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Food Protein Induced Enterocolitis Syndrome (FPIES)

Pediatric EM Morsels

Our patients have varied past medical histories that require us to be well-versed in even the most uncommon disorders (or know where to look things up in a pinch)! Patients with FPIES can have marked dehydration due to vomiting and diarrhea, even to the point of hypotension! Volume Status?!

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emDOCs Podcast – Episode 93: BRASH Syndrome

EMDocs

Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. An inciting event will typically push them over the edge into BRASH syndrome: Dehydration Hypotension from sepsis or another condition GI illness Dosage increase of a chronic medication (e.g.,

Shock 86
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Cholera: ED presentation, evaluation, and management

EMDocs

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.

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Travel-Related Illnesses in Children

Pediatric EM Morsels

Pediatric patients with recent travel and fever of unknown origin should be considered for admission if malaria is a possible diagnosis. Malaria requires 3 negative thick and thin smears over 12 hours to fully exclude.

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Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

She had septic shock on presentation and was resuscitated with 60ml/kg of balanced crystalloid solution and escalating vasoactive medications. If the fractional excretion of sodium is <1%, you agree with your consultant that you will also ask the nurses to account for the replacement of 5% dehydration (900ml) over 48h (≈ 19ml/h).

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End of Life Care in the ED

Northwestern EM Blog

Emergency doctors know intuitively what trajectory patients are on, a chronically ill elderly patient presenting with shock requiring pressors have an extremely high mortality risk and we should be clear with families about that. Anticipatory guidance is not just for well-child checks ! Reassure and validate at every opportunity.

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Neonatal Jaundice

Pediatric Emergency Playbook

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. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. Their livers are immature. Bhutani et al.