Pediatric Education

APRIL 30, 2023

She had a history of neonatal stroke for which she had received physical and occupational therapy. The mother and medical records confirmed that a cause had not been determined but the child had a neonatal arterial ischemic stroke. The mother had been evaluated for hypercoagulability which was negative.

Stroke 52

Stroke Seizures Pediatrics Hyperthermia / Hypothermia 52

Mount Sinai EM

MARCH 20, 2023

Stroke Both ischemic and hemorrhagic strokes may be seen with SCD. Those with low Hb, high WBC, HTN, history of silent infarcts, and history of ACS are at higher risks for stroke. Also consider that management may involve exchange transfusion and IVF instead (usually pediatric patients).

Stroke 130

Stroke Pediatrics 130

Emergency Medicine Cases

SEPTEMBER 21, 2021

The post EM Quick Hits 32 Checkpoint Inhibitors, Adult Epiglotitits, HSP, Heat Stroke, Bell’s Palsy and Leukemia appeared first on Emergency Medicine Cases.

Stroke 52

Stroke EMS Pediatrics Resuscitation 52

JournalFeed

APRIL 25, 2020

We cover blunt cerebrovascular injury, head CT in patients on antithrombotic agents, cooling heat stroke victims, avoiding antibiotics in pediatric pneumonia, and surviving quarantine. Here is the JournalFeed Podcast for the week of April 20-24, 2020. Special thanks to Lara Fesdekjian for writing theme music!

Stroke 52

Stroke Pediatrics 52

Broome Docs

DECEMBER 9, 2023

Does BP management in haemorrhagic stroke matter? Choosing wisely for kids From the American Academy of Pediatrics and the Canadian Association of Emergency Physicians, we have the Choosing Wisely recommendations for pediatric emergency medicine. Does BP management in haemorrhagic stroke matter? 2023 Oct 12. 2023.21019.

Infectious Diseases 114

Infectious Diseases Emergency Department Stroke Pediatrics 114

JournalFeed

APRIL 4, 2020

We cover Pediatric Surviving Sepsis; mortality risk after out-of-hospital naloxone; spontaneous pneumothorax - tube or no tube; opioids prior to pediatric sedation; and HINTS by emergency physicians and stroke risk. Here is the JournalFeed Podcast for the week of March 30- April 3, 2020.

Sepsis 52

Sepsis Stroke Pediatrics Hospitals 52

EMDocs

SEPTEMBER 2, 2023

. #1: Dual Antiplatelets or Lytics for Minor Stroke? Spoon Feed In minor acute ischemic stroke (AIS) patients presenting within 4.5 Source Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke: The ARAMIS Randomized Clinical Trial. JAMA Pediatr. 2023 Aug 14;e232900.

Stroke 88

Stroke Pediatrics Outcomes 88

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Get up-to-date in the understanding and management of pediatric status epilepticus. Pediatric status epilepticus is analogous to the multi-organ dysfunction syndrome in severe sepsis. Case 3: Headache and Arteriovenous Malformation Unlike in adults, stroke in children is divided evenly between hemorrhagic and ischemic etiologies.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 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. doi: 10.1097/CCM.0000000000005952.

Stroke 77

Stroke Shock Pediatrics Resuscitation 77

Sensible Medicine

JUNE 5, 2023

For instance, in the FOURIER trial, the super-expensive PCSCK9 inhibitor, evolocumab, reduced a primary composite outcome (CV death, MI, Stroke, unstable angina, coronary revascularization) vs placebo. Contrast this with the THAPCA trial of cooling pediatric survivors of cardiac arrest. We call this acute ischemic stroke or AIS.

Stroke 98

Stroke Hyperthermia / Hypothermia Outcomes Shock 98

Don't Forget the Bubbles

NOVEMBER 27, 2023

The amount of blood that comes from the heart with each contraction is the stroke volume (SV). The stroke volume is the difference between how full it is at the start and how full it is after a contraction. The next element of stroke volume is the emptying. Pediatr Crit Care Med. Pediatr Crit Care Med.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Pediatric Education

NOVEMBER 3, 2024

Learning Point Potential complications of MVP include: MVR Arrhythmias including atrial fibrillation Congestive heart failure Sudden cardiac arrest Endocarditis Stroke Questions for Further Discussion 1. Surgical Results of Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients with Mitral Valve Prolapse. Pediatr Cardiol.

