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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. Typically this includes multiple small meals in a day.

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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!

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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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Three normal high sensitivity troponins over 4 hours with a "normal ECG"

Dr. Smith's ECG Blog

Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." Smith comment: No patient over 25 years of age with unexplained chest burning should be discharged without a troponin rule out, no matter how normal the ECG. The following ECG was obtained.

EKG/ECG 123
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What can you find with continuous ST monitoring in the ED?

Dr. Smith's ECG Blog

This was written by one of our fine residents, who will soon be an EMS fellow: Michael Perlmutter Case A mid-50s male came to the ED with a burning sensation that was acutely worse while at home. When pressed, he endorsed mild, very brief periods of a retrosternal burning sensation and serial ECGs were obtained. Mobitz II is not.

EKG/ECG 113
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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. Studies have compared IO to peripheral intravenous (PIV) and central venous (CVC) access for resuscitation.

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Therapeutics: Pacing Through Skin and Vein

Taming the SRU

Conduction Abnormalities AV blocks, which can also be seen in patients with MI, may require pacing as well, due to ischemia affecting the electrical pathways of the heart. Skin burns and irritation can also result from the pacing pads and cause pain. Sedation can be adequately achieved with benzodiazepines.