The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Taming the SRU

NOVEMBER 21, 2023

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? The time from diagnosis to treatment does not affect outcomes in patients with AML.

Pediatrics 92

Pediatrics EKG/ECG Resuscitation Dehydration 92

Emergency Medicine Cases

AUGUST 24, 2021

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?

Resuscitation 52

Resuscitation Head Injuries Airway Management Shock 52

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. Obviously, one also needs to address the cause of the shock, or any efforts in resuscitation will only bring a temporary improvement. Pediatr Crit Care Med. Pediatr Crit Care Med. After 40ml/kg of IV 0.9%

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

The Skeptics' Guide to EM

MAY 20, 2023

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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

Don't Forget the Bubbles

MAY 6, 2024

Acad Pediatr. Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. The primary outcome was the successful intubation on the second attempt. Pediatric Critical Care Medicine , 25 (3), pp.e117-e128. 2024;24(1):111-118.

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

Don't Forget the Bubbles

AUGUST 7, 2023

The study also did not assess outcomes for each patient, and as such, the impact on deviation from the normal range was not explored. Yes Was the outcome accurately measured to minimize bias? Pediatrics. Evaluating the Pediatric Early Warning Score (PEWS) System for Admitted Patients in the Pediatric Emergency Department.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Don't Forget the Bubbles

MAY 8, 2024

An interesting study (JAMA Pediatrics) shows the benefits of newborn screening for spinal muscular atrophy (SMA), as initiating disease-modifying therapy earlier improves clinical outcomes. These findings advocate for expanding newborn screening programs to enhance outcomes for children with SMA. Pediatr Nephrol.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

PEMBlog

AUGUST 20, 2024

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.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

PHEM Cast

APRIL 16, 2018

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.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

Critical Care Now

JUNE 30, 2024

The latest Surviving Sepsis Campaign (SSC 2021) guidelines say the following about albumin in in sepsis: The lack of proven benefit and higher cost of albumin compared to crystalloids contributed to our strong recommendation for the use of crystalloids as first-line fluid for resuscitation in sepsis and septic shock.

Sepsis 52

Sepsis Fluid Resuscitation Shock Resuscitation 52

AED Leader

JULY 5, 2024

It features a clear and intuitive interface that guides users through the resuscitation process with step-by-step voice prompts and visual instructions. Smart CPR Guidance Cardiopulmonary resuscitation (CPR) is a critical component of saving a life during a cardiac arrest.

CPR 52

CPR Resuscitation Shock Pediatrics 52

AED Leader

APRIL 22, 2024

Lifepak AED Defibrillators: Cutting-Edge Technology Lifepak AED defibrillators are at the forefront of AED technology, incorporating advanced features and innovations to improve outcomes in cases of sudden cardiac arrest. This feature helps rescuers optimize their CPR technique and improve the chances of a successful resuscitation.

CPR 52

CPR Shock Resuscitation Operations 52

AED Leader

JULY 3, 2024

Real-Time CPR Feedback Performing cardiopulmonary resuscitation (CPR) correctly is crucial for the success of a resuscitation attempt. Real-time feedback minimizes the risk of human error and maximizes the chances of a successful resuscitation. Yes, Cardiac Science AEDs have pediatric capabilities.

CPR 52

CPR Resuscitation Pediatrics Operations 52

Don't Forget the Bubbles

NOVEMBER 15, 2023

One-liner… Understanding how to manage maintenance fluids in critically unwell children best is a basic but important way to improve outcomes. 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. Pediatrics.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

AED Leader

JULY 1, 2024

The clear and intuitive interface provides step-by-step instructions, guiding users through the resuscitation process. With quick charging and short analysis times, the LifePak 100 allows for rapid intervention, increasing the chances of a positive outcome. The LifePak 100 defibrillator can be used on adult and pediatric patients.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Pediatric Emergency Playbook

APRIL 1, 2016

Read on to go from bread-and-butter pediatric blood work to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids? This is especially true in children – the majority of pediatric ambulatory visits do not require blood work to make a decision about acute care. The punchline is, use a pediatric reference.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Taming the SRU

SEPTEMBER 15, 2023

Limited availability of radiology-performed US services in certain hospitals, especially overnight Can avoid unnecessary anticoagulation in patients Reduce time in ED to disposition In terms of workflow, when there is suspicion for a DVT, you need to first calculate a Wells’ Score for a DVT If low/moderate risk, can start with a D-dimer prior to committing (..)

CPR 91

CPR Burns Airway Management Wellness 91

Don't Forget the Bubbles

OCTOBER 2, 2024

As the resuscitation continues, his heart rate falls, his respiratory effort becomes increasingly irregular and his systolic blood pressure rises. Guidelines for the management of pediatric severe traumatic brain injury, third edition: Update of the brain trauma foundation guidelines. Pediatric Critical Care Medicine.

