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Food Protein Induced Enterocolitis Syndrome (FPIES)

Pediatric EM Morsels

Patients with FPIES can have marked dehydration due to vomiting and diarrhea, even to the point of hypotension! – As always, treat symptoms and dehydration based on severity. It may sound silly (“FPIES”), but it can be serious! Volume Status?!

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Rebaked: Inborn Errors of Metabolism presenting in the ED

Pediatric EM Morsels

Dehydration Surgery Pregnancy ( If we don’t ask we don’t know ) Many important IEM are included in the Newborn Screen. For milder forms of IEM, children can compensate until the body is under stress and may recover after stress (leading to delayed diagnosis). Viral infections also may cause metabolic stress.

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But Can You Just PO?

Taming the SRU

Other conditions that lead to intravascular fluid depletion include but are not limited to starvation/dehydration, vomiting, diarrhea, burns/trauma, hyperglycemia, and hemorrhage. Contraindications to ORT include evidence of severe dehydration which is defined as a volume loss greater than 10%. AtherlyJohn et al.

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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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Journal Feed Weekly Wrap-Up

EMDocs

. #3: Can Clinical or Lab Variables Predict Dehydration Severity in Children with DKA? Spoon Feed Most pediatric patients with diabetic ketoacidosis (DKA) have mild to moderate dehydration. Source Clinical and Laboratory Predictors of Dehydration Severity in Children With Diabetic Ketoacidosis.

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Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

Kids < 5 years of age New onset of diabetes at presentation Longer duration of symptoms Severity of acidosis Elevated BUN Greater degree of dehydration and hyperventilation Cerebral Edema and DKA: Diagnostic Considerations Early detection and treatment is the best means to prevent brain injury and death.

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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. However, the crystalloid fluids are not flowing freely. Multiple attempts were made to place this line with the latest having a flash of blood return and a smoothly flowing saline flush.