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?

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Mind The Bleep

OCTOBER 29, 2024

Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. National Poisons Information Service (0344 892 0111) and TOXBASE have useful information on special chemicals and are accessible 24/7. Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% Check temperature and blood glucose levels.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

ALiEM

NOVEMBER 1, 2023

Critical illness requiring intubation and propofol sedation Cyanide toxicity requiring sodium thiosulfate Iron toxicity treated with deferoxamine Refractory vasoplegic shock treated with methylene blue Septic shock treated with vancomycin and cefepime Reveal the Answer 3. For iron toxicity, what are the indications for deferoxamine?

Shock 64

Shock Poisoning Pediatrics 64

Taming the SRU

JULY 19, 2023

Fundamentals of ECMO - leadership curriculum - ultrasound GR - macgyver techniques fundamentals of ecmo WITH dr. bonomo ECPR from the ED: The ideal patients: Young patients with refractory VF/VT arrest ≤ 30 min since arrest onset Poisonings with cardiogenic shock Severe hypothermia with arrest Massive PE with arrest Key points: Good CPR/advanced ACLS (..)

Ultrasounds 84

Ultrasounds Leadership Hyperthermia / Hypothermia Poisoning 84

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

2) Hypoxia, including poisons of oxidative phosphorylation such as HS, CO, CN. 3) Anemia, or poisons of hemoglobin such as methemoglobin or CO 4) Fixed coronary stenosis that limits flow. Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. If you can use Doppler, then you can diagnose it.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Emergency Medicine Cases

JANUARY 2, 2024

Based on a blend of number of listens, feedback from listeners, website visits and personal faves, EM Cases Best of 2023 Top 10. The post EM Cases Best of 2023 Top 10 appeared first on Emergency Medicine Cases.

EMS 119

EMS Poisoning Shock 119

Taming the SRU

APRIL 13, 2023

Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

RebelEM

FEBRUARY 15, 2024

There has been no high level evidence to help guide practice until now…the Non-Invasive Airway Management of Comatose Poisoned Emergency Patients (NICO) trial. Effect of Noninvasive Airway management of Comatose Patients with Acute Poisoning: A Randomized Clinical Trial. Paper: Freund Y et al. References: Freund Y et al.

Poisoning 141

Poisoning Airway Management Seizures Shock 141

EMDocs

DECEMBER 6, 2024

In the late 1990s, iron was the leading cause of poisoning deaths reported to poison control centers for children less than 6 years of age. Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. This stage does not always occur. 2 L/hr in adults. Tenenbein M.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

Pediatric EM Morsels

JULY 21, 2023

We have mentioned the Glasgow Coma Scale in multiple delicious morsels: Minor closed head injuries in <3 month olds and in the rebaked morsel , Blunt cerebrovascular injury , Cerebral edema in DKA , Pediatric Trauma Pitfalls , and Carbon monoxide poisoning. When is it useful and what does it tell us? Fun fact for animal lovers!-

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

JournalFeed

APRIL 12, 2025

Monday Spoon Feed : Lidocaine use during pre-hospital resuscitation from ventricular fibrillation or ventricular tachycardia (VF/VT) resistant to defibrillation, when compared to amiodarone, was associated with higher rates of ROSC, fewer post-drug shocks, and greater odds of survival to discharge in this observational study.

Poisoning 52

Poisoning Resuscitation Shock Hospitals 52

RebelEM

JUNE 12, 2024

Background and Physiology Shock secondary to beta-blocker (BB) or calcium-channel blocker (CCB) toxicity bears a tremendous degree of morbidity and mortality. 2022 Annual Report of the National Poison Data System ® (NPDS) from America’s Poison Centers ® : 40th Annual Report. Clin Toxicol (Phila). 2023;61(10):717-939.

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Poisoning Stroke Shock Administration 103

Pediatric EM Morsels

MARCH 17, 2023

Call your friends … at the Poison Center! Your state poison center and local toxicologists are a wealth of knowledge and help for management and treatment. J Emerg Trauma Shock. as far west as Texas Cottonmouths/Water Moccasins live in the southeastern U.S. But that puts them at risk for snake bites in some areas.

CDC 130

CDC Poisoning Pediatrics Shock 130

EMDocs

DECEMBER 31, 2023

Without further ado, here is our list of top posts from 2023 based on viewership from you, the readers: Neurogenic Shock: Definition, Identification, and Management in the ED We start off the list with a clinical post from Kira Brayan and Jenny Beck-Esmay on diagnosing and managing neurogenic shock!

Poisoning 97

Poisoning Shock EMS Hospitals 97

EMDocs

AUGUST 15, 2023

Treatment of snakebite poisoning. Clinically often swelling and tenderness may be considered significant if they extend beyond one major joint from the bite site (e.g., Am J Hosp Pharm. 1991;48(10):2190-2196. Venomous Snakes | NIOSH | CDC. Published April 15, 2022. Accessed May 7, 2022. link] Buchanan JT, Thurman J.

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Poisoning CDC Administration EMS 98

EMDocs

JUNE 25, 2024

Systemic poisoning from inhaled toxins, obstruction of the upper airway from heat injury and edema, and chemical injury to the lower respiratory system from smoke inhalation. If the patient is altered after smoke exposure in an enclosed spaced, consider carbon monoxide or cyanide poisoning. CO toxicity: treat with supplemental oxygen.

