Don't Forget the Bubbles

JUNE 30, 2023

She has a right parietal-occipital region haematoma, and you think you might be able to feel a step – you’re pretty convinced she has a palpable skull fracture. The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Two IVs go in, one in each antecubital fossa.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

Don't Forget the Bubbles

NOVEMBER 11, 2024

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. His CT scan showed extensive cranial fractures, traumatic subarachnoid haemorrhage, and intraparenchymal haemorrhage. At the scene, his lowest GCS was 5 (E1V2M2).

Hyperthermia / Hypothermia 116

Hyperthermia / Hypothermia Outcomes Pediatrics Resuscitation 116

Taming the SRU

AUGUST 25, 2023

doxycycline Consider a splint/cast window to allow direct monitoring mainly used for fracture blisters and/or open wounds yet takes away from the strength of the splint/cast Case #3 43yo with FOOSH injury and closed wrist deformity, yet no x-ray machine is available to you Least likely injuries to need an x-ray in a resource-limiting setting?

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

PEMBlog

SEPTEMBER 13, 2023

Team members and families eagerly await your intervention to halt the seizure and understand its underlying cause. The lack of utility of laboratory testing in children with an unprovoked generalized seizure, or a simple febrile seizure is supported by several observational studies.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Documentation/Coding Fractures Administration 95

Taming the SRU

MARCH 17, 2023

mepivacaine (1-3 h) 1% lidocaine +/- epi (2-3h) 0.25% bupivacaine (2-3 h) 0.25-0.5% mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2

Seizures 40

Seizures Fractures Burns Pediatrics 40

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

He is not on anticoagulation and there is no history of seizures. In an attempt to improve resource utilization, emergency department length of stay, limit cost and improve outcomes, there have been multiple Clinical Decision Rules (CDRs) created to help guide clinicians in their decision-making process.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52