Pediatric EM Morsels

JUNE 16, 2023

Sometimes this can be used to our advantage, like when we need to give subcutaneous fluids to a dehydrated patient without an IV, or when we need to give SQ medications for things like Sulfonylurea overdose , Hereditary Angioedema , or DVTs. The subcutaneous space is a vast region of potential space where things can collect.

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The Skeptics' Guide to EM

APRIL 27, 2019

Crocco is a Pediatric Emergency Physician and is the Medical Director & Division Head of the Division of Pediatric Emergency at McMaster’s Children’s Hospital. Anthony […] The post SGEM#254: Probiotics for Pediatric Gastroenteritis – I Can’t Go For that…No Can Do first appeared on The Skeptics Guide to Emergency Medicine.

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Pediatric Emergency Playbook

JANUARY 1, 2022

Early presentation from 3 to 5 weeks of age: projectile vomiting Later presentation up to 12 weeks: dehydration, failure to thrive, possibly the elusive olive Labs may show hypOchloremic, hypOkalemic metabOlic acidosis: “ all the Os ” Watch out for hyperbilirubinemia, the “icteropyloric syndrome”: unconjugated hyperbilirubinemia from dehydration.

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Pediatric Emergency Playbook

MAY 1, 2017

They may get a little dehydrated, especially if mother’s milk is late to come in. Pediatrics. Pediatrics. Home care The neonate who is safe to go home is well appearing, and not dehydrated. Most babies with hyperbilirubinemia are dehydrated, which just exacerbates the problem. Their livers are immature.

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Dr. Smith's ECG Blog

JANUARY 29, 2013

so it must be a pediatric ECG. This is typical of pediatric ECGs because the fetal circulation depends on the right ventricle. With management of fever and dehydration, the heart rate normalized. What can you say about this ECG at a rate of 230 beats per minute? Answer below  The QRS is very narrow (about 70 ms?),

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The Skeptics' Guide to EM

MAY 4, 2019

Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. You confirm her bedside ketones to be 6 and have secured a cannula (intravenous) ready to reverse her dehydration – but what fluids should you use and at what rate?

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Don't Forget the Bubbles

DECEMBER 13, 2023

Are there signs of significant dehydration or malnutrition? If severely dehydrated or malnourished, then they require admission for close monitoring with rehydration and refeeding. Eur J Pediatr. They have supportive parents who live nearby and a good friend network. First and foremost, do they look well or unwell?

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Pediatric Education

SEPTEMBER 3, 2023

With your sickle cell trait you usually shouldn’t have any problems, but dehydration could cause problems for you. Actually dehydration can cause problems for everyone, so just take an extra ounce or two than everyone else to really stay hydrated,” he counseled. Pediatr Emerg Med Pract. Subramaniam S, Chao JH.

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The Skeptics' Guide to EM

SEPTEMBER 7, 2018

She is not clinically dehydrated and has a temp of 38.2C The bottom line was that there seemed to be a knowledge gap when it comes to managing bronchiolitis in the community setting (previous evidence as suggested a knowledge gap also exists in the academic pediatric hospitals).

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Don't Forget the Bubbles

NOVEMBER 15, 2023

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). Given the present urine output of 0.3ml/kg/hr and no dehydration replacement, you estimate she will receive ~1mmol/kg/day of sodium. Pediatrics.

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PEMBlog

OCTOBER 2, 2024

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , I explore the complexities of gastroesophageal reflux (GER) and gastritis in children and adolescents. Topics covered include: The pathophysiology of GER and GERD in the pediatric population. J Pediatr Gastroenterol Nutr. J Pediatr Gastroenterol Nutr.

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Mind The Bleep

FEBRUARY 27, 2024

This is a child who is clearly dehydrated and unable to tolerate oral fluids therefore IV fluids are the best option. Once cardiovascular status has improved start maintenance fluids at 38ml/hr, monitor urine output closely, liaise with your local paediatric renal team. Answers (1) [B] is the correct answer.

