Pediatric Emergency Playbook

MARCH 1, 2016

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. How Children are Different in Trauma In adults, we speak of “permissive hypotension” (also called “balanced resuscitation” or “damage control resuscitation”).

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Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

ALiEM

APRIL 12, 2023

Ever finally step away from a busy resuscitation and someone stops you for peripheral IV access? The thin alcohol layer serves to eliminate any air bubbles under the adhesive cover as well as minimizes residual adhesive material sticking to the probe when removing the cover. No problem. Trick of the Trade 1.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

Taming the SRU

JULY 24, 2023

The following day, Interventional Radiology placed a percutaneous cholecystostomy tube. Risk factors associated with increased risk of acute perforated cholecystitis include age greater than 65 years old, as well as diabetes mellitus, atherosclerosis, or organ failure (1, 2). Patients should be resuscitated as deemed appropriate.

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Ultrasounds Sepsis Radiology Radiology 76

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. doi:10.1148/radiology.144.4.7111716 Resuscitation. Ann Emerg Med.

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Fractures COPD Hospitals Emergency Department 94

RCEM Learning

NOVEMBER 28, 2022

It is important to closely monitor the patient’s haemodynamic status and repeat the pelvic x-ray post binder removal because a well-applied pelvic binder can mask fracture. REBOA Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is increasingly used as a non-invasive clamp of the aorta. From the case rID 52597 Fig.

Fractures 52

Fractures Blood Transfusions Sepsis Operations 52

Mind The Bleep

FEBRUARY 29, 2024

This may well seem daunting given how unwell and complex the patients might be but a thorough, well-structured A-E will give you most of the information you need to progress that patient’s care. 1ml/kg/hour On the other end of the spectrum, if the patient is producing high volumes of urine (e.g.

Documentation/Coding 52

Documentation/Coding Hospitals Wellness Best Practices 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

The latter 1950s and 1960s, quested for nerve gas defense studying expired air resuscitation and modern resuscitology; developing intensive care units. To me, it harkens a new scientific renaissance of resuscitation science, emergency care, and creating systems for care. 1950s & 1960s Resuscitation Research. EDNA->ENA.

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Emergency Nursing EMS Resuscitation Military 40

The Trauma Pro

JULY 10, 2023

This stream of information continues after the patient leaves the trauma bay for CT, imaging, interventional radiology, operating room, ICU, or floor bed. Once this occurs, the entire record is suspect and will not represent the true flow of the resuscitation. All of these occur during a relatively brief period of time.

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Resuscitation Radiology Radiology Administration 100

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. For example, patients with misdiagnosed disease has less RLQ pain and tenderness as well as diminished anorexia, nausea, and vomiting.

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Ultrasounds Radiology Radiology Sepsis 40

Don't Forget the Bubbles

AUGUST 13, 2023

After a short period of observation in the ED, he looks well and has been eating and drinking normally and playing. You are called to the resuscitation bay in your ED following arrival of the expected pediatric alert. However, if radiological evidence of raised intracranial pressure is seen, do not perform lumbar puncture.

Seizures 95

Seizures Pediatrics Dehydration Radiology 95

RebelEM

JUNE 26, 2023

4F-PCC contains factors II, VII, IX, X as well as Proteins S and C. Clinical Take Home Point: In adult patients with trauma at risk of massive transfusion, receiving standard trauma resuscitation management, the addition of 4F-PCC did not result in a decrease in blood product consumption over 24 hours compared to placebo.

Administration 144

Administration Outcomes Resuscitation Radiology 144

EMDocs

JUNE 3, 2023

5 Initial Evaluation The key to the initial resuscitation of the unstable pelvic trauma patient is to rapidly identify and treat the most life-threatening pathology. 13 Massive transfusion protocols (MTP) are hallmarks of trauma resuscitation, and they are critical to the unstable pelvic fracture patient.

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Fractures Resuscitation Operations EMS 54

PEMBlog

JUNE 5, 2024

Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. Resuscitate with volume and blood. In my experience, doing a neurologic exam is really difficult in the resuscitation area, especially when a patient is supine and has an immobilized c spine.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. For the sake of completeness, just be aware that there is also the biliopancreatic diversion with or without a duodenal switch, as well as a vertical banded gastroplasty.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

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, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 63

Documentation/Coding Seizures Wellness Psychiatric 63

RebelEM

JANUARY 25, 2023

Radiology US 90% 96% 14.1 Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 0.27 – 0.83 Abdominal Distension 62 – 67% 89 – 96% 5.64 – 16.8

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Taming the SRU

MAY 30, 2023

Legal implications vary from country to country. mg/mL) single-dose 2*-mL ampule or equivalent, 2 Lidocaine injection, 20-mg/mL single-dose 5-mL ampule or equivalent, 2 Nitroglycerin, 0.4-mg

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

Downeast Emergency Medicine

MARCH 13, 2022

Key Concepts Quickly rule out life-threatening emergencies that require immediate resuscitation. Discuss treatment options as well as disposition for your patient once labs and imaging have returned. You can also use ultrasound testing for evaluation of biliary pathology as well as ovarian/testicular torsion. Silverio, Luz.

Ultrasounds 52

Ultrasounds EKG/ECG Radiology Radiology 52

Pediatric Emergency Playbook

JUNE 1, 2017

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EB Medicine

JANUARY 2, 2019

Jeff: All patients with a positive pregnancy test and vaginal bleeding should receive an ultrasound performed by either an emergency physician or by radiology. Nachi: All unstable patients or those with suspected or proven ectopic or heterotopic pregnancies should be immediately resuscitated and taken for surgical intervention.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

Pediatric Emergency Playbook

APRIL 1, 2017

Look for a small tip diameter (to fit in the ear canal as well as the nose) and a strong “hold” (at least a 3-lb hold). 34 “The mother, or other trusted adult, places her mouth over the child’s open mouth, forming a firm seal as if about to perform mouth-to-mouth resuscitation. button batteries in the nose or ears).29,30 2008.01.013.

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Pediatrics CPR Operations Resuscitation 52