Don't Forget the Bubbles

DECEMBER 13, 2023

Susan had issues initially with ensuring the correct latch, but after a review with a lactation consultant, feeding is going well. Though it has been hard, they have been coping well and enjoying parenthood. First and foremost, do they look well or unwell? Are there signs of significant dehydration or malnutrition?

Dehydration 98

Dehydration CDC Hospitals Wellness 98

Dr. Smith's ECG Blog

OCTOBER 26, 2010

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. Furthermore, notice the well-formed Q-waves in inferior leads. The patient was suffering from severe dehydration, possibly with sepsis.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

EMDocs

MAY 25, 2024

Risk factors include oral neoplasms, sialolithiasis, advanced age, dehydration, ductal foreign bodies, concomitant tracheostomy, and recent receipt of an anesthetic agent. Patients who are immunocompromised may experience infection related to gram-negative organisms (e.g., Pseudomonas aeruginosa , Escherichia coli ).

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EMS Dehydration Operations Hospitals 80

Pediatric Emergency Playbook

MAY 1, 2017

They may get a little dehydrated, especially if mother’s milk is late to come in. Home care The neonate who is safe to go home is well appearing, and not dehydrated. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. Their livers are immature. Bhutani et al.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Ziqitza HealthCare Ltd

MAY 24, 2023

Traveling for work can be exciting, but it can also take a toll on your health and well-being. Lastly, prioritize mental and emotional well-being. By addressing these various aspects of your overall well-being, you can proactively prevent common health issues and lead a healthier, happier life.

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Dehydration Ambulance Services Wellness Research 52

Taming the SRU

AUGUST 27, 2024

This differential is broad and reflects the clinical diversity of their presentations - in this post we will parse through the specifics of bullous lesions as well as what there is to do for them acutely. There is typically no mucous membrane involvement, however children will also have poor feeding resulting in fluid loss and dehydration.

Emergency Department 82

Emergency Department Dehydration Burns Sepsis 82

ACEP Now

OCTOBER 30, 2023

Oftentimes, it can be an indication of pain, infection, distress, anxiety, dehydration, or the first sign of sepsis. If they are part of the Deaf community, ensure that they have an American Sign Language interpreter present, as well as an in-person interpreter to best communicate the emotion behind their speech.

Sexual Assault 98

Sexual Assault Teamwork Outcomes Dehydration 98

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Infections, fever, acidosis, hypoxia, dehydration and exposure to extreme temperatures can trigger VOC even though often no cause is identified.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

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? Well, it turns out, what is old is new again. Hypodermoclysis , otherwise known as subcutaneous rehydration.

Allergic Reactions 52

Allergic Reactions Dehydration Pediatrics Administration 52

Pediatric Education

SEPTEMBER 3, 2023

He had no concerns and he was doing well in school and with his friends. He had a sprained ankle the previous year that he says was well-healed. With your sickle cell trait you usually shouldn’t have any problems, but dehydration could cause problems for you. The past medical history was positive for sickle cell trait.

Dehydration 40

Dehydration Hyperthermia / Hypothermia Pediatrics Military 40

Don't Forget the Bubbles

NOVEMBER 15, 2023

As well as requesting relevant investigations and reviewing her drugs, you send paired urine and serum electrolytes to calculate a fractional excretion of sodium to categorise the cause as pre-renal vs other (see [link] for more information). Is it any wonder all of our PICU patients suffer from fluid overload?!

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Resuscitation Dehydration Administration Shock 80

EMDocs

JULY 29, 2023

Other bacterial causes include anaerobic oral flora, Strep viridans, E. Other bacterial causes include anaerobic oral flora, Strep viridans, E.

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EMS Dehydration Ultrasounds Emergency Department 71

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. His immunizations are current and has received all pneumococcal vaccinations. C or 100.4

Pediatrics 76

Pediatrics Dehydration EMS Hospitals 76

Don't Forget the Bubbles

JANUARY 17, 2024

Other symptoms, such as constipation, abdominal pain and dehydration, were also be seen. Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present. Zamora et al., Persistent vomiting affected all 43 cases.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

EMDocs

FEBRUARY 7, 2024

Multiple well-designed, multicenter, multinational studies suggest GLP-1 agonists are associated with improved glucose control in diabetes type 2 and approximately a 15% reduction in weight over 1-2 years (around 2/3s of patients regain weight if treatment is stopped). Obesity affects over 40% of U.S.

