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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. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. 2022; 23( 7): 835- 856. Lesson = treat early! 2002 Dec;141(6):793-7.

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Trauma Resuscitation Updates

RebelEM

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2] NEJM 1994. [2]

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EM@3AM: Leukopenia

EMDocs

Management is directed based on underlying etiology, but consider fluid resuscitation, antipyretics, and antibiotics as indicated. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. Philadelphia, PA: Elsevier; 2022:1-11. 101,33 (2022): e30116.

EMS 95
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Adjunctive Methylene Blue in Septic Shock?

RebelEM

Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e.

Shock 145
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emDOCs Videocast: EBM Update – Fluids in Pancreatitis and Hypertriglyceridemic Pancreatitis

EMDocs

Fluids in Pancreatitis #1 : de-Madaria E, Buxbaum JL, Maisonneuve P, et al; ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. 2022 Sep 15;387(11):989-1000. cc/kg/hour of LR Control: LR Bolus of 20 cc/kg (regardless of fluid status) followed by 3.0 2.18) Fluid Overload: 20.5%

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The 90th Bubble wrap DFTB X The Bridge

Don't Forget the Bubbles

This was a secondary analysis of the Management and Outcome of Fever in Children in Europe (MOFICHE) study. The primary outcome measure was SBI, and 1854 children included were diagnosed with an SBI. Lack of fluid monitoring throughout the PICU stay led to underreporting of MODS resulting from late-onset FO. Whats it about?

Sepsis 59
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emDOCs Videocast: EBM Update – Fluids in Pancreatitis, Hypertriglyceridemic Pancreatitis

EMDocs

EBM Update: Fluids in Pancreatitis, Hypertriglyceridemic Pancreatitis #1: de-Madaria E, Buxbaum JL, Maisonneuve P, et al; ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. 2022 Sep 15;387(11):989-1000. vs. Placebo 11.9%, NNT 18 Median Fluid Received: Aggressive: 7.8L (Range 6.5