Remove 2022 Remove Dehydration Remove Resuscitation
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Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

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! Pediatr Diabetes.

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Diabetic Ketoacidosis in Paediatrics

Mind The Bleep

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

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But Can You Just PO?

Taming the SRU

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none. AtherlyJohn et al.

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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

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.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. 2022 Aug;58:235-244. Epub 2022 Jun 11. HbS has reduced solubility in the setting of hypoxia, leading to sickling of the RBCs.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

2022 Jul 5;328(1):57-68. 2022 Aug;58:235244. Epub 2022 Jun 11. 2022 Aug;58:235-244. Epub 2022 Jun 11. 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 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02

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Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

RebelEM

Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc). 2022 Sep 7. However, digoxin is known for its rate-control properties and its direct vagal effect on the atrioventricular node. Paper: Mason JM, et al. Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med.