Mind The Bleep

APRIL 26, 2024

Note: Painful teeth in well patients with mild, soft swellings with no palpable collection are often treatable with a course of oral antibiotics and seeking emergency dental treatment in the community via NHS111. Is there any asymmetry/fullness in the pharyngeal area? Is there tenderness of teeth to percussion/palpation?

Emergency Department 52

Emergency Department Fluid Resuscitation Dehydration Resuscitation 52

Don't Forget the Bubbles

NOVEMBER 15, 2023

As well as requesting relevant investigations and reviewing her drugs, you send paired urine and serum electrolytes to calculate a fractional excretion of sodium to categorise the cause as pre-renal vs other (see [link] for more information). Is it any wonder all of our PICU patients suffer from fluid overload?!

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

PEMBlog

JANUARY 17, 2024

Well when a break in the skin occurs, normal skin, flora, and bacteria can enter the subcutaneous tissue, where they do not belong, and they can also invade the lymphatic system. You can also see petechiae and hemorrhage, as well as superficial bulla, vesicles, or even echemosis. Well, bacteria, and the most common etiology.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

EMDocs

FEBRUARY 7, 2024

Multiple well-designed, multicenter, multinational studies suggest GLP-1 agonists are associated with improved glucose control in diabetes type 2 and approximately a 15% reduction in weight over 1-2 years (around 2/3s of patients regain weight if treatment is stopped). Obesity affects over 40% of U.S.

Allergic Reactions 74

Allergic Reactions Anaphylaxis Dehydration Wellness 74

EMDocs

JULY 29, 2023

Other bacterial causes include anaerobic oral flora, Strep viridans, E. Other bacterial causes include anaerobic oral flora, Strep viridans, E.

EMS 70

EMS Dehydration Ultrasounds Emergency Department 70

Northwestern EM Blog

FEBRUARY 21, 2022

Anticipatory guidance is not just for well-child checks ! We’ve all seen an end-of-life situation generate a second patient with dehydration mediated syncopal episode at the bedside, let’s try to prevent that. Second, I insist that the family especially the decision-maker drink a bottle of water and eat a sandwich.

Dehydration 52

Dehydration Shock Hospitals Wellness 52

Don't Forget the Bubbles

JANUARY 1, 2024

While adenotonsillectomy may not directly impact cognitive functions, it can benefit other aspects of health and well-being in children with mild sleep-disordered breathing. Reviews and opinion articles Use of POCUS for the assessment of dehydration in pediatric patients-a narrative review. Musolino AM, et al. Eur J Pediatr.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Mind The Bleep

FEBRUARY 27, 2024

1] It is worth mentioning this formula was designed for well, euvolaemic children, which does not represent the popluation of children who require IV fluids. This is a child who is clearly dehydrated and unable to tolerate oral fluids therefore IV fluids are the best option. Answers (1) [B] is the correct answer.

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96

Pediatric Emergency Playbook

AUGUST 1, 2016

⇒ You have a stable child who just needs fluids, but no laboratory tests ⇒ You’ve tried PO hydration, to no avail, despite anti-emetics ⇒ You’re poking the stable, but dehydrated child repeatedly without success What now? Well, it turns out, what is old is new again. Hypodermoclysis , otherwise known as subcutaneous rehydration.

Allergic Reactions 52

Allergic Reactions Dehydration Pediatrics Administration 52

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. Furthermore, notice the well-formed Q-waves in inferior leads. The patient was suffering from severe dehydration, possibly with sepsis.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

Pediatric EM Morsels

JUNE 2, 2023

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?!

Dehydration 189

Dehydration Shock Pediatrics Emergency Department 189

Don't Forget the Bubbles

JANUARY 17, 2024

Other symptoms, such as constipation, abdominal pain and dehydration, were also be seen. Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present. Zamora et al., Persistent vomiting affected all 43 cases.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

APRIL 27, 2019

She is otherwise well appearing and has normal vitals and examines normally. We looked at a trial by Freedman et al using half-strength apple juice or fluids of choice to treat mild gastroenteritis in children who were minimally dehydrated ( SGEM#158 ). Anthony is known for his online RANThonys and website SketchyEBM.

