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Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

Kendra Jackson and Rebecca Raffler While we’ve gotten to snack on a Morsel on this subject before , new guidelines and research surrounding DKA and cerebral edema have come to light since the first go ‘round! The Pediatric Emergency Medicine Collaborative Research Commitee. Authors: Drs. Then we’ve likely got DKA. PMID: 12461495.

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EM@3AM: Leukopenia

EMDocs

0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. BioMed Research International, 2020, 1-10. Journal of Research in Pharmacy Practice, 6(1), 31. An update on the diagnosis and treatment of chronic idiopathic neutropenia. Curr Opin Hematol. 2017;24(1):46-53.

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Are we on the right TRACT? 

Don't Forget the Bubbles

The factorial design chosen by Dr Maitland and her research group means that several comparisons in transfusion practice could be carried out at the same time. What were the research questions? Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. N Engl J Med. 2019;381(5):407-419.

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Haemolytic Uraemic Syndrome

Don't Forget the Bubbles

She appears pale and dehydrated , and her level of alertness fluctuates. Pay specific attention to fluid status, looking for evidence of dehydration. Manage hydration Children may be dehydrated or present with signs of fluid overload. Early Volume Expansion and Outcomes of Hemolytic Uremic Syndrome. 2016 Jan;6(1):e009933.

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Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

One-liner… Understanding how to manage maintenance fluids in critically unwell children best is a basic but important way to improve outcomes. If the fractional excretion of sodium is <1%, you agree with your consultant that you will also ask the nurses to account for the replacement of 5% dehydration (900ml) over 48h (≈ 19ml/h).

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Hemolytic Uremic Syndrome (HUS): Rebaked Morsel

Pediatric EM Morsels

HUS findings: Microangiopathic hemolytic anemia , Renal failure , and Thrombocytopenia The most dreaded outcomes of HUS include need for renal replacement therapy both short and long term and unfortunately death. It is critical to detect HUS early in its disease course to ensure the best outcomes. Protect the Kidneys! 2020.12.077.

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Paediatric IV Fluid Prescribing

Mind The Bleep

The children who received no bolus had significantly better outcomes and reduced mortality compared to the two bolus group. [2] saline), however more research is needed in this area. [4] This is a child who is clearly dehydrated and unable to tolerate oral fluids therefore IV fluids are the best option.