The Skeptics' Guide to EM

MAY 4, 2019

You confirm her bedside ketones to be 6 and have secured a cannula (intravenous) ready to reverse her dehydration – but what fluids should you use and at what rate? As such, protocols recommend slow administration of IV fluids in children with DKA. On her blood gas her pH is 7.1 and her glucose is 35 mmol/l (630mg/dl).

Pediatrics 52

Pediatrics Dehydration Research Emergency Department 52

RebelEM

FEBRUARY 2, 2023

Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc). Unfortunately, the exact dose and time of administration of first line medications was not reported before a second line medication was given. Lastly, there is a substantial amount of data missing, specifically the underlying cause of the Atrial Fibrillation with RVR (ie.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

Dr. Smith's ECG Blog

OCTOBER 25, 2022

The following EKG was obtained after administration of adenosine. ie, dehydration, periods of increased stress or anxiety, stimulants such as caffeine, alcohol, recreational drugs, etc.); There are retrograde P waves seen immediately after the QRS complex in most leads. They are inverted in lead II, for example. Same as initial ECG.

EKG/ECG 52

EKG/ECG Administration Dehydration Emergency Department 52

Don't Forget the Bubbles

APRIL 7, 2025

This condition, known as diabetes insipidus (DI) , results in dehydration and high sodium concentrations in the blood. A stimulating substance is administered to provoke hormone secretion, with levels measured before, during, and after administration at regular intervals. The most commonly used stimulation tests include: 1.

Dehydration 72

Dehydration Pediatrics Administration Seizures 72

Pediatric EM Morsels

JULY 28, 2023

Risk Factors that seem to stay consistent: Administration of Bicarb for correction of acidosis has been shown to be associated with cerebral edema and DOES persist after correcting for severity of DKA!

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

EMDocs

DECEMBER 6, 2024

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. 6 Can see subsequent electrolyte disturbances and dehydration related to severity of GI symptoms. Typically presents in the first few hours following ingestion.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

Pediatric Emergency Playbook

AUGUST 1, 2016

⇒ You have a stable child who just needs fluids, but no laboratory tests ⇒ You’ve tried PO hydration, to no avail, despite anti-emetics ⇒ You’re poking the stable, but dehydrated child repeatedly without success What now? in 2007 compared subcutaneous administration of lactated ringer’s solution by gravity with and without hyalurondase.

Allergic Reactions 52

Allergic Reactions Dehydration Pediatrics Geriatric Emergencies 52

EMDocs

OCTOBER 10, 2024

She had no persistent vomiting, was not dehydrated and had no fever. Delay in administration of antibiotics. A delay in antibiotics administration was unfortunate but no one can say on a “more probable than not” basis that earlier treatment would have changed the outcome. You never took her condition seriously.

Documentation/Coding 97

Documentation/Coding Hospitals Sepsis Infectious Diseases 97

Mind The Bleep

MAY 12, 2023

Administration of human albumin solution (HAS) in SBP reduces the incidence of renal failure by 72% and mortality by 47%. In those who are grossly obese, it may be better to employ a more cautious approach with regard to albumin administration. The number needed to treat to prevent one death is around 5 in SBP. On Day 3 (i.e.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

EB Medicine

DECEMBER 30, 2019

Emergency Department Treatment Oxygen Keep O2 saturation >90% Clinicians may choose not to use continuous pulse oximetry (weak recommendation due to low-level evidence and reasoning) 1 Fluids IV or NG administration of fluids to combat dehydration, until respiratory distress and tachypnea resolve.

Emergency Department 40

Emergency Department Allergic Reactions Dehydration Pediatrics 40

EB Medicine

AUGUST 1, 2018

Also, be aware that there are various formulations of cannabis that allow for different routes of administration. Basically, any way you can imagine, it seems like a route of administration has been explored. On the longer end, rectal cannabis administration can take up to 8 hours to reach peak plasma concentrations.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

EMDocs

NOVEMBER 4, 2024

Prophylactic Administration of Diphenhydramine to Reduce Neuroleptic Side Effects in the Acute Care Setting: A Systematic Review and Meta-Analysis. Prophylactic Administration of Diphenhydramine to Reduce Neuroleptic Side Effects in the Acute Care Setting: A Systematic Review and Meta-Analysis. Emerg Med J. May 2018;35(5):325-331.

Emergency Department 106

Emergency Department Fractures Burns EMS 106

American Medical Compliance

JANUARY 31, 2025

Nutritional neglect Providing inadequate nutrition, leading to malnutrition and dehydration. Proactive Health Monitoring Teams that work closely together can detect early warning signs of neglect, such as pressure ulcers or signs of dehydration. While policies and compliance measures are essential, they alone are not enough.

Teamwork 91

Teamwork Dehydration Leadership Best Practices 91

Dr. Smith's ECG Blog

APRIL 8, 2015

Also consider non-hemorrhagic volume depletion, dehydration : orthostatic vitals may uncover this [see Mendu et al. (3)]. Premonitory symptoms (Nausea, pallor, diaphoresis, flushing), or triggers (Valsalva, Pain, Emotion, Prolonged Standing, Dehydration) are very useful in making the diagnosis. Vasovagal syncope is generally benign.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Taming the SRU

NOVEMBER 18, 2024

Prolonged hiccups can also cause a myriad of negative health consequences including sleep deprivation, exhaustion, malnutrition, dehydration, and depression. However, as hiccups become increasingly frequent or persistent, they can be distressing for patients and can be a sign of underlying disease. mg IV Olanzapine 2.5

Stroke 86

Stroke Administration COPD Dehydration 86

EMDocs

JANUARY 20, 2025

For patients who are elderly, orthostasis is an unreliable clinical finding and may be present in the absence of dehydration. 36-37 There is little evidence regarding oral rehydration in adults with gastroenteritis, though it seems reasonable that adults with mild dehydration could be safely hydrated orally. Modified from: Pringle, K.,

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

JANUARY 1, 2024

Reviews and opinion articles Use of POCUS for the assessment of dehydration in pediatric patients-a narrative review. Late surfactant administration after 48 hours of age in preterm neonates with respiratory insufficiency: a systematic review and meta-analysis. You will find the list is broken down into four sections: 1.Reviews

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

EMDocs

MARCH 11, 2024

As the disease progress the patients will experience profound dehydration and start to develops signs and symptoms such as: Rapid heart rate Loss of skin elasticity Dry mucous membranes Low blood pressure If left untreated, severe dehydration may lead to kidney failure, shock, coma, and death within hours.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111

Don't Forget the Bubbles

AUGUST 13, 2023

Treatment : IV hydration – based on percentage of dehydration and the calculated water deficit Ceftriaxone – IV or IM IV aciclovir Lucy has another prolonged generalised tonic clonic seizure in the ED. The overall risk of subsequent epilepsy in simple febrile seizures is only slightly above that of the general population (1-2%).

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

Don't Forget the Bubbles

JULY 5, 2023

Infections, fever, acidosis, hypoxia, dehydration and exposure to extreme temperatures can trigger VOC even though often no cause is identified. Home analgesia: Advise families at home to increase fluid intake to avoid dehydration (dehydration will prolong painful episodes). Rotavirus gastroenteritis and dehydration C.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

EMDocs

DECEMBER 9, 2024

Source: By Dr Graham Beards – Own work, CC BY-SA 4.0, [link] Less common physical exam findings associated with mpox complications can include secondary skin infections, proctitis, bronchopneumonia, diarrhea and dehydration, eye-related issues, and, in very rare cases, encephalitis.

CDC 75

CDC Documentation/Coding Infectious Diseases Dehydration 75