Pediatrics 40

Pediatrics Dehydration Emergency Department Hospitals 40

EMDocs

MARCH 11, 2024

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.

Dehydration 88

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 88

PEMBlog

MARCH 27, 2024

Or, well, the ringer called me. GI symptoms are the second most common, and they include vomiting, food intolerance, food aversion, GERD, refractory to normal antireflux measures, diarrhea, and dehydration. This was made by people who know them very well. And you’re thinking, hey! No, I’m not.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

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. On examination she is febrile, well perfused with a CRT of less than 2sec, heart rate of 155 and respiratory rate of 35. The child is back to his normal self, febrile with a temperature of 38.60

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Mind The Bleep

MAY 16, 2023

It is also sensible to advised to ensure good fluid intake throughout treatment to help avoid dehydration which can occur with laxatives. If the child has evidence of faltering growth , we should always test for coeliac disease and hypothyroidism.

Dehydration 52

Dehydration Best Practices Documentation/Coding Emergency Department 52

Dr. Smith's ECG Blog

MARCH 15, 2023

But when you see this, you should suspect that the AV node is not well. My main concern about Apple Watch monitoring — is the potential for increasing the anxiety of otherwise well individuals who become overly focused on, “What terrible arrhythmia is my Apple Watch now showing at this particular moment?”

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

Dr. No

DECEMBER 19, 2021

It’s not often that Dr No’s flabber gets well and truly ghasted. An extraordinary exchange on twitter (scroll down a page or so to get to the start of the substance, and click here to see the above tweet) has revealed what many have long suspected: SAGE purposely cook the books in its modelling reports.

Outcomes 52

Outcomes Infectious Diseases Dehydration Operations 52

EB Medicine

DECEMBER 4, 2019

Well, with that, let’s get started on our final scheduled episode of EMplify ! Thanks as well to the peer editors, Dr. Knight, and Dr. Hill of the University of Cincinnati. Show More v Jeff: Well, this is a first! Jeff: Just as on the ground, shockable rhythms do well with good BLS care. Nachi: Interesting.

Wellness 40

Wellness Dehydration EMS Burns 40

Dr. Smith's ECG Blog

FEBRUARY 29, 2016

He is worried that he may be dehydrated. Answer: There are well-formed Q-waves in inferior and lateral leads. He did have one episode of diarrhea. He denied fevers and chills, abdominal pain, chest pain, or SOB. Has been able to intermittently tolerate PO intake. He did not finish his dialysis run today.

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 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

Mind The Bleep

JULY 23, 2023

Abnormal bicarbonate secretion due to CFTR mutation causes an acidic and dehydrated environment which results in thick, viscous mucous that forms thick meconium that can then obstruct the lumen. NG feeds if not feeding well. Biopsy shows absence of parasympathetic ganglia and presence of hypertrophied nerve trunks in the bowel wall.

Sepsis 52

Sepsis Blood Transfusions Dehydration 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. Groups were well matched at baseline. Were the study groups similar at the start of the trial?

Blood Transfusions 78

Blood Transfusions Outcomes Research Hospitals 78

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. At 6 to 8 mL/kg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Dr. Smith's ECG Blog

OCTOBER 25, 2022

ie, dehydration, periods of increased stress or anxiety, stimulants such as caffeine, alcohol, recreational drugs, etc.); My patient with stress-induced SVT did well for months at a time when her stress was controlled. How often she gets it? — and — How long it takes vagal maneuvers to work?; and , iv ) Previous treatments tried?

EKG/ECG 52

EKG/ECG Administration Dehydration Emergency Department 52

Don't Forget the Bubbles

DECEMBER 13, 2023

Susan had issues initially with ensuring the correct latch, but after a review with a lactation consultant, feeding is going well. Though it has been hard, they have been coping well and enjoying parenthood. First and foremost, do they look well or unwell? Are there signs of significant dehydration or malnutrition?

Dehydