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Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Pediatr Diabetes. The mortality rate for cerebral edema is 21%–24%.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS Decreases splinting and improves tidal volumes.

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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis Sickling leads to vascular occlusion, end-organ ischemia, and decreased RBC lifespan, which, in turn, leads to pain crisis, acute anemia, sequestration, infection, and acute chest syndrome (ACS.) times maintenance.

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Haemolytic Uraemic Syndrome

Don't Forget the Bubbles

She appears pale and dehydrated , and her level of alertness fluctuates. She receives fluid resuscitation, and you organise some tests to find out why she is so tired. Pay specific attention to fluid status, looking for evidence of dehydration. Pediatric Nephrology. 2015 Jul 4;30(12):2115–9.

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Cholera: ED presentation, evaluation, and management

EMDocs

As the disease progress the patients will experience profound dehydration and start to develops signs and symptoms such as: Rapid heart rate Loss of skin elasticity Dry mucous membranes Low blood pressure If left untreated, severe dehydration may lead to kidney failure, shock, coma, and death within hours.

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EM@3AM: Crush Injury

EMDocs

neurologic damage and thrombosis) 20,21 Resuscitation Lactated ringers > Normal saline due to reduced need for urinary alkalinization 22 Place foley and target urine output >300 mL/hr Electrolyte abnormalities Hyperkalemia: Obtain an ECG Stabilization: Calcium gluconate 2 g over 5-10 min. BMC Pediatr. Clin Biochem.

EMS 72
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Paediatric IV Fluid Prescribing

Mind The Bleep

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. Answers (1) [B] is the correct answer.