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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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Syncope and ST Elevation on the Prehospital ECG

Dr. Smith's ECG Blog

The medics recorded an ECG: There is STE in V1-V3 and aVL, with reciprocal ST depression in II, III, aVF. An ECG was recorded: Now you can see what the medics could not: The QRS is enormous. ECG 3 hours later was unchanged He was not started on heparin as type II MI was favored over NonSTEMI as the etiology of his troponin elevation.

EKG/ECG 52
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Medical Malpractice Insights: A Rare Presentation – Groin pain? Nec fasc? Diabetes? Appendicitis?

EMDocs

EKG shows atrial fibrillation with a rate of 169. Hospital Inpatient : R thigh is indurated and blistered but abdomen is all but ignored. Hospital Inpatient : R thigh is indurated and blistered but abdomen is all but ignored. On the 2nd hospital day, she becomes obtunded and is intubated. Glucose is 490, CO2 8, and pH 7.26

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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. HbS has reduced solubility in the setting of hypoxia, leading to sickling of the RBCs.

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Back to basics: what is this rhythm? What are your options for treating this patient?

Dr. Smith's ECG Blog

Her initial EKG is below. The following EKG was obtained after administration of adenosine. Unfortunately, shortly after this EKG was obtained, the patient returned to SVT. Same as initial ECG. ie, dehydration, periods of increased stress or anxiety, stimulants such as caffeine, alcohol, recreational drugs, etc.);

EKG/ECG 52
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Wide Complex Tachycardia. What is the Diagnosis?

Dr. Smith's ECG Blog

On arrival, here is his initial ED ECG, and is identical to the prehospital ECG and at the same rate: There is a regular, wide complex. The patient ' s baseline ECG looks exactly the same, except that it is slower (93) and the p-waves are obvious. Maybe the patient has dehydration, sepsis, hemorrhage, or PE.

EKG/ECG 52