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Neurogenic Shock in Children

Pediatric EM Morsels

” Children compensate for blood and volume loss very well… until they don’t. Physical exam findings of occult shock in children can be subtle. Fortunately, there are screening tools for occult shock. It may, however, be seen preceding or concurrently with neurogenic shock.

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The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

RebelEM

Background: Cardiogenic shock develops in up to 10% of patients with acute myocardial infarction (AMI) and carries a 30 day mortality rate around 50%. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8%

Shock 136
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A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

What is Shock? Shock is defined as a type of circulatory failure where lack of oxygen leads to dysfunction of vital organs. There are many types of shock which may affect children, and management is specific to the type of shock. The overall goal in managing any cause of shock is to restore oxygen delivery to the organs.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. Fun fact for animal lovers!-

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Diastolic Shock Index: A clinically relevant predictor of poor outcome in septic shock?

Taming the SRU

Diastolic shock index and clinical outcomes in patients with septic shock. O: There was an association between increased diastolic shock index score and mortality at 90 days and performed similarly to more advanced measures of morbidity and mortality in septic shock including lactate levels and SOFA scores.

Shock 52
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EM@3AM: Stercoral Colitis

EMDocs

Well keep it short, while you keep that EM brain sharp. 2, 8-10, 14 The clinical symptoms range from vague abdominal pain to florid septic shock and peritonitis secondary to bowel perforation. 2-4 Any patient with evidence of complications or septic shock may need surgical management or a higher level of care. Mathis, K.

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Trauma Resuscitation Updates

RebelEM

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4% NEJM 1994. [2] NEJM 1994. [2]