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.

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Pediatrics Hospitals CPR Resuscitation 52

Pediatric Emergency Playbook

AUGUST 1, 2017

Pediatr Rev. Intestinal Malrotation – Not Just the Pediatric Surgeon’s Problem. Pediatr Surg Int. Necrotizing Enterocolitis: A Practitioner’s Perspective. 1988; 9(7):219-226. Malrotation with Midgut Volvulus Applegate KE. Intestinal Malrotation in Children: A Problem-Solving Approach to the Upper Gastrointestinal Series.

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Pediatrics Ultrasounds Resuscitation Sepsis 52

Emergency Medicine Cases

AUGUST 24, 2021

Just as pediatric patients are not small adults, geriatric patients are not just old adults. What is the utility of the Shock Index in older patients? What is the utility of the Shock Index in older patients? How should we adjust airway management for the older trauma patient? and many more.

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Resuscitation Head Injuries Airway Management Shock 52

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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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 116

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 109

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

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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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

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.

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Sepsis Fluid Resuscitation Shock Resuscitation 52

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

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

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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Resuscitation Shock Ultrasounds CPR 52

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 Resuscitation 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.

Fractures 89

Fractures Leadership Dislocations Resuscitation 89

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 Pediatrics Outcomes Documentation/Coding 75

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

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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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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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

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

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.

CPR 52

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.

Pediatrics 52

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.

CPR 52

CPR EKG/ECG Shock Pediatrics 52

AED Leader

MAY 3, 2024

By delivering a controlled electric shock to the heart, these devices can restore its normal rhythm and increase the chances of survival. Some Travel AEDs come with additional features like child pads specifically designed for pediatric use. Yes, some Travel AEDs come with child pads or settings that allow pediatric use.

Shock 52

Shock Pediatrics Resuscitation Wellness 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 (..)

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CPR Burns Airway Management Wellness 90

AED Leader

JUNE 3, 2024

Pediatric Capability While sudden cardiac arrest can affect individuals of all ages, having an AED with pediatric capability is crucial, especially in environments where children are present. The device’s shock delivery is safe for the mother and the unborn child. Can AEDs be used on pregnant women?

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CPR Pediatrics Resuscitation Shock 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.

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Stroke Documentation/Coding Emergency Department Resuscitation 40

Pediatric Emergency Playbook

OCTOBER 1, 2016

It is important to note that 15% of necrotizing enterocolitis occurs in full-term babies; malrotation can present simply in shock, without initial overt bleed. Actively bleeding : radio-labeled red blood-cell scan (resuscitate and call your surgeons!) Pediatrics. J Pediatr Gastroenterol Nutr. Curr Gastroenterol Rep.

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Pediatrics Wellness Shock Resuscitation 52

AED Leader

DECEMBER 2, 2024

Furthermore, regular maintenance and training in cardiopulmonary resuscitation (CPR) techniques significantly enhance the potential effectiveness of AEDs in emergencies. Defibrillation: Once a dangerous rhythm is detected, the AED delivers a controlled electric shock to help restore normal heart rhythm.

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CPR Basic Life Support Resuscitation Hospitals 52

Don't Forget the Bubbles

JUNE 26, 2023

But, they may present postnatally with cyanosis/hypoxaemia due to insufficient pulmonary blood flow, cardiogenic shock due to insufficient systemic blood flow, or both. The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. 2014;165(3):490-496.e8.

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Operations Research Hyperthermia / Hypothermia Hospitals 128

Taming the SRU

JULY 31, 2024

morbidity and mortality - faculty case follow-up - R4 Capstone - high-risk, low prevalence diseases in pediatrics morbidity and mortality WITH dr. moulds Syncope Complete heart block is a rare but important cause of syncope P waves outnumbering QRS complexes should clue to you to high grade heart block Triage EKGs are often obtained to screen for cardiac (..)

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

The Pediatric Assessment Triangle is a rapid, global assessment tool using only visual and auditory clues to make determinations on three key domains: appearance, work of breathing, and circulation to the skin. Pediatr Clin N Am. Part 15: Neonatal Resuscitation: 2010 American Heart Association Guidelines. 2006; 53:69-84.

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Seizures Sepsis Pediatrics Shock 40

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. saline), however more research is needed in this area. [4]

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Fluid Resuscitation Dehydration Hospitals Research 96

Pediatric Emergency Playbook

OCTOBER 1, 2015

He is in compensated shock. The Huber needle is not a resuscitative line. Vascular Devices: assume the line is not functional, and use another to resuscitate, especially in port-a-caths. Pediatr Surg Int (2002) 18: 50-53 DiBaise JK, Scolapio JS. Pediatr Clin N Am 55 (2008) 1343–1358 Garton HJ. Hydrocephalus.

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