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James Broselow, a family medicine-turned-emergency medicine physician from Hickory, North Carolina , recognized that his team spent a lot of time trying to calculate doses of medications rather than spending their mental energy on the actual medical decisions for the resuscitation. This system has now become the “ industry standard.”
Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. Cureus, 15(7), e41705.
To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Unfortunately, there are numerous other pitfalls that can be encountered during the management of pediatric trauma patients.
Neonatal resuscitation is common; 10 percent of the four million newborns in the U.S. 2 These rare scenarios are difficult to prepare for; resuscitation guidelines are not strictly followed in more than 90 percent of cases. Neonatal resuscitation is common; 10 percent of the four million newborns in the U.S. 3 Click to enlarge.
On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine (..)
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 Pediatric Emergency Medicine Collaborative Research Commitee.
We’ll keep it short, while you keep that EM brain sharp. CT scans are typically not recommended in pediatric patients, but can be useful in adults with concern for tracheal stenosis or recurrent tracheitis, however airway stabilization takes precedence. [2][3] Hospital Pediatrics. Pediatric Pulmonology. Published 2023.
3 A three-pronged management approach provides a framework for addressing post-tonsillectomy bleeds: resuscitation, early ENT consultation with transport arrangements, and temporizing measures applied to control bleeding. Special thanks to Dr. Kevin Wasko, guest expert on the EM Cases podcast on this topic, who inspired this column.
Pediatric trauma is a high acuity but low frequency event (2). There is a well-documented correlation amongst EMS and adult ED physicians who provide less pediatric care to […] The post Pediatric Traumatic Cardiac Arrest appeared first on EMOttawa Blog.
EM Quick Hits is a brand new EM Cases podcast that contains 5 minute segments chosen from 10 specific topics by 10 different experts and educators. They include toxicology, trauma, ophthalmology, orthopaedics, resuscitation, human factors, addiction and pediatric emergencies.
Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Arch Pediatr Adolesc Med. 1 Obtain a single view abdominal x-ray.
Of course, we all have a healthy respect for post-tonsillectomy hemorrhage and we like to talk about Damage Control Resuscitation. Acute Esophageal Variceal Bleeding: Basics Pediatric liver disease may be due to numerous causes. Pediatric patients with cirrhosis and acute Upper GI Bleeds are at risk of developing bacterial infections.
On this month's EM Quick Hits: Christina Shenvi on ACS in older people, Nour Khatib on rural NRP, Jess McLaren on how not to get fooled by ECG computer interpretation, Brit Long on hemophilia recognition and workup, Maria Ivankovic on persistent and intractable hiccups from EM Cases Summit 2021.
Things like inaccurate estimation of burn size, unnecessary endotracheal intubation, over- and under-estimation of fluid resuscitation volumes, inadequate analgesia and inappropriate wound dressings are just some of the issues where a small change to ED practice patterns could have a huge impact on patient care.
In this EM Cases Best Case Ever podcast, Dr. Kari Sampsel, Emergency Physician at Ottawa Hospital and Assistant Professor at University of Ottawa, Medical Director of Sexual Assault and Partner Abuse Care Program guides us through an example of a perimortem C-section - a resuscitative hysterotomy at Janus General.
Management of the pediatric trauma patient is challenging regardless of where you work. How do you clear the pediatric c-spine? Are atropine and fentanyl recommended as pre-induction agents in the pediatric trauma patient? Is tranexamic acid recommended in early pediatric trauma like it is in adults? and many more.
In this EM Cases Best Case Ever podcast Rajiv interviews Dr. Eric Russell, Assistant Professor of Pediatrics at the Baylor College of Medicine, Pediatric Emergency Medicine attending physician at the Texas Children's Hospital, and editor at the Human Diagnosis Project.
The GCS should be measured after airway, breathing, and circulation are assessed, after a clear airway is established, and after necessary ventilatory or circulatory resuscitation has been performed. The guidelines also address issues related to EMS provider skill level, transportation modality, and destination for the patient.
r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Assessed and provided feedback of pediatricresuscitations based on video review.
In anticipation of EM Cases Episode 90 on the Pediatric Advanced Life Support (PALS) guidelines with the lead author Dr. Allan DeCaen and Dr. Anthony Crocco, Dr. DeCaen tells his Best Case Ever showing us the value of orchestrated team work and a great example of the saying, "they're not dead until they're warm and dead".
The post EM Quick Hits 5 Ludwig’s Angina, Transient Monocular Vision Loss, D-dimer for PE Workup in Pregnancy, Pediatric Nasal Foreign Bodies, Trimethoprim Drug Interactions, Airway Management in Cardiac Arrest appeared first on Emergency Medicine Cases.