Administration 49

Administration Pediatrics Outcomes Research 49

AED Leader

DECEMBER 2, 2024

Furthermore, regular maintenance and training in cardiopulmonary resuscitation (CPR) techniques significantly enhance the potential effectiveness of AEDs in emergencies. Rapid treatment is vital to improve survival outcomes. Cardiac arrests can happen anywhere, from public spaces to private homes.

CPR 52

CPR Basic Life Support Resuscitation Hospitals 52

JournalFeed

MARCH 26, 2022

Epi vs. NorEpi Spoon feed: Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine. Check out journalfeed.org for details.

Stroke 40

Stroke Documentation/Coding Emergency Department Resuscitation 40

Advanced Emergency Nursing from AENJ

NOVEMBER 27, 2017

AHA gives focused recommendations ​. ​ ​​ The International Liaison Committee on Resuscitation (ILCOR) has for some years been meeting and agreeing upon resuscitation practices every five years; in addition to which there is the necessary slack time before and after each meeting to produce and disseminate the newly appropriate course materials.

CPR 40

CPR Basic Life Support Resuscitation Pediatrics 40

EM Literature of Note

JANUARY 9, 2022

The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We Omnipotent or Incompetent?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

Don't Forget the Bubbles

JUNE 26, 2023

The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. These cases illustrate some of the common issues associated with each shunt type, but what does the evidence say about outcomes? What is the best option for repair? 2014;165(3):490-496.e8.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Dr. Smith's ECG Blog

JULY 22, 2012

There is some old literature which I read in the 1980's (but cannot find now), that suggested that ST abnormalities due to myocardial contusion have the highest risk of any ECG finding for adverse outcomes and a higher risk than positive cardiac biomarkers (at that time, the biomarker was CK or CK-MB). Could an angiogram have found this?

Head Injuries 52

Head Injuries EKG/ECG Ultrasounds Outcomes 52

Mind The Bleep

FEBRUARY 27, 2024

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. Boluses were given in 20-40ml/kg aliquots.

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

Don't Forget the Bubbles

SEPTEMBER 5, 2024

Comparing the performance of pediatric weight estimation methods. In the emergency department resuscitation room, weight is usually estimated using an age-based formula until the child is stabilised and can be safely weighed. Obesity is considered a contributing factor for some musculoskeletal outcomes. Front Pediatr.

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. EtOH, amphetamines, or cocaine) Prescription drugs (i.e. cuffed ETT) preloaded and intubate through the stoma if PPV needed Infection (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Emergency Medicine Cases

JANUARY 18, 2022

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.

Anaphylaxis 52

Anaphylaxis EMS Outcomes Hyperthermia / Hypothermia 52

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. The aim of TTM is to control the body and brain’s temperature, thus reducing secondary brain injury and improving the neurological outcome. What do the guidelines recommend?

Hyperthermia / Hypothermia 117

Hyperthermia / Hypothermia Pediatrics Outcomes Resuscitation 117

EB Medicine

AUGUST 6, 2019

In the end, they reported similar rates of recurrence and bleeding outcomes for acute treatment. Nachi: Though you can, in theory, test for plasma DOAC concentrations, such tests are not routinely indicated as levels don’t correspond to bleeding outcomes. of patients per year. Nachi: Next we have apixaban, tradename Eliquis.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 40

Pediatric EM Morsels

JULY 28, 2023

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.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

EMDocs

DECEMBER 6, 2024

Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). 7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Antiemetics as needed.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

EB Medicine

JULY 8, 2019

Jeff: Resuscitation should be aimed at early fluid replacement with IV crystalloids for hypovolemic patients and packed RBC transfusions for patients presumed to be unstable from hemorrhage. with generally good clinical outcomes including improved quality of life and reducing or staving off comorbidities. 2015;25(4):622-627.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ACEP Now

OCTOBER 11, 2024

Pediatric submersion injuries are one of the leading causes of preventable morbidity and mortality in the pediatric population. 1,2 Clinical outcomes in submersion injuries are largely dependent on the degree of hypoxic injury experienced by the victim, making prehospital care of paramount importance.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

ACEP Now

OCTOBER 3, 2023

These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. This document is an update of guidelines first published in 2000, and then updated in 2007.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

EMDocs

OCTOBER 19, 2024

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] 2][3][9] Glucocorticoid were not shown to alter clinical course or patient outcomes. [2][3] Hospital Pediatrics.

EMS 110

EMS Pediatrics Sepsis Airway Management 110