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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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emDOCs Podcast – Episode 93: BRASH Syndrome

EMDocs

Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. An inciting event will typically push them over the edge into BRASH syndrome: Dehydration Hypotension from sepsis or another condition GI illness Dosage increase of a chronic medication (e.g.,

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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. Are the lungs clear?

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What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

Dr. Smith's ECG Blog

Here is her EKG: What is unusual about this? Here is the ECG after ibutilide: What do you notice? Here is the post-cardioversion ECG: Sinus rhythm, still with the longer QT interval. We designed a step-up protocol in which shocks at 50, 100, 200, 300, and 360 J were used for transthoracic cardioversion.

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Grand Rounds Recap 4.5.23

Taming the SRU

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

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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
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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. DISCUSSION: The 12-lead EKG EMS initially obtained for this patient showed severe ischemia, with profound "infero-lateral" ST depression and reciprocal ST elevation in lead aVR. What should be done?

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