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Diabetic Ketoacidosis in Paediatrics

Mind The Bleep

Common stressors in children and adolescents include: Infections: urinary tract infections, gastroenteritis, pneumonias, Poor compliance to insulin therapy, Dehydration, Fasting state, Heatstroke Trauma. or HCO3 10-15 mmol/L: mild DKA (5% dehydration) pH < 7.2 or HCO3 5-10 mmol/L: moderate DKA (5% dehydration) pH < 7.1

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Journal Feed Weekly Wrap-Up

EMDocs

. #3: Can Clinical or Lab Variables Predict Dehydration Severity in Children with DKA? Spoon Feed Most pediatric patients with diabetic ketoacidosis (DKA) have mild to moderate dehydration. Source Clinical and Laboratory Predictors of Dehydration Severity in Children With Diabetic Ketoacidosis.

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Medical Malpractice Insights: Brain Abscess

EMDocs

He has been ill for 3 days with abdominal pain, fever, diarrhea, and vomiting, and his father thinks his son is dehydrated. He reasoned that dehydration and orthostatic hypotension led to a syncopal episode with limb shaking. The elevated WBC could be due to dehydration. VS are normal with a temp of 97.3.

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Rebaked: Inborn Errors of Metabolism presenting in the ED

Pediatric EM Morsels

Dehydration Surgery Pregnancy ( If we don’t ask we don’t know ) Many important IEM are included in the Newborn Screen. For milder forms of IEM, children can compensate until the body is under stress and may recover after stress (leading to delayed diagnosis). Viral infections also may cause metabolic stress.

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Duration of IVC Collapse

Ultrasound Gel

These authors looked at the Inferior Vena Cava collapse duration in children with dehydration. These authors looked at the Inferior Vena Cava collapse duration in children with dehydration. Will this novel measurement help with figuring out who needs IV fluids? link] [link] What do we do with IVC's in kids?!

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Trick of Trade: Alternative to a Pressure Bag for IV Fluids

ALiEM

You have a severely dehydrated patient with a peripheral IV line, requiring urgent fluid resuscitation. However, the crystalloid fluids are not flowing freely. Multiple attempts were made to place this line with the latest having a flash of blood return and a smoothly flowing saline flush.

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EM@3AM: Sialadenitis

EMDocs

Risk factors include oral neoplasms, sialolithiasis, advanced age, dehydration, ductal foreign bodies, concomitant tracheostomy, and recent receipt of an anesthetic agent. Patients who are immunocompromised may experience infection related to gram-negative organisms (e.g., Pseudomonas aeruginosa , Escherichia coli ).

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