Pediatrics 40

Pediatrics Stroke Wellness 40

ACEP Now

JANUARY 5, 2025

One of the paradoxical oddities of treatment for acute stroke is the reversal of anticoagulation to enable treatment with thrombolysis. Authors of one study clearly felt the same way and implemented a direct admission program across three pediatric health systems. Pediatrics. Theodorou A, Melanis K, Bakola E, et al.

Sepsis 40

Sepsis Research Airway Management Stroke 40

Don't Forget the Bubbles

JUNE 30, 2023

Again, there was no increase in thrombotic stroke in the TXA group – TXA looks safe. Tranexamic acid administration to pediatric trauma patients in a combat setting: the pediatric trauma and tranexamic acid study (PED-TRAX). Safety of Tranexamic Acid During Pediatric Trauma: A Nationwide Database Study. 2022.01.069.

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. She is a Professor of Pediatrics and Interim Chief of the Section of Pediatric Emergency Medicine at the Medical College of Wisconsin.

Emergency Department 74

Emergency Department Pediatrics Head Injuries Administration 74

EMDocs

JANUARY 11, 2025

A 75-year-old woman who is bedridden after a stroke presents to the ED from a nursing facility with abdominal pain and constipation. Pediatric Emergency Care 34(9):p e159-e160, September 2018. | Low threshold for antibiotics and escalation of care with surgery consultation. Cureus, 15(7), e41705. DOI: 10.1097/PEC.0000000000001600

EMS 94

EMS Sepsis Shock Fluid Resuscitation 94

Taming the SRU

FEBRUARY 24, 2024

non-invasive positive pressure ventilation and IV nitroglycerin infusion have been shown to reduce morbidity (intubation rates, ICU admission) & mortality.

Leadership 94

Leadership EMS Pediatrics Stroke 94

JournalFeed

DECEMBER 11, 2021

We cover patient-centered diagnostic excellence, alteplase before endovascular stroke treatment, steroids for pediatric retropharyngeal abscess, LP for febrile seizure, and the new AHA chest pain guideline. It’s the JournalFeed Podcast for the week of December 6-10, 2021.

Seizures 52

Seizures Stroke Pediatrics 52

Pediatric Emergency Playbook

AUGUST 1, 2020

Pediatrics 2011; 128:e741. In: Pediatric Emergency Medicine, Baren JM, Rothrock SG, Brennan JA, Brown L (Eds), Saunders Elsevier, Philadelphia 2008. Heat illness and heat stroke. Pediatr Rev 2007; 28:249. Casa DJ et al. J Athl Train. 2013 Jul-Aug; 48(4): 546–553. Environmental issues for team physicians. Am J Sports Med.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Stroke Burns Pediatrics 52

EM Curious

SEPTEMBER 9, 2015

CUTTING EDGE ACUTE ISCHEMIC STROKE CARE [LECTURE]: Dr. Melissa Motta, a neuro-critical care expert breaks down current best practice in acute ischemic stroke in an excellent talk at Maryland CC Project. Listen to the podcast here on how to approach the undifferentiated sick infant.

Stroke 52

Stroke Pediatrics Best Practices EMS 52

ACEP Now

OCTOBER 3, 2023

This guideline revision is particularly timely as EMS systems have shown their abilities to dramatically improve survival and neurologic outcome after cardiac arrest, STEMI, acute stroke, and other time-sensitive conditions. The mode of transport should be selected to minimize the time to definitive interventions for the patient with TBI.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Taming the SRU

SEPTEMBER 27, 2023

pediatric airways - Landmark studies in em - ebm in the prehospital setting - cpc - r1 diagnostics: pneumothorax - r4 capstone pediatric airways WITH dr. dean Intubation attempts should follow distinct, slow, and deliberate steps. This study did stop early using these rules.

Stroke 52

Stroke EMS Pediatrics Outcomes 52

ACEP Now

JANUARY 30, 2024

Be Prepared for All Pediatric Challenges Whether you want to brush up on your pediatric EM skills or take your dual-boarded training to the next level, the Advanced Pediatric EM Assembly helps you be prepared for any pediatric patient you may treat. Look for “Qual-ED” in your preferred podcast platform.

Pediatrics 52

Pediatrics EMS Documentation/Coding Stroke 52

PEMBlog

MARCH 19, 2024

We published the first pediatric SOAR review in AEM Education and Training on the topic of respiratory infectious disease. In this new pediatric SOAR review, we found that only 36 of the 441 blog posts reached this high-quality threshold score. We want to help you learn! How can I use these findings?

