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EM@3AM: Sialadenitis

EMDocs

Risk factors include oral neoplasms, sialolithiasis, advanced age, dehydration, ductal foreign bodies, concomitant tracheostomy, and recent receipt of an anesthetic agent. Published 2018 Nov 15. Patients who are immunocompromised may experience infection related to gram-negative organisms (e.g., J Clin Imaging Sci. 2020;64:87-104.

EMS 96
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Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

As well as requesting relevant investigations and reviewing her drugs, you send paired urine and serum electrolytes to calculate a fractional excretion of sodium to categorise the cause as pre-renal vs other (see [link] for more information). 2018 Apr;44(4):409-417. Epub 2018 Mar 27. Intensive Care Med.

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emDOCs Podcast – Episode 94: GLP-1 Agonist Complications

EMDocs

Multiple well-designed, multicenter, multinational studies suggest GLP-1 agonists are associated with improved glucose control in diabetes type 2 and approximately a 15% reduction in weight over 1-2 years (around 2/3s of patients regain weight if treatment is stopped). 2018 Apr 17;319(15):1580-1591. Obesity affects over 40% of U.S.

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What Are the Complications of Sickle Cell Trait?

Pediatric Education

He had no concerns and he was doing well in school and with his friends. He had a sprained ankle the previous year that he says was well-healed. With your sickle cell trait you usually shouldn’t have any problems, but dehydration could cause problems for you. The past medical history was positive for sickle cell trait.

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SGEM#254: Probiotics for Pediatric Gastroenteritis – I Can’t Go For that…No Can Do

The Skeptics' Guide to EM

NEJM 2018 Guest Skeptic: Dr. Anthony G. NEJM 2018 Guest Skeptic: Dr. Anthony G. She is otherwise well appearing and has normal vitals and examines normally. Date: April 16th, 2019 Reference: Schnadower et al. Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children.

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Found comatose with prehospital ECG showing "bigeminal PVCs" and "Tachycardia at a rate of 156"

Dr. Smith's ECG Blog

The patient had a glucose of 1400, was severely dehydrated, and after receiving 4 liters of fluid, albuterol, and insulin, the K had dropped precipitously to 5.8 Comment by K EN G RAUER, MD ( 12/11/2018 ): = I love this case — because it brings home 3 of my favorite teaching points about electrolyte disorders and ECG interpretation.

EKG/ECG 52
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Could you have prevented this young man's cardiac arrest?

Dr. Smith's ECG Blog

Sinus tachycardia with unequivocal evidence of hyperkalemia, including widened QRS with "pulled apart" morphology (widened QRS) compared to baseline, as well as clearly peaked T-waves. We advised them to give more calcium as well as other hyperkalemia treatment during transport. This patient must receive calcium as soon as possible.

EKG/ECG 52