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A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

What is Shock? Shock is defined as a type of circulatory failure where lack of oxygen leads to dysfunction of vital organs. There are many types of shock which may affect children, and management is specific to the type of shock. The overall goal in managing any cause of shock is to restore oxygen delivery to the organs.

Shock 143
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Trauma Resuscitation Updates

RebelEM

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4%

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Sickle Cell Disease Module

Don't Forget the Bubbles

Be careful if the patient has received a recent blood transfusion since it may be misinterpreted as sickle cell trait instead of sickle cell disease. In these cases, repeat the Hb electrophoresis three months after the last blood transfusion. Would you consider this patient for blood transfusion?

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Neonatal Hypotension

Don't Forget the Bubbles

Perinatal Blood Loss: Significant blood loss during delivery, whether due to placental abruption, vasa previa, or traumatic delivery, can result in anaemia and subsequent hypotension. If anaemia is confirmed, a blood transfusion may be necessary to restore adequate circulatory volume and improve oxygen-carrying capacity.

Sepsis 59
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Imported Malaria

Pediatric EM Morsels

Food and Drug Administration Approval of Artesunate for Severe Malaria: Enough to Achieve Best Practice? falciparum parasitemia , and no other defined cause of AMS (WHO 2023). Imported Malaria in Countries where Malaria Is Not Endemic: a Comparison of Semi-immune and Nonimmune Travelers. Clin Microbiol Rev. 2020 Mar 11;33(2):e00104-19.

Seizures 278
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Vasopressor Nonresponse

Northwestern EM Blog

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

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ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 2

PulmCCM

shows blood administration with a direct linear relationship between Pra and CO/VR; only Pmsf is varied here. In the second thought experiment, let us consider a patient with significant blood volume loss that is replenished with a series of blood transfusions. OP is operating point. See text for details.