Infectious Diseases 52

Infectious Diseases Pediatrics Stroke Academics 52

Pediatric Emergency Playbook

OCTOBER 1, 2017

Also used for severe MS, stroke, TBI, chronic pain. J Neurosurg Pediatrics. Complications of Intrathecal Baclofen Pump Therapy in Pediatric Patients. J Pediatr Orthop. Pediatr Neurosurg. for the Pediatric Heart Transplant Study Investigators. Prospective Trial of a Pediatric Ventricular Assist Device.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

EM Literature of Note

OCTOBER 20, 2022

How FAST Can You Spot a Pneumothorax? Thin Evidence Supporting Thrombolysis of Those on Blood Thinners Epinephrine Norepinephrine, That Is the Question Ill PREPAREd-II Intubate the Critically Ill Enjoy!

Stroke 40

Stroke Sepsis Pediatrics Resuscitation 40

PEMBlog

SEPTEMBER 6, 2023

However, the vast majority of pediatric patients with psychiatric complaints do not present with undifferentiated acute psychosis; rather, they are seen for behavioral concerns or suicidal ideation. Decades ago, psychiatric complaints in the pediatric ED were infrequent.

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

ACEP Now

MARCH 6, 2024

What’s New in Stroke Care? The simplicity of tenecteplase administration makes its use likely the preferred agent for treating acute ischemic stroke. the “ARAMIS” trial throws up another red flag for patients suffering mild stroke. the “ARAMIS” trial throws up another red flag for patients suffering mild stroke.

Research 52

Research Airway Management Stroke Outcomes 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

It can cause significant internal injuries, including carotid artery dissection, stroke, and acquired brain injury, but in 50% of patients, there are no external signs of injury. Disability – Altered mentation, seizure, stroke symptoms, severe headache, neurological deficit, visual symptoms. link] Surtees TL, Kumar I, Garton HJL.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

Pediatric Education

JULY 23, 2023

In adults, cryptogenic stroke is a current indication for treatment of an identified PFO. Adults with a cryotogenic stroke are more likely to have a PFO (up to 40-50%), and a 2017 New England Journal of Medicine study found that interventional closure of adult PFO decreased recurrent ischemic strokes. with timing 37-5137 days).

Stroke 40

Stroke Pediatrics Outcomes Hospitals 40

PulmCCM

MAY 8, 2023

Read in JAMA Endovascular thrombectomy for large ischemic stroke came to prominence based on limited data showing its efficacy in patients with smaller strokes; large strokes were excluded. This was a noninferiority trial; remifentanil fell below the prespecified threshold for inferiority, though with a wide confidence interval.

Stroke 52

Stroke Blood Transfusions Hospice Anaphylaxis 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

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

EMDocs

MAY 15, 2024

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. Based on light absorption from blood flow at the sensor site (using HbA, not HbS) Underestimates alveolar hypoxemia.

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

JournalFeed

MARCH 26, 2022

High-dose IN Fentanyl Spoon Feed: Higher doses of intranasal (IN) fentanyl for pain ranging from 2-5 μg/kg (with a maximum of 200 μg) were given in a pediatric emergency department, with no documented episodes of apnea, hypotension, or respiratory failure.

Stroke 40

Stroke Documentation/Coding Emergency Department Shock 40

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

. * Population: Randomized trials examining critically ill adult ICU or cardiac surgery patients * Exclusions: Inappropriate setting (cardiac or ICU) or study design (RCT), pediatrics, non-critically ill * Intervention: Any type of vitamin C formulation or regimen * Comparison: Placebo or no therapy * Outcome: * Primary outcome: Mortality at the longest (..)

Sepsis 52

Sepsis Shock Outcomes Stroke 52

Pediatric Emergency Playbook

MAY 1, 2016

For altered adults, use AEIOU TIPS (Alcohol-Epilepsy-Insulin-Overdose-Uremia-Trauma-Infection-Psychosis-Stroke). Pediatrics International. Pediatrics. Keep your mind open to the possibilities, and be ready to change it, when new information becomes available. V – Vascular (e.g. Ann Intern Med 1984; 101:692. 2015; 57(4):659–664.

Seizures 40

Seizures Sepsis Stroke Pediatrics 40