Pediatric Emergency Playbook

JUNE 1, 2016

Do we recognize shock early enough? World wide, shock is a leading cause of morbidity and mortality in children, mostly for failure to recognize or to treat adequately. So, what is shock? Simply put, shock is the inadequate delivery of oxygen to your tissues. How do we prioritize our interventions? Pericardial Effusion?

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Shock Sepsis Pediatrics Ultrasounds 40

EMDocs

JANUARY 13, 2024

sodium chloride) reduced acute kidney injury and improved other outcomes in these pediatric patients with septic shock. Source Multiple Electrolytes Solution Versus Saline as Bolus Fluid for Resuscitation in Pediatric Septic Shock: A Multicenter Randomized Clinical Trial. Crit Care Med. 2023 Nov 1;51(11):1449-1460.

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Stroke Shock Pediatrics Resuscitation 62

Don't Forget the Bubbles

JUNE 30, 2023

Ranulf went white with the shock. 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.

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Resuscitation Operations Sepsis Pediatrics 139

Emergency Medicine Cases

MARCH 10, 2020

Dr. Allan Shefrin tells his Best Case Ever of a child who presents in shock and discusses the causes of tension hydrothorax, indications for tube thoracostomy for hydrothorax and integration of POCUS into pediatric resuscitation. The post BCE 81 Tension Hydrothorax appeared first on Emergency Medicine Cases.

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Shock Pediatrics Resuscitation Ultrasounds 52

Taming the SRU

JANUARY 12, 2024

pediatric small groups WITH our cchmc colleagues Dermatologic emergencies Children can present with a wide range of rashes, many of which are benign, however identifying concerning rashes is very important. Use your resources to differentiate scary from benign! Children are not just small adults!

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Fluid Resuscitation Pediatrics Sepsis Shock 59

Pediatric Emergency Playbook

FEBRUARY 1, 2016

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 ?

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Resuscitation Pediatrics Fractures Emergency Department 40

Advanced Emergency Nursing from AENJ

MAY 3, 2014

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.

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EMDocs

OCTOBER 8, 2024

Pediatric rate cut off for tachycardia varies with age but again is defined as a heart rate great than what the normal appropriate resting heart rate for that particular age range. Additional resuscitation Have we addressed all potential sources of shock for the patient in front of us? What is this patient’s disposition?

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AED Leader

JUNE 11, 2024

Philips defibrillators come with clear visual and audio prompts that guide users through each step of the resuscitation process. Smart CPR Feedback and Real-Time Monitoring Adequate cardiopulmonary resuscitation (CPR) is crucial for increasing the chances of survival during a cardiac arrest.

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CPR Shock Resuscitation Operations 52

EMDocs

DECEMBER 6, 2024

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. 6 Severe toxicity and shock are typically seen with serum iron concentrations above 500 g/dL and serum iron concentrations above 1000 g/dL are associated with significant mortality. Arch Pediatr Adolesc Med.

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Poisoning Fluid Resuscitation Seizures Resuscitation 77

EMDocs

NOVEMBER 6, 2023

Use of 20% intravenous lipid emulsion can be efficacious in the resuscitation of life-threatening local anesthetic toxicity, especially from bupivacaine. Venoarterial extracorporeal membrane oxygenation can be lifesaving for patients with cardiogenic shock or dysrhythmias that are refractory to other treatment measure s.

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Poisoning Hyperthermia / Hypothermia Seizures Administration 95

AED Leader

APRIL 22, 2024

The Role of AEDs in Sudden Cardiac Arrest AEDs are portable electronic devices designed to deliver an electric shock to the heart and restore its rhythm during SCA. AEDs analyze the heart’s rhythm and determine whether a shock is needed. Quick Shock Technology Time is of the essence in a sudden cardiac arrest situation.

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CPR Shock Resuscitation Operations 52

Don't Forget the Bubbles

MAY 10, 2023

A shocked friend is being ushered out of the way. Resuscitation is a team sport. Role stickers or role aprons with names on them are simple measures to highlight resuscitation roles. A study in Denmark in 2021 explored barriers to effective resuscitation in over 900 in-hospital resuscitations across six hospitals in Denmark.

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Emergency Department Resuscitation Documentation/Coding Teamwork 91

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. The HeartStart OnSite AED boasts a quick start-up time and delivers a shock within eight seconds if it detects a shockable rhythm.

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CPR Resuscitation Shock Pediatrics 52

AED Leader

SEPTEMBER 23, 2024

Avoid using it on someone with a Do Not Resuscitate (DNR) order. Use pediatric pads for children under eight years old or weighing less than 55 pounds. That tiny shock given by the defibrillator? Also, if the person has a Do Not Resuscitate (DNR) order in place, using a defibrillator isn’t recommended.

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Shock Resuscitation CPR Pediatrics 52

Taming the SRU

JANUARY 24, 2024

ETT Depth = ETT size x3 initial defibrillation: 2J/kg (next shock is 4J/kg) Toxicology Quick Hits Fomepizole is the treatment for both polyethylene glycol and methanol toxicity.

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Fractures Leadership Dislocations Resuscitation 87

EMDocs

JUNE 25, 2024

Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion. Typically for adults with a TBSA of at least 20% or 10% in pediatric patients. IOs and central lines are also options. Total amount over 24 hours.

