Pediatric EM Morsels

JUNE 2, 2023

Patients with FPIES can have marked dehydration due to vomiting and diarrhea, even to the point of hypotension! – As always, treat symptoms and dehydration based on severity. It may sound silly (“FPIES”), but it can be serious! Volume Status?!

Dehydration 189

Dehydration Shock Pediatrics Emergency Department 189

Dr. Smith's ECG Blog

OCTOBER 26, 2010

ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. Then ACS (STEMI) might be primary; this might be cardiogenic shock. The patient was suffering from severe dehydration, possibly with sepsis. Are the lungs clear? Is the patient cool and pale? Large volume fluid resuscitation was undertaken.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

EMDocs

MARCH 11, 2024

The clinical picture of this patient was consistent with hypovolemic shock secondary to acute cholera infection. 10 In non-endemic regions, suspicion arises in patients with severe dehydration or death from acute watery diarrhea. 11 The presentation of cholera on physical examination depends on the patient’s level of dehydration.

Dehydration 87

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 87

Mind The Bleep

FEBRUARY 27, 2024

saline vs balanced crystalloid solutions for initial fluid management in the treatment of septic shock which may give us more insight into this topic. [5] This is a child who is clearly dehydrated and unable to tolerate oral fluids therefore IV fluids are the best option. saline), however more research is needed in this area. [4]

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96

Don't Forget the Bubbles

AUGUST 13, 2023

Treatment : IV hydration – based on percentage of dehydration and the calculated water deficit Ceftriaxone – IV or IM IV aciclovir Lucy has another prolonged generalised tonic clonic seizure in the ED. The overall risk of subsequent epilepsy in simple febrile seizures is only slightly above that of the general population (1-2%).

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

PEMBlog

JANUARY 17, 2024

Full blown sepsis and toxic shock syndrome. Now you could even admit a kid for IV antibiotics, maybe they’re dehydrated or they can’t take PO for some reason, without sending a blood culture. That’s probably something different. Fortunately, those are rare. You don’t routinely need a blood culture.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Dr. Smith's ECG Blog

NOVEMBER 9, 2012

Maybe the patient has dehydration, sepsis, hemorrhage, or PE. If you were to give verapamil to someone with sinus tach secondary to underlying pathology, you would harm them and perhaps provoke hypotension and shock. Sinus tach is usually compensatory to some underlying illness.

EKG/ECG 52

EKG/ECG Dehydration Sepsis Shock 52

Taming the SRU

APRIL 13, 2023

beta blockers decrease ability to dissipate heat through increase CO, diuretics predispose to dehydration, or anticholinergic agents can affect thermoregulation) Clinical Presentation: Temperature elevation, usually 40.5C EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Dr. Smith's ECG Blog

MARCH 15, 2023

We designed a step-up protocol in which shocks at 50, 100, 200, 300, and 360 J were used for transthoracic cardioversion. One hundred patients who had had atrial fibrillation for a mean (±SD) of 117±201 days were randomly assigned to undergo transthoracic cardioversion with or without pretreatment with 1 mg of ibutilide.

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

Don't Forget the Bubbles

JANUARY 10, 2024

These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. Were the study groups similar at the start of the trial? Groups were well matched at baseline.

Blood Transfusions 78

Blood Transfusions Outcomes Research Hospitals 78

EB Medicine

JULY 8, 2019

Consider IV access and early IV fluids in those at risk for dehydration and intra-abdominal infections. Jeff: Tachycardic patients should make you concerned for hypovolemia 2/2 dehydration, sepsis, leaks, and blood loss. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EB Medicine

DECEMBER 4, 2019

Most of the dehydration that occurs is more likely due to inadequate water intake and excess caffeine and alcohol consumption depending on the time of day. Nachi: AEDs are also required and have been since 2001 and amazingly when a shock was delivered in flight, 40% survived to hospital discharge with a good outcome.

Wellness 40

Wellness Dehydration EMS Burns 40

Pediatric Emergency Playbook

MAY 1, 2017

They may get a little dehydrated, especially if mother’s milk is late to come in. Home care The neonate who is safe to go home is well appearing, and not dehydrated. Most babies with hyperbilirubinemia are dehydrated, which just exacerbates the problem. None of them became dehydrated or became sunburned. Bhutani et al.

Dehydration 52

Dehydration Pediatrics Wellness 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: The hyperemetic phase lasts 24-48 hours and can lead to dehydration, electrolyte abnormalities, and weight loss. Be sure to look for and treat dehydration, acute renal failure, and rhabdo though.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. This patient’s severe aortic stenosis (AS) and associated severe cardiogenic shock likely created the ECG pattern, resulting in a very difficult challenge for our inpatient team. Fundamentally, cardiogenic shock is an issue of decreased cardiac output.

EKG/ECG 52

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 52

EMDocs

DECEMBER 16, 2023

Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. Broad-spectrum antibiotics (A) for septic shock are not inappropriate given the hyperthermia, tachycardia, and hypotension. Temps greater than 41.5C

Hyperthermia / Hypothermia 67

Hyperthermia / Hypothermia EMS Stroke Seizures 67

Don't Forget the Bubbles

JULY 5, 2023

Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. Infections, fever, acidosis, hypoxia, dehydration and exposure to extreme temperatures can trigger VOC even though often no cause is identified. Rotavirus gastroenteritis and dehydration C.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126