Burns 97

Burns Fluid Resuscitation Resuscitation Poisoning 97

Taming the SRU

JUNE 7, 2023

CPC: Rheumatic Fever - Carbon Monoxide Poisoning - Pediatrics: Toxicology - Combined EM/IM: Competency CPC: Rheumatic Fever WITH Drs.

Poisoning 76

Poisoning EKG/ECG Pediatrics Burns 76

EMDocs

JANUARY 4, 2024

Cardiogenic shock and hypotension can occur (systolic heart failure with reduced ejection fraction.) 10,12 Refractory shock or malignant arrhythmias occur in < 5% of patients. 6,15 Discuss cases of overdose, including pediatric exploratory ingestions, with a medical toxicologist or your local poison center. Wu P, Juurlink D.

Seizures 91

Seizures EKG/ECG Poisoning Shock 91

Taming the SRU

FEBRUARY 7, 2024

Tillotson and Hinckley Simulation Communication on arrival to a scene is key, both between you and your flight nurse before you enter the ambulance and with the EMS crew Reassessing the potential reasons for shock in a trauma is important to pick up causes that are not initially on your mind initially (blood products for hemorrhage, controlling a significant (..)

PPE 98

PPE Administration Ultrasounds Poisoning 98

Sensible Medicine

SEPTEMBER 3, 2024

Your supervisor says, “Look, the plant has some similarities to poison ivy. When we tested a treatment for this rash in mice, a specific prescription strength poison ivy cream cleared it right up. But this cream is not FDA approved for “freaky plant rash“, it is only approved for poison ivy.

Pediatrics 78

Pediatrics Poisoning Research Military 78

Taming the SRU

MAY 1, 2023

Subsequent exposure results in a T-cell mediated response (Type IV hypersensitivity reaction) Plants: Toxicodendron species (poison ivy, poison oak, poison sumac) Also present in foods, including pistachio, cashew, and mango.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

EB Medicine

SEPTEMBER 1, 2018

Nachi: And don’t forget our peer reviewers this month, Dr. Daniel Sessions, a medical toxicologist working at the South Texas Poison Center, and our very own editor-in-chief, Dr. Andy Jagoda, who is also Chair of the Department of Emergency Medicine at Mount Sinai in New York City. Jeff: What a team! But, let’s get back to the snakes.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

Emergency Medicine Ireland

MAY 27, 2024

This is a somewhat philosophical approach that reminds us that the PA pressures themselves don’t prognosticate especially well but a failure of flow from right to left will result in cardiogenic shock and death. The ventilator is a bit of a poisoned chalice. The ventilator is a bit of a poisoned chalice.

Poisoning 52

Poisoning Wellness Shock 52

EB Medicine

MARCH 4, 2020

not ED specific) Food poisoning is responsible for 5% of AGE but results in 30% of deaths. Ciguatera Fish Poisoning Toxin produced by algae consumed by reef fish like grouper, red snapper, sea bass and Spanish mackerel. IV hydration for patients with severe dehydration, hypovolemic shock, septic shock, or failed oral rehydration.

Emergency Department 40

Emergency Department Dehydration Poisoning Allergic Reactions 40

PulmCCM

DECEMBER 3, 2023

This review in poisoned patients suggested early intubation was associated with lower rates of aspiration pneumonia, but most others did not. Patients were excluded if they had reasons for emergency intubation: respiratory distress, severe hypoxemia, vomiting, or shock.)

Poisoning 64

Poisoning Hospitals Outcomes Academics 64

Thinking Critical Care

MAY 18, 2023

In 1983 I was an Englishman abroad, the London anaesthetist who was appointed to be the English anaesthetist on the Shock Team only because the outstanding candidate from Oxford had preferred to take up a job doing muscle relaxant research with Kitz and Katz in the USA. 4] The research agenda at the time was broad.

Shock 40

Shock Research Sepsis Resuscitation 40

Ziqitza HealthCare Ltd

JUNE 13, 2024

Common reasons include infections, gastrointestinal issues, and food poisoning. However, if severe instances are not addressed, they can lead to shock or kidney failure. Severe or persistent vomiting or diarrhea Prolonged episodes of severe vomiting or diarrhea can cause electrolyte imbalances and dehydration.

Burns 52

Burns Stroke Ambulance Services Seizures 52

EB Medicine

AUGUST 1, 2018

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 Jeff: And according to the national poison data system, states with marijuana use laws have seen a 30% increase in calls related to marijuana use by children. million, and cocaine at 1.9

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EB Medicine

MAY 3, 2019

Jeff: And while it seems crass to even mention the financial impact, the number is shocking - suicide has an estimated economic burden of $5.4 In one study, sending a brief postcard 9 times a year with a quick “hope things are well” type message to patients discharged after deliberate self-harm reduced self-poisonings by 50%.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

Intensive Blog

FEBRUARY 9, 2023

Show answer In this case, the history pointed towards mushroom poisoning. Most cases of mushroom poisoning are self-limiting episodes of gastrointestinal upset. There are many different syndromes associated with mushroom poisoning in Australia including cholinergic, hallucinogenic, glutaminergic, disulfram-like and hepatotoxic 3.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

Taming the SRU

SEPTEMBER 1, 2023

Shewakramani Sepsis is associated with 20-40% mortality Screening tools for detecting patient at risk for sepsis in the ED SIRS Criteria (more sensitive tool) Temp <36C (96.8F) or >38C (100.4F) HR >90 RR >20 WBC <4k or >12k (or >10% bands) qSOFA Score GCS <15 RR >22 SBP <100mmHg Overall, SIRS Criteria remains (..)

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89