Just as pediatric patients are not small adults, geriatric patients are not just old adults. In this Part 1 of our 2-part EM Cases podcast series on Geriatric Trauma, Dr. Barbara Haas, Dr. Camilla Wong and Dr. Bourke Tillman answer questions such as: why are older patients under-triaged to trauma centers and how does that affect outcomes?
General resuscitation with broad spectrum antibiotics and volume resuscitation if the patient appears to be septic. Predictive value of visible lesions (cheeks, lips, oropharynx) in suspected caustic ingestion: may endoscopy reasonably be omitted in completely negative pediatric patients? Pediatr Emerg Care. N Engl J Med.
In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. to −0.5%]; P = 0.03.).
Direct Oral Anticoagulants in Pediatrics Spoon Feed Treatment with direct oral anticoagulants (DOACs) in pediatric patients appears to reduce venous thromboembolism (VTE) recurrence compared to standard of care, with no difference in major bleeding or serious adverse events. Resuscitation. Ann Emerg Med. 2023 Aug;82(2):219-221.
Neonatal resuscitation in the delivery room. Cardiopulmonary resuscitation. Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine. Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review My EMCert Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. 100% 21% 30% 50% References Fernandes CJ.
For decades, only one major organization—the American Heart Association (AHA)—provided standardized training and certifications in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS). In 2015, it introduced Basic Life Support (BLS) training and certification for EMS personnel.
The post Neonatal Resuscitation NRP Rapid Reviews Video appeared first on Emergency Medicine Cases. Nick Clarridge runs through the NRP algorithm and delivers the nuggets of wisdom on how best to prepare for the sick neonate, best monitoring practices and ventilation strategies of the neonate.
A bayesian interpretation of a pediatric cardiac arrest trial (THAPCA-OH). She is part of the Don’t Forget the Bubbles team and faculty at Queen Mary […] The post SGEM #404: Sitting on the Dock of the Bay-esian Interpretation of Therapeutic Hypothermia for Pediatric Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.
Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Czech Military resuscitation kit, 1969, mfr.
The post EM Quick Hits 32 Checkpoint Inhibitors, Adult Epiglotitits, HSP, Heat Stroke, Bell’s Palsy and Leukemia appeared first on Emergency Medicine Cases.
When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. 11) A bolus dose at 1.5 Am J Case Rep. 2019;20:640-2.
Hilary Whyte, Dr. Jabeen Fayyaz, Dr. Emily MacNeill discuss a neonatal resuscitation algorithm, airway management, fluid resuscitation, central access tips, glucose and temperature control and transport tips.
In this months EM Quick Hits podcast: The mighty return of Carr's Cases! The post EM Quick Hits 34 Carr’s Case, Septic Arthritis vs Transient Synovitis, Managing Tracheostomies, Ethylene Glycol Poisoning, Ketamine for Agitation appeared first on Emergency Medicine Cases.
Crash course in pediatric anatomy and physiology in trauma When you think of trauma in children, think of Charlie Brown. In pediatric trauma, we need to be proactive. Chest Tube Pearl #1: Chest tube sizing in pediatrics is straightforward if we remember that the traditional chest tube size is 4 x the ETT size. In children ?
In this month's EM Quick Hits podcast, Anand Swaminathan on postpartum hemorrhage, Justin Morgenstern on phenobarbital in pediatric status epilepticus, Michelle Klaiman on managed alcohol programs, Andrew Petrosoniak on traumatic cardiac arrest, Brit Long on cholangitis pearls and pitfalls and Bourke Tillman on ED approach to ARDS.
The post Neonatal Resuscitation Rapid Review Video Part 2 – Chest Compressions, Epinephrine, Algorithm Pearls and Pitfalls appeared first on Emergency Medicine Cases.
This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. ELSO guidelines for adult and pediatric extracorporeal membrane oxygenation circuits. Extracorporeal Cardiopulmonary Resuscitation. Resuscitation.
But, over the past 15 years, survival to discharge from pediatric cardiac arrest has markedly improved, at least for in-hospital arrests. The post Episode 93 – PALS Guidelines appeared first on Emergency Medicine Cases.
It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.
The post EM Quick Hits 35 – 10 Best Papers of 2021, Peripartum Cardiomyopathy, Crashing Asthmatic, Febrile Neutropenia, Anaphylaxis update appeared first on Emergency Medicine Cases.
The post EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines appeared first on Emergency Medicine Cases.
Salim Rezaie on single syringe adenosine for SVT, Sarah Reid on pertussis pearls, Elisha Targonsky on management of hyperemesis gravidarum , Joe Nemeth on the utility of hypertension as a risk factor in EM, Justin Morgenstern on tramadol myths, Reuben Strayer on ketamine only breathing intubation (KOBI).
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