Allergic Reactions 75

Allergic Reactions Anaphylaxis Dehydration Wellness 75

Dr. Smith's ECG Blog

DECEMBER 11, 2018

The patient had a glucose of 1400, was severely dehydrated, and after receiving 4 liters of fluid, albuterol, and insulin, the K had dropped precipitously to 5.8 Severe dehydration. When we did get a chem back (drawn after 6 g Ca gluconate), the K was 9.0 mEq/L and the ionized calcium was not reported because it was too low.

EKG/ECG 52

EKG/ECG Dehydration Burns Outcomes 52

Don't Forget the Bubbles

JANUARY 1, 2024

While adenotonsillectomy may not directly impact cognitive functions, it can benefit other aspects of health and well-being in children with mild sleep-disordered breathing. Reviews and opinion articles Use of POCUS for the assessment of dehydration in pediatric patients-a narrative review. Musolino AM, et al. Eur J Pediatr.

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Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Northwestern EM Blog

FEBRUARY 21, 2022

Anticipatory guidance is not just for well-child checks ! We’ve all seen an end-of-life situation generate a second patient with dehydration mediated syncopal episode at the bedside, let’s try to prevent that. Second, I insist that the family especially the decision-maker drink a bottle of water and eat a sandwich.

Dehydration 52

Dehydration Shock Hospitals Wellness 52

Dr. Smith's ECG Blog

JUNE 20, 2020

. - He rehydrated and had no orthostatic symptoms prior to discharge, ambulated well. - He was not interested in remaining hospitalized for further cardiac monitoring or inpatient EP consultation as he felt well, was convinced dehydration was the reason for his syncope, and he adamantly wanted to go home.

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EKG/ECG Dehydration Hospitals Wellness 52

Don't Forget the Bubbles

JULY 17, 2023

Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study. 2023 Jun;182(6):2735-2757 Point-of-care ultrasound to assess degree of dehydration in children: a systematic review with meta-analysis. 2023 Jun;257:113325. Selvaratnam RJ, et al. J Paediatr Child Health. 2023 Jun 9. N Engl J Med.

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Pediatrics Emergency Department Outcomes Fractures 98

PEMBlog

JANUARY 17, 2024

Well when a break in the skin occurs, normal skin, flora, and bacteria can enter the subcutaneous tissue, where they do not belong, and they can also invade the lymphatic system. You can also see petechiae and hemorrhage, as well as superficial bulla, vesicles, or even echemosis. Well, bacteria, and the most common etiology.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Pediatric Emergency Playbook

FEBRUARY 1, 2017

Symptoms – either typical dysuria, urgency, frequency in a verbal child, or non-descript abdominal pain or vomiting in a well appearing child. In a low risk child, with obviously very vigilant parents, who is well appearing, you may choose not to test now, and ensure close follow up. No obvious source? How should I treat UTIs?

Wellness 52

Wellness Dehydration Ultrasounds Pediatrics 52

Don't Forget the Bubbles

AUGUST 13, 2023

After a short period of observation in the ED, he looks well and has been eating and drinking normally and playing. On examination she is febrile, well perfused with a CRT of less than 2sec, heart rate of 155 and respiratory rate of 35. The child is back to his normal self, febrile with a temperature of 38.60

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

The Skeptics' Guide to EM

APRIL 27, 2019

She is otherwise well appearing and has normal vitals and examines normally. We looked at a trial by Freedman et al using half-strength apple juice or fluids of choice to treat mild gastroenteritis in children who were minimally dehydrated ( SGEM#158 ). Anthony is known for his online RANThonys and website SketchyEBM.

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Pediatrics Dehydration Emergency Department Hospitals 40

Mind The Bleep

APRIL 26, 2024

Note: Painful teeth in well patients with mild, soft swellings with no palpable collection are often treatable with a course of oral antibiotics and seeking emergency dental treatment in the community via NHS111. Is there any asymmetry/fullness in the pharyngeal area? Is there tenderness of teeth to percussion/palpation?

