Pediatric Emergency Playbook

NOVEMBER 1, 2015

Etomidate is perfectly acceptable, but ketamine is actually a superior drug to etomidate in the rapid sequence intubation of children in septic shock. Ketamine is reasonable as well: there is no contraindication to ketamine except for known hydrocephalus. We often have limited information in critical situations. Relax, it’s a myth.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

Rural Doctors Net

AUGUST 30, 2013

The visual confrontation of a man in pain with an obvious amputation and airway burns will induce a catecholamine surge in all but the psychopathic. Sure he’s got a traumatic amputation – your tourniquet has arrested the bleeding, but there may well be more blood loss. Before we even get to this patient, it’s worth stepping back.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

Northwestern EM Blog

DECEMBER 27, 2021

Marc Sala, summarize the current literature on the peripheral infusion of vasopressors, which is becoming more and more commonplace as the evidence evolves to support earlier initiation of pressors and more judicious use of crystalloid for many forms of shock.

Dislocations 52

Dislocations Emergency Department Burns Shock 52

ALiEM

JULY 17, 2023

as well as an analysis of the 2023 Match by Pupazan and Cook in Emergency Medicine News [3,4]. Match Data The unprecedented numbers of unfilled PGY-1 EM residency training positions in the NRMP Match results shocked the specialty these last two years. Murano T, Weizberg M, Burns B, Hopson LR. Ann Emerg Med. PMID: 37436344.

EMS 52

EMS Burns Emergency Department Shock 52

AED Leader

OCTOBER 11, 2023

If you are hosting a meal at your home, consider brushing up on your CPR, the Heimlich Maneuver, and the steps to take for cuts and burns. Some portable defibrillators can connect to WiFi at a receiving hospital and send the patient’s heart rhythm and a record of the shocks given.

CPR 52

CPR Burns Hospitals Shock 52

AED Leader

OCTOBER 11, 2023

If you are hosting a meal at your home, consider brushing up on your CPR, the Heimlich Maneuver, and the steps to take for cuts and burns. Some portable defibrillators can connect to WiFi at a receiving hospital and send the patient’s heart rhythm and a record of the shocks given.

CPR 52

CPR Burns Hospitals Shock 52

Don't Forget the Bubbles

OCTOBER 16, 2024

Don’t forget the essentials: Eat Hydrate +/- caffeinate Exercise Unwind Sleep It’s not rocket science, but it’s shocking how many of us forget! Are there distinctive sub-specialty referral pathways for your area e.g. liver, burns, surgery, neurosurgery etc. A well-rested team is a safe and productive one. Ever heard of a WOCL?

Teamwork 52

Teamwork Documentation/Coding Leadership Burns 52

PEMBlog

OCTOBER 2, 2024

Children with respiratory conditions and chronic lung disease like asthma are more prone to GERD as well. It’s a burning sensation in the chest or epigastrium, and that is the classic symptom in this age group. So, the parents may say, well, he Doesn’t ever seem full. Well, baby doesn’t know how to be full.

Pediatrics 52

Pediatrics Emergency Department Ultrasounds Wellness 52

PEMBlog

JUNE 5, 2024

Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. You should also consider the possibility of quote unquote spinal shock. than it is spinal shock. And hypotension, bradycardia, or temperature instability can result from hemorrhagic and or spinal shock.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Don't Forget the Bubbles

OCTOBER 7, 2024

Up to 5% of burns occur secondary to electrical injuries, and this rises to 27% in developing countries. Significant injuries can occur even in the absence of extensive burns or other signs of external injury. Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)?

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

Northwestern EM Blog

JANUARY 24, 2022

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.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Taming the SRU

SEPTEMBER 15, 2023

Limited availability of radiology-performed US services in certain hospitals, especially overnight Can avoid unnecessary anticoagulation in patients Reduce time in ED to disposition In terms of workflow, when there is suspicion for a DVT, you need to first calculate a Wells’ Score for a DVT If low/moderate risk, can start with a D-dimer prior to committing (..)

CPR 89

CPR Burns Airway Management Wellness 89

EB Medicine

NOVEMBER 1, 2018

Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. You’re probably familiar with this concept when you see high voltages arcing through the air without direct contact with the actual electrical source, leading to diffuse burns.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Pediatric Emergency Playbook

DECEMBER 1, 2015

Victims of electrical injuries present either in extremis or as the seeming well patient with insidious, developing disease. Most patients do well, and the burn heals by secondary intention. Most patients do well, and the burn heals by secondary intention. Injury from electrical burns can be subtle.

Burns 40

Burns Emergency Department EKG/ECG Shock 40

EMDocs

JULY 15, 2023

She has had pruritus and swelling to the site accompanied by a painful burning sensation and a couple “painful knots” on her right inguinal region. The patient reported feeling better, pain and other symptoms were well controlled 24 hours after starting antibiotics and pain medication. pneumoniae , S.

EMS 76

EMS Infectious Diseases Shock Ultrasounds 76

ACEP Now

MARCH 14, 2024

Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm. FIGURE 1: Electrical burns of the patient’s bilateral feet. FIGURE 2: Traumatic amputation and electrical burn of the patient’s left arm. He was intubated by EMS due to the extent of his injuries.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Pediatric Emergency Playbook

JANUARY 1, 2017

Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. For children greater than one year who are preverbal, a well performing scale is the FLACC score: Face, Legs, Activity, Cry, Consolability ( Table 3 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. However, PCT can be elevated in severe trauma, such as burns or surgery [5,25]. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021 Nov;47(11):1181-1247.

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

EB Medicine

DECEMBER 4, 2019

Well, with that, let’s get started on our final scheduled episode of EMplify ! Thanks as well to the peer editors, Dr. Knight, and Dr. Hill of the University of Cincinnati. Show More v Jeff: Well, this is a first! Jeff: Just as on the ground, shockable rhythms do well with good BLS care.

Dehydration 40

Dehydration EMS Wellness Burns 40

Dr. Smith's ECG Blog

JANUARY 11, 2025

See our other cases with similar patters, to burn this deep into your brain files: Smith : In my experience, these cases of LAD OMI with RBBB and LAFB are either about to arrest, post-arrest, and/or in cardiogenic shock. 3rd seeing definite ST elevation in lead I , as well as in the other high-lateral lead ( = lead aVL ).

EKG/ECG 139

EKG/ECG Shock Resuscitation Burns 139

EMDocs

JANUARY 20, 2025

1,2 For hypervolemia in heart failure patients, orthopnea >2 pillows is the most reliable clinical finding, 3,4 though an increase in peripheral edema and increased weight can be useful as well. 6-8 In patients who are on long-term hemodialysis, typical non-invasive signs of volume assessment seem to be unreliable as well.

Dehydration 69

Dehydration Fluid Resuscitation Sepsis Resuscitation 69

EMDocs

JANUARY 6, 2025

Based on available hospital resources, the patient is treated for septic shock secondary to pneumonia and an infected wound using broad-spectrum antibiotics and IV crystalloid fluids. She receives IV calcium gluconate and bicarbonate as well as oral potassium binders for hyperkalemia. Hypoglycemia is managed with IV dextrose.

Infectious Diseases 67

Infectious Diseases CDC PPE Rapid Diagnostic Testing 67

EMDocs

FEBRUARY 8, 2025

Well keep it short, while you keep that EM brain sharp. IFI patients may require ICU level of care as they often present in septic shock, have increasing oxygen requirements, and may also require urgent bronchoscopy with lavage/tissue sampling for definitive diagnosis. She is well appearing with otherwise normal vital signs.

Infectious Diseases 61

Infectious Diseases EMS COPD Research 61