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Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

Additionally, one must be prepared for definitive airway management and know when laboratory investigations will prove valuable to guide further management. Resuscitation Begin by positioning the patient upright in their position of comfort to reduce the risk for aspiration and improve visualization of the bleeding site.

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EM@3AM: Murine Typhus

EMDocs

Food and Drug Administration. Emerg Infect Dis. 2017;23(8):1268-1273. doi:10.3201/eid2308.161861 Cross R, Ling C, Day NP, McGready R, Paris DH. Revisiting doxycycline in pregnancy and early childhood–time to rebuild its reputation? Expert Opin Drug Saf. 2016;15(3):367-82. Doxycycline Capsules USP. January 2022. Available at: [link].

EMS 101
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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. While some studies showed that CPRIC is associated with increased survival to hospital discharge, administering muscle relaxants during resuscitation increased mortality. Another attempt led to an oesophageal intubation.

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Acute Esophageal Variceal Bleeding in Children

Pediatric EM Morsels

Of course, we all have a healthy respect for post-tonsillectomy hemorrhage and we like to talk about Damage Control Resuscitation. Multimodal management can help avoid variceal bleeding. Prepare airway management tools (hoping to avoid needing them). Keep patient comfortable. Obtain large-bore access. Call them early!

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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations. Li Y, editor.

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emDOCs Revamp: Esophageal Perforation

EMDocs

6 Treatment : Airway Definitive airway management should be performed in those with respiratory distress with attention to appropriate resuscitation started beforehand in the setting of potential distributive shock from mediastinitis. 4 Fluid resuscitation and vasopressor use as appropriate.

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REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

RebelEM

The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, altered mental status and hypoxemia can make securing a definitive airway both an anatomic and physiologic challenge. that would not be possible in an agitated/combative patient.