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Burns Fluid Resuscitation Resuscitation Poisoning 74

Pediatric Emergency Playbook

MARCH 1, 2016

On arrival, he was in compensated shock, with tachycardia. Pediatric Massive Transfusion 40 mL/kg of blood products given at any time within the first 24 hours. Resuscitative Pearls Our goal here is damage control. Otherwise, resuscitate, identify the bleeding source, and slow or stop the bleeding with blood products or surgery.

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Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

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.

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Emergency Medicine Cases

MARCH 14, 2017

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.

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CPR Resuscitation Pediatrics Hospitals 52

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] Pediatric Bacterial Tracheitis—A Variable Entity: Case Series with Literature Review. Hospital Pediatrics. Published 2023.

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EMS Pediatrics Sepsis Airway Management 88

AED Leader

MAY 27, 2024

Look for AEDs with clear visual and audio prompts that guide the user through resuscitation. Pediatric Capability Children are not immune to sudden cardiac arrest, and having an AED with pediatric capability is crucial for schools. Look for AEDs with pediatric pads or electrodes specifically designed for children.

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CPR Pediatrics Shock Administration 52

EMDocs

OCTOBER 9, 2023

1 Though hydrocortisone is often included in ‘crash carts,’ the most recent consensus on cardiopulmonary resuscitation (CPR) has a weak recommendation against the use of corticosteroids during CPR. 6 However, due to the vasoconstrictive effects, hydrocortisone may be useful in refractory shock. Pediatr Nephrol. Circulation.

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Basic Life Support CPR Fractures Emergency Department 82

Don't Forget the Bubbles

MAY 6, 2024

Acad Pediatr. Pediatric Critical Care Medicine , 25 (3), pp.e117-e128. The mean time to randomisation was 2 hours, which excludes the initial resuscitation window. However, this study did not include the acute resuscitation period or non-ventilated children. 2024;24(1):111-118. doi:10.1016/j.acap.2023.06.023

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Sepsis Outcomes Pediatrics Documentation/Coding 75

Pediatric Emergency Playbook

JANUARY 1, 2017

The guiding principles in pediatric pain assessment and management are: know the child; know the family; and know the physiology. As the pendulum on pain management swings one way or the other, do not let your pediatric patient get knocked by the wayside. Pediatric burns should be assessed carefully and treated aggressively.

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Pediatrics Soft Tissue Injuries Burns Emergency Department 40

AED Leader

NOVEMBER 7, 2023

Cardiopulmonary resuscitation (CPR) can save a life in the event of a cardiac emergency, but very few people know how to perform CPR correctly. Cardiopulmonary Resuscitation To administer CPR successfully, you just need to remember the acronym CAB: Compressions, Airway, Breathing. When that occurs, you need to act immediately.

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CPR Resuscitation Shock Pediatrics 52

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. The nurse triages both to beds in the acute/resuscitation area of the department.

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Sepsis Emergency Department Seizures Pediatrics 52

AED Leader

APRIL 29, 2024

AEDs are portable devices that can be used to deliver an electric shock to the heart in case of sudden cardiac arrest (SCA), a condition that can strike anyone, anywhere, at any time. These devices provide clear and concise voice prompts and visual instructions to guide the user through resuscitation. How much does an AED cost?

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Shock Resuscitation Pediatrics CPR 52

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). Background: It’s interesting to see how fluid resuscitation has been debated over the years. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL).

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Fluid Resuscitation Resuscitation Emergency Department Shock 52

AED Leader

JUNE 2, 2024

With innovative technology and intelligent algorithms, this AED delivers high-quality, accurate shocks to restore normal heart rhythm. Clear visual and audio prompts guide the user through each step of the resuscitation process, ensuring that anyone can confidently use the AED in an emergency.

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CPR Shock Pediatrics Operations 52

Don't Forget the Bubbles

NOVEMBER 15, 2023

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. There is growing interest in giving no maintenance fluid and using the input from drug infusions and resuscitative boluses only. Pediatrics. sodium chloride.

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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.

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Pediatrics Sepsis Shock Outcomes 52

EMDocs

JUNE 27, 2024

Pediatr Allergy Immunol Pulmonol. smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4 C or 100.4

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Pediatrics Dehydration EMS Hospitals 76

AED Leader

JUNE 17, 2024

These devices are designed to analyze the heart rhythm and deliver a potentially life-saving electric shock called defibrillation to restore the heart’s normal rhythm. These devices utilize biphasic waveform technology, which delivers a controlled amount of energy to the heart for a more efficient and effective shock.

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CPR Pediatrics Shock Operations 52

AED Leader

JULY 1, 2024

The clear and intuitive interface provides step-by-step instructions, guiding users through the resuscitation process. It features ADAPTIV biphasic waveform technology, which adjusts energy levels based on the patient’s needs, ensuring effective and safe defibrillation shocks.

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Pediatrics CPR Operations Resuscitation 52

AED Leader

JULY 10, 2024

The Powerheart G5 is a user-friendly AED that provides real-time CPR feedback and can be used for adult and pediatric patients. It provides detailed cardiac information to medical professionals during resuscitation. It provides real-time feedback on the quality of CPR being performed and adjusts the shock energy accordingly.

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CPR EKG/ECG Shock Pediatrics 52

Don't Forget the Bubbles

OCTOBER 2, 2024

In our guideline section, we chose a review in Pediatrics looking at phototherapy to prevent severe neonatal hyperbilirubinemia. In this issue of Pediatrics , Leyenaar and colleagues reported on a trial to compare the effectiveness of direct admission to bypass their emergency departments. Pediatrics. Eur J Pediatr.

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