Pediatric EM Morsels

JULY 28, 2023

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. 2022; 23( 7): 835- 856. Lesson = treat early!

Fluid Resuscitation 245

Fluid Resuscitation Pediatrics Resuscitation Research 245

Mind The Bleep

DECEMBER 19, 2023

Common stressors in children and adolescents include: Infections: urinary tract infections, gastroenteritis, pneumonias, Poor compliance to insulin therapy, Dehydration, Fasting state, Heatstroke Trauma. or HCO3 10-15 mmol/L: mild DKA (5% dehydration) pH < 7.2 or HCO3 5-10 mmol/L: moderate DKA (5% dehydration) pH < 7.1

Dehydration 98

Dehydration Fluid Resuscitation Shock Resuscitation 98

EMDocs

MAY 15, 2024

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis Sickling leads to vascular occlusion, end-organ ischemia, and decreased RBC lifespan, which, in turn, leads to pain crisis, acute anemia, sequestration, infection, and acute chest syndrome (ACS.) 2022 Aug;58:235-244. Epub 2022 Jun 11.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

EMDocs

MAY 28, 2024

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS 2022 Aug;58:235-244. Epub 2022 Jun 11.

Blood Transfusions 76

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 76

EMDocs

JUNE 27, 2024

2022 Jul 5;328(1):57-68. 2022 Aug;58:235244. Epub 2022 Jun 11. 2022 Aug;58:235-244. Epub 2022 Jun 11. 2022 Aug 29;13:796837. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. C or 100.4 mg/kg, max 0.4

Pediatrics 76

Pediatrics Dehydration EMS Hospitals 76

Mind The Bleep

FEBRUARY 27, 2024

There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose. Answers (1) [B] is the correct answer.

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96

EMDocs

MARCH 11, 2024

2 As of 2022 cholera was estimated to be responsible for over 4 million cases and 143,000 deaths each year, with a case fatality rate of 50% without timely and appropriate treatment. 10 In non-endemic regions, suspicion arises in patients with severe dehydration or death from acute watery diarrhea.

Dehydration 90

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 90