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Pediatric Emergency Playbook

FEBRUARY 1, 2017

in Pediatric Emergency Care. Think about poor feeding, irritability, dehydration – in that case, just go with your gut and call it pyelonephritis, and admit. Pearl : the enhanced urinalysis is the addition of a gram stain. A positive gram stain has a LR+ of 87 in infants less than 60 days, according to a study by Dayan et al.

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Dehydration Wellness Ultrasounds Pediatrics 52

Taming the SRU

APRIL 13, 2023

beta blockers decrease ability to dissipate heat through increase CO, diuretics predispose to dehydration, or anticholinergic agents can affect thermoregulation) Clinical Presentation: Temperature elevation, usually 40.5C EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

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Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

EB Medicine

JULY 8, 2019

Consider IV access and early IV fluids in those at risk for dehydration and intra-abdominal infections. Jeff: Tachycardic patients should make you concerned for hypovolemia 2/2 dehydration, sepsis, leaks, and blood loss. ASMBS pediatric committee best practice guidelines. At 6 to 8 mL/kg. 2015;25(4):622-627. Surg Obes Relat Dis.

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Don't Forget the Bubbles

APRIL 7, 2025

This condition, known as diabetes insipidus (DI) , results in dehydration and high sodium concentrations in the blood. As dehydration can rapidly worsen in children , this test must be performed in a hospital setting with strict monitoring. PROP1, POU1F1, LHX3, and LHX4 mutations in congenital hypopituitarism).

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Pediatric EM Morsels

JULY 28, 2023

Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. Pediatr Diabetes. Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Commitee. 2013 Sep;163(3):761-6. PMID: 23499379.

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Pediatric EM Morsels

SEPTEMBER 20, 2024

Diarrhea is one of the most common complaints in the pediatric emergency department, especially in the summer and early fall. Sure this may cause blood in stool, but consider Hemolytic Uremic Syndrome when evaluating pediatric patients with Bloody Diarrhea. Clin Pediatr (Phila). Protect the Kidneys! 2010 May;49(5):418-21.

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EMDocs

DECEMBER 6, 2024

6 Can see subsequent electrolyte disturbances and dehydration related to severity of GI symptoms. Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). Arch Pediatr Adolesc Med. 1 Obtain a single view abdominal x-ray.

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Don't Forget the Bubbles

JANUARY 27, 2025

2017) Pediatric Ovarian Torsion, Surg Clin North Am, 97(1):209-221. Scheier E (2022) Diagnosis and Management of Pediatric Ovarian Torsion in the Emergency Department: Current Insights 14: 283291, PMC9236466. Sims MJ, Price AB, Hirsig LE, Collins HR, Hill JG, Titus MO (2022) Pediatric Ovarian Torsion: Should you go with the flow?

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Downeast Emergency Medicine

MARCH 24, 2021

OVERVIEW Diarrhea is a common complaint for our pediatric patients in the emergency department. Most pediatric diarrhea is not life threatening, and usually is treated with supportive care. However, there are important red flags to consider when assessing a pediatric patient with diarrhea. Pediatr Emerg Care 1997, 13(3):179-182.

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Don't Forget the Bubbles

JANUARY 17, 2024

The liquids were chosen to “approximate a pediatric digestive environment.” Other symptoms, such as constipation, abdominal pain and dehydration, were also be seen. BMC Pediatrics , 20 , pp.1-5. J Pediatr Surg Case Rep. Orbeez: the magic water absorbing bead—risk of pediatric bowel obstruction?

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EMDocs

MAY 15, 2024

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.) times maintenance.

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EMDocs

MAY 28, 2024

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Episode 101: Acute Chest Syndrome Part 2 Background SCD is an autosomal recessive condition that results in the formation of hemoglobin S (HbS).

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Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

Don't Forget the Bubbles

MARCH 18, 2024

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. Pediatric Nephrology. She is apyrexial, tachycardic and normotensive.

