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Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children

Pediatric EM Morsels

Ganss, 2018) There are additional associations with scoliosis, burn injuries, and spinal cord injuries. (Oka, Oka, 2023) Abdominal ultrasound with doppler can also be used to measure the angle, and with a trained ultra-sonographer was found to be as sensitive as CTA.

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HEMS Debrief #10 – Dr Brian Burns (part two)

Greater Sydney Area HEMS

Join for the second part of Dr Brian Burns’ episode, as we continue to discuss mimics of shock in our trauma population. Show notes: Reference on pulmonary embolism : [link] Reference on pulmonary contusion: [link] Reference on pulmonary contusion lung ultrasound : [link] See some show notes below for more resources.

Burns 52
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Grand Rounds Recap 4.10.24

Taming the SRU

cm is normal Hazard ratio in patients with abnormal TAPSE in normotensive patients is high even though the patient is currently hemodynamically stable Acute vs chronic right heart strain Acute McConnell’s sign: apical hypokinesis with RV free wall hypokinesis Will be present in all causes of increased RV pressure including PE, pulmonary HTN, etc.

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Grand Rounds Recap 1.31.24

Taming the SRU

Ultrasound: Make “windows of access”. The Aircare package to increase DASH-1A airways includes placing patient on AirCare monitor, apneic oxygenation, 3 minutes NRB, bagging after paralytic given, starting only when patient > 97%, push dose pressors if needed for hypotension before paralytic, and make sure to use the checklist!

PPE 98
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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

However, in at least 10% of patients, blind insertion of a peripheral IV may be unsuccessful for a variety of reasons including obesity, edema, IV drug use, surgical scars, dialysis, burns, and others (1,2). Ultrasound Guided Peripheral IV (USGIV) Access anatomy of arm veins when considering USGIV. Use a long (1.8 inch) catheter (4).

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Another Study on Peripheral Vasopressors

RebelEM

of cases) Catheter ultrasound confirmation: 49.8% (i.e. Not met in 16.7% of cases) Catheter location: 66.5% (i.e. Not met in 33.5% Not met in 50.2% of cases) Appropriate vasopressor dose: 84.3% (i.e. Not met in 15.7% No Extravasation Event vs Extravasation Event Age: 63 vs 67 years BMI: 28.3 All Catheter Criteria Met: 44.3%

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Midline Catheters in Paediatrics – The Long and Short of it.

Don't Forget the Bubbles

Ultrasound-guided insertion is by far the ideal method of venous catheterisation, especially in Paediatrics. What are the methods for cannulation?