Taming the SRU

APRIL 13, 2023

EtOH, amphetamines, or cocaine) Prescription drugs (i.e. beta blockers decrease ability to dissipate heat through increase CO, diuretics predispose to dehydration, or anticholinergic agents can affect thermoregulation) Clinical Presentation: Temperature elevation, usually 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Don't Forget the Bubbles

NOVEMBER 11, 2024

Therapeutic hypothermia is thought to decrease the brain’s metabolic demand, reduce inflammation and cell death, and reduce the risk of seizures. Pediatr Crit Care Med. Targeted Temperature Management in Pediatric Traumatic Brain Injury: A Systematic Review and Network Meta-Analysis. What do the guidelines recommend?

Hyperthermia / Hypothermia 117

Hyperthermia / Hypothermia Pediatrics Outcomes Resuscitation 117

EMDocs

DECEMBER 6, 2024

Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). 2 L/hr in adults.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

Don't Forget the Bubbles

FEBRUARY 5, 2025

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation. Administer O2 if necessary.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

ACEP Now

OCTOBER 3, 2023

Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. The GCS must be obtained through interaction with the patient (i.e., The GCS must be obtained through interaction with the patient (i.e.,

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

EMDocs

JANUARY 4, 2024

Bupropion lowers the seizure threshold and even at therapeutic doses patients can have seizures. 6 Severe toxicity: Seizures: It is unclear if seizures are caused by bupropion or the active metabolite, hydroxybupropion. 3 Seizures are dose-dependent. 3 Seizures are dose-dependent.

Seizures 91

Seizures EKG/ECG Poisoning Shock 91

Don't Forget the Bubbles

AUGUST 12, 2024

After a traumatic brain injury, all children and young people should have a C-ABCDE rapid assessment for life-threatening injuries (as per ATLS guidelines) focussed on trauma resuscitation and stabilisation, followed by a secondary assessment. Do we need seizure prophylaxis? An update on pediatric traumatic brain injury.

Seizures 75

Seizures Pediatrics Emergency Department Ambulance Services 75

EMDocs

MAY 15, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. There are a variety of triggers, including infection (most common in pediatric patients), fat embolism, vaso-occlusive pain crisis, pulmonary embolism, and others. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. times maintenance.

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

EMDocs

JANUARY 17, 2024

She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9)

Poisoning 89

Poisoning Seizures Pediatrics EMS 89

EMDocs

JULY 30, 2024

Shortly after this, he began vomiting, and developed a tonic clonic seizure. There was no prodromal illness, recent trauma, polyuria or polydipsia, family history of seizure disorder or diabetes. Treat the DKA as you would with any other patient; insulin, appropriate fluid resuscitation, and electrolyte repletion. N Engl J Med.

Poisoning 74

Poisoning Seizures Fluid Resuscitation Pediatrics 74

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. There are a variety of triggers, including infection (most common in pediatric patients), fat embolism, vaso-occlusive pain crisis, pulmonary embolism, and others. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. times maintenance.

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

Cook County EM Blog

MAY 29, 2023

As resuscitation measures are underway, you obtain collateral from EMS and parents. Signs and symptoms of toxicity include alerted mental status, seizures, CNS depression, apnea, respiratory failure, hypotension, ventricular dysrhythmias, and cardiac arrest. Seizures should be treated with benzodiazepines. 28 June 2019.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

Pediatric Emergency Playbook

JUNE 1, 2017

Hemodynamically labile children should be resuscitated and a stat transesophageal echocardiogram obtained. The child with seizure disorder and chest pain: anti-epileptics Some anti-epileptic agents, such as carbamazepine, promote a poor lipid profile, leading to atherosclerosis and early MI. J Curr Pediatr. Pediatr Cardiol.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. A similar process can also occur in the CNS (causing seizures ), the liver and the pancreas. Pediatric Nephrology. 4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy. She is apyrexial, tachycardic and normotensive.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Taming the SRU

FEBRUARY 23, 2024

Clinical pathologic case presentation - r1 diagnostics/therapeutics: Lumbar punctures - AIRWAY GROUND ROUNDS- r4 capstone - r3 taming the sru - ultrasound grand rounds Clinical pathologic case presentation WITH Drs.

Pediatrics 75

Pediatrics Ultrasounds Fractures Wellness 75

Taming the SRU

MAY 30, 2023

Comiskey Hyperammonemia 10% of of patient presenting with hepatic encephalopathy do not have elevated ammonias Most commonly seen in adults is secondary to liver dysfunction with cirrhosis or portal venous system shunting. Legal implications vary from country to country.