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Pediatric Emergency Playbook

AUGUST 1, 2016

⇒ You have a stable child who just needs fluids, but no laboratory tests ⇒ You’ve tried PO hydration, to no avail, despite anti-emetics ⇒ You’re poking the stable, but dehydrated child repeatedly without success What now? Recombinant human hyaluronidase-enabled subcutaneous pediatric rehydration. Pediatrics. Pediatrics.

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Allergic Reactions Dehydration Pediatrics Geriatric Emergencies 52

EB Medicine

MARCH 4, 2020

Literature Review: There is abundant literature on pediatric AGE but sparse research on AGE in adults. Therefore, many recommendations are extrapolated from the pediatric literature. Laboratory Testing and Imaging: Dehydration is the biggest contributor to mortality, especially in the very young and elderly. No data in AGE.

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EB Medicine

DECEMBER 30, 2019

This episode reviews risk factors for apnea and severe bronchiolitis; discusses treatments/therapies and provides evidence-based recommendations for the management of pediatric patients with bronchiolitis. 35-37 High Flow Nasal Cannula (HFNC) Several small pediatric ICU studies show a benefit in severe cases. Further study needed.

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PEMBlog

MARCH 27, 2024

My special guest podcaster, Emily Groopman, is an actual Pediatric Geneticist in training and we hope that you will find this episode useful. Pediatr Rev. Pediatrics. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast.

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Pediatrics Seizures Emergency Department Sepsis 59

Don't Forget the Bubbles

JANUARY 10, 2024

These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. Pediatr Crit Care Med. Transfusion strategies for patients in pediatric intensive care units.

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EB Medicine

AUGUST 1, 2018

Jeff: For more on synthetic intoxications in the ED, be sure to take a look at the recent May 2018 issue of Pediatric Emergency Medicine Practice on Synthetic Drug Intoxication in Children if you haven’t already read it. Jeff: The hyperemetic phase lasts 24-48 hours and can lead to dehydration, electrolyte abnormalities, and weight loss.

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Seizures Hyperthermia / Hypothermia Administration Dehydration 40

ACEP Now

MARCH 11, 2025

A survey that looked at 637 residency programs including pediatric, family, and internal medicine in 2014 found that only 42 programs offered formal training in eating disorders. Pediatrics. Identification A range of medical conditions can mimic the symptoms of eating disordershence the description of the great masquerader.

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Emergency Department Psychiatric Dehydration Pediatrics 83

EMDocs

OCTOBER 7, 2023

Clinical spectrum of rhabdomyolysis presented to pediatric emergency department. BMC Pediatr. The incidence of a similar condition, traumatic rhabdomyolysis, is estimated to be around 0.074%. Non-traumatic rhabdomyolysis: Background, laboratory features, and acute clinical management. Clin Biochem. 2017;50(12):656-662. 2013;13:134.

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Don't Forget the Bubbles

MAY 15, 2023

His systemic examination is normal, apart from signs of dehydration. Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children. The Journal of Pediatrics. A history of consanguinity is important to consider when looking at metabolic disorders.

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EMDocs

NOVEMBER 4, 2024

Eosinophils and mast cells as therapeutic targets in pediatric functional dyspepsia. Effects of hydration and dehydration on blood rheology in sickle cell trait carriers during exercise. Characterizing the role of haloperidol for analgesia in the Emergency Department. J Pain Manag. 2019;12(2):141-146. Nov 06 2013;4(4):86-96.

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Pediatric EM Morsels

FEBRUARY 2, 2024

Pediatric patients with recent travel and fever of unknown origin should be considered for admission if malaria is a possible diagnosis. Fever in the Returned Pediatric Traveler. Glob Pediatr Health. Curr Probl Pediatr Adolesc Health Care. Pediatr Emerg Care. References Abdel-Haq N, Asmar BI. 2021 May; 8:1-16.

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Pediatric Education

DECEMBER 15, 2024

The American Academy of Pediatrics 2022 Clinical Guidelines states that: “[t]he effectiveness of phototherapy is dependent on the intensity of phototherapy administered and the surface area of the infant exposed to phototherapy (ie, double-sided). .” However it caries risk of dehydration, sunburn, and hypothermia.

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