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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. A systematic review by Freedman et al.

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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. Glucose > 200 mg/dL Moderate or Large Ketonuria The severity of DKA is categorized by the degree of acidosis Mild : venous pH < 7.3 The mortality rate for cerebral edema is 21%–24%.

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Trick of Trade: Alternative to a Pressure Bag for IV Fluids

ALiEM

You have a severely dehydrated patient with a peripheral IV line, requiring urgent fluid resuscitation. You can not seem to find your pressure infusion cuff to squeeze the IV bag and accelerate fluid administration. You can not seem to find your pressure infusion cuff to squeeze the IV bag and accelerate fluid administration.

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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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Grand Rounds Recap 11.8.23

Taming the SRU

Abdominal pain, nausea, vomiting, and dehydration are common. Management IVF resuscitation: will want to give at least 20 cc/kg bolus, however there has been some discussion about doing this in two 10 cc/kg boluses to avoid cerebral edema (as noted below, recent evidence has not supported this). given 60 (half KPhos and KCl) K < 2.5:

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Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

Currently, the administration of water for the paediatric population is based on the Holliday-Segar formula (100ml/kg/day for the first 10kg of weight, 50ml/kg/day for the second 10kg of weight and 20ml/kg/day for weight over 20kg). What do we need to give? Most drugs are chosen to be dissolved in 0.9% sodium chloride.

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ToxCard: Iron

EMDocs

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. 2 L/hr in adults.