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Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none.
Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Pediatr Diabetes. The mortality rate for cerebral edema is 21%–24%. PMID: 23499379.
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.
airway grand rounds - r1 clinical knowledge: heavy metals - consultant corner: acute leukemia - pediatric sim - pediatric cases airway grand rounds WITH dr. carleton Difficult airway algorithm: when should we RSI? Abdominal pain, nausea, vomiting, and dehydration are common. given 60 (half KPhos and KCl) K < 2.5:
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.
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).
In a PICU setting, sodium can come from various sources (resuscitation fluids, IV drugs and infusions, enteral feed), not just the maintenance fluids we prescribe. There is growing interest in giving no maintenance fluid and using the input from drug infusions and resuscitative boluses only. Pediatrics. sodium chloride.
She appears pale and dehydrated , and her level of alertness fluctuates. She receives fluid resuscitation, and you organise some tests to find out why she is so tired. Pay specific attention to fluid status, looking for evidence of dehydration. Manage hydration Children may be dehydrated or present with signs of fluid overload.
There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose. Answers (1) [B] is the correct answer.
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.
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.
Management ED management should focus on appropriate resuscitation of the patient and early referral to the surgical team. 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.
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. BMC Pediatr. Clin Biochem.
Pediatr Allergy Immunol Pulmonol. smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4 C or 100.4
Assessment of the child ( NICE guidelines + NCBI – management of pediatric febrile seizures ) If the child is actively having seizures in the ED: Airway assessment and management – confirm and protect the airway. You are called to the resuscitation bay in your ED following arrival of the expected pediatric alert.
For patients who are elderly, orthostasis is an unreliable clinical finding and may be present in the absence of dehydration. For patients who are elderly, orthostasis is an unreliable clinical finding and may be present in the absence of dehydration. 9 In terms of assessing volume status in general, Joseph et al. Andrews et al.
It is also worth noting that these aggressive hematologic cancers occur more commonly in children and thus the risk of TLS can be higher in the pediatric population6. mg/dl (pediatrics) calcium < 7 mg/dl Clinical Tumor Lysis Syndrome (2) - laboratory TLS + one of the following: cardiac arrhythmia seizure sudden death creatinine > 1.5x
As the disease progress the patients will experience profound dehydration and start to develops signs and symptoms such as: Rapid heart rate Loss of skin elasticity Dry mucous membranes Low blood pressure If left untreated, severe dehydration may lead to kidney failure, shock, coma, and death within hours.
92 Refugee patients with SAM, dehydration, or shock should be admitted for further management. BMC Pediatr. ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. After isolation, the patient is placed on supplemental oxygen therapy at 15 L/min via a non-rebreather mask. Nat Rev Dis Primer. 2017;3:17067.
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