Remove Dehydration Remove EKG/ECG Remove Fluid Resuscitation
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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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Tachycardia must make you doubt an ACS or STEMI diagnosis; put it all in clinical context

Dr. Smith's ECG Blog

He had this ECG recorded. He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. But, remember, we do not evaluate and treat ECGs, we evaluate and treat patients. The K returned at 6.9

EKG/ECG 52
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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis Sickling leads to vascular occlusion, end-organ ischemia, and decreased RBC lifespan, which, in turn, leads to pain crisis, acute anemia, sequestration, infection, and acute chest syndrome (ACS.) ECG: Evaluate for ischemia, right heart strain.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis. ECG: Evaluate for ischemia, right heart strain. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

An immediate 12-lead EKG was obtained: There is ST elevation in leads aVR and V1, with marked ST depression in I, II, III, aVF, V3-V6. In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure. What should be done? Should the cath lab be activated?

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EM@3AM: Crush Injury

EMDocs

neurologic damage and thrombosis) 20,21 Resuscitation Lactated ringers > Normal saline due to reduced need for urinary alkalinization 22 Place foley and target urine output >300 mL/hr Electrolyte abnormalities Hyperkalemia: Obtain an ECG Stabilization: Calcium gluconate 2 g over 5-10 min.

EMS 73
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EM@3AM: Hyperthermia

EMDocs

A 12-lead EKG shows sinus tachycardia but is otherwise normal. Triage vital signs include BP 80/40 mm Hg, HR 154 bpm, T 41C rectal, RR 28 breaths per minute, saturation 94% on room air. The patient is agitated, not oriented, and becoming combative with ED staff. Temps greater than 41.5C Temps greater than 41.5C Temps greater than 41.5C