ, et al. J Paediatr Child Health. 2023 Jun 9.

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ToxCard: Iron

EMDocs

6 Can see subsequent electrolyte disturbances and dehydration related to severity of GI symptoms. McGraw Hill; 2016. Typically presents in the first few hours following ingestion. Children without vomiting within 6 hours of iron ingestion will almost never have significant toxic effects. Hernandez SH, Nelson LS. & Rangan, C.