Emergency Department 52

Emergency Department Fluid Resuscitation Dehydration Resuscitation 52

Dr. Smith's ECG Blog

FEBRUARY 29, 2016

He is worried that he may be dehydrated. Answer: There are well-formed Q-waves in inferior and lateral leads. He did have one episode of diarrhea. He denied fevers and chills, abdominal pain, chest pain, or SOB. Has been able to intermittently tolerate PO intake. He did not finish his dialysis run today.

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

EMDocs

DECEMBER 6, 2024

6 Can see subsequent electrolyte disturbances and dehydration related to severity of GI symptoms. Typically presents in the first few hours following ingestion. Children without vomiting within 6 hours of iron ingestion will almost never have significant toxic effects. In severe toxicity, hematemesis, melena, or hematochezia may occur.

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Poisoning Fluid Resuscitation Seizures Resuscitation 76

Dr. Smith's ECG Blog

JULY 24, 2018

Sinus tachycardia with unequivocal evidence of hyperkalemia, including widened QRS with "pulled apart" morphology (widened QRS) compared to baseline, as well as clearly peaked T-waves. We advised them to give more calcium as well as other hyperkalemia treatment during transport. This patient must receive calcium as soon as possible.

EKG/ECG 52

EKG/ECG Dehydration Resuscitation Documentation/Coding 52

Don't Forget the Bubbles

SEPTEMBER 29, 2024

Most children are generally well and can be sent home directly from the ED with appropriate safety netting and follow-up. Let’s break it down: Less than 50% of normal fluid intake in a 24-hour period Children who are sick generally don’t eat or drink, so dehydration is a legitimate concern. Then, they are safe for discharge.

Emergency Department 52

Emergency Department Dehydration Hospitals Fractures 52

Mind The Bleep

JUNE 18, 2023

environmental factors, pain, infection, dehydration, electrolyte disturbance, head injury, medication etc) Does the individual have capacity? In a general hospital there are the dementia and delirium team, as well as Liaison Psychiatry who you can refer to.

Psychiatric 52

Psychiatric Documentation/Coding Stroke Fractures 52

PEMBlog

MARCH 27, 2024

Or, well, the ringer called me. GI symptoms are the second most common, and they include vomiting, food intolerance, food aversion, GERD, refractory to normal antireflux measures, diarrhea, and dehydration. This was made by people who know them very well. And you’re thinking, hey! No, I’m not.

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Pediatrics Seizures Emergency Department Sepsis 59

Dr. No

DECEMBER 19, 2021

It’s not often that Dr No’s flabber gets well and truly ghasted. An extraordinary exchange on twitter (scroll down a page or so to get to the start of the substance, and click here to see the above tweet) has revealed what many have long suspected: SAGE purposely cook the books in its modelling reports.

Infectious Diseases 52

Infectious Diseases Outcomes Dehydration Operations 52

Dr. Smith's ECG Blog

MARCH 15, 2023

But when you see this, you should suspect that the AV node is not well. My main concern about Apple Watch monitoring — is the potential for increasing the anxiety of otherwise well individuals who become overly focused on, “What terrible arrhythmia is my Apple Watch now showing at this particular moment?”

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

Mind The Bleep

MAY 16, 2023

It is also sensible to advised to ensure good fluid intake throughout treatment to help avoid dehydration which can occur with laxatives. If the child has evidence of faltering growth , we should always test for coeliac disease and hypothyroidism.

Dehydration 52

Dehydration Best Practices Documentation/Coding Emergency Department 52

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. For the sake of completeness, just be aware that there is also the biliopancreatic diversion with or without a duodenal switch, as well as a vertical banded gastroplasty. At 6 to 8 mL/kg.

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Emergency Department Sepsis Operations Ultrasounds 40

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Pediatric Education

DECEMBER 15, 2024

He was acting well, and attempting to breastfeed. However it caries risk of dehydration, sunburn, and hypothermia. Patient Presentation A 36-hour-old, 38 6/7 week male in the newborn nursery was noted to be more yellow in his skin color. He had had 2 wet diapers and 1 stool since birth.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Pediatrics Dehydration Wellness 40