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

HELLP Syndrome [pdf] Sara Paul MD Intrauterine Fetal Demise [ppt] Irene Hwang, MD Obesity in Pregnancy [pdf] Rafael Garabis, MD Seizures in Pregnancy [ppt] Sherifia Heron , MD Substance Abuse in Pregnancy [ppt] Sophia Y. Reid, C (2011) Prehospital resuscitative hysterotomy op.cit. Episiotomy [ppt] Alice Teich, MD. Weingart, S.,

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Critical Care Now

JUNE 21, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. His coach and fellow players witnessed a seizure-like activity immediately after collapsing. Later in the pediatric intensive care unit (PICU), he developed pulmonary edema, but he continued to improve neurologically.

Seizures 52

Seizures EKG/ECG CPR Shock 52

Pediatric Education

NOVEMBER 10, 2024

What are the basic first steps for newborn resuscitation? Toxoplasma gondii infections in pediatric neurosurgery. D’Alessandro, MD Professor of Pediatrics, University of Iowa The classic triad of congenital toxoplasmosis is chorioretinitis (bilateral), intracranial calcifications and hydrocephalus. Clinics in Perinatology.

Infectious Diseases 40

Infectious Diseases Pediatrics Seizures Resuscitation 40

Pediatric EM Morsels

MARCH 7, 2025

Let’s take a moment to review TXA (Tranexamic Acid) in Pediatrics! Wouldnt it be nice if there were adjuncts to prevent further bleeding or add benefit when blood may not be option (prehospital)? Enter TXA or tranexamic acid , The Clot Stabilizer!Let’s mg/kg [Nishijima 2016] Poorly studied in renally impaired patients.

Pediatrics 231

Pediatrics Blood Transfusions Anaphylaxis Military 231

EMDocs

JUNE 7, 2023

mg/kg pediatrics) Double dose every 5 min Titrate up to end point of therapy and may require very large doses Target End Point of Therapy = clear chest sounds, HR > 80/min, pupil size greater than pinpoint, and dry axillae. Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. See figure below.

Poisoning 98

Poisoning Airway Management Seizures PPE 98

Taming the SRU

FEBRUARY 3, 2025

These can lead to a wide spectrum of emergent complications including but not limited to cardiac dysrhythmias, seizures, and acute renal failure. It is also worth noting that these aggressive hematologic cancers occur more commonly in children and thus the risk of TLS can be higher in the pediatric population6. in females and 2.5-7.0

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

Don't Forget the Bubbles

AUGUST 13, 2023

Most febrile seizures are generalized tonic clonic seizures, lasting for a few minutes (less than 10 mins) and are conventionally classified as being simple (70%) and complex (30%). Simple febrile seizures are generalized (i.e. Any febrile seizure lasting for > 30 mins is considered febrile status epilepticus.

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, HAJDU Mild TBI’s & Concussions in the Emergency Department TBI’s are relatively common >3 million TBI’s in the US annually 2.5

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Don't Forget the Bubbles

OCTOBER 9, 2023

A 13-year-old girl came to the ED with an unprecedented, prolonged seizure. When she arrived in the department, the seizure had stopped. I emailed him, apologising for the inconvenience explaining that I was resuscitating a child and lost track of time. A head CT scan was arranged. Unexpectedly, he replied with an apology.

Seizures 116

Seizures Incident Reporting Emergency Department Research 116

Taming the SRU

NOVEMBER 13, 2024

opiates or anticholinergics): Use initial nomogram and treat if initial level is above the treatment line. haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S.,

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89

Taming the SRU

AUGUST 25, 2023

wrist in extension clavicle tibial pediatric forearm Most likely injuries to need an x-ray? bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

EMDocs

MARCH 11, 2024

Rehydration therapy for patients with cholera should include volume resuscitation and electrolyte repletion. Patients who cannot tolerate oral intake of fluids should receive intravenous (IV) fluid resuscitation but are encouraged to start drinking ORS as soon as they are able. Pediatr Infect Dis J. 2013;8(1):e54395.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111

ACEP Now

OCTOBER 29, 2024

Pediatric cardiology was consulted. 3-6 Additional features include first-degree atrioventricular block, atrial arrhythmias, nocturnal agonal breathing, and seizures. 7 The ECG findings can be concealed or transient after resuscitation from cardiac arrest. Pediatr Cardiol. Click to enlarge.) Figures 4: A. 2024;11(3):281.

Pediatrics 52

Pediatrics EKG/ECG Documentation/Coding Hospitals 52

EMDocs

JANUARY 6, 2025

She presents with a seven-day history of fever, fatigue, and myalgias associated with decreased oral intake and an episode of seizure-like activity three hours prior to arrival. Additionally, there is no family history of seizure disorders. BMC Pediatr. A review of systems is notable for nausea and vomiting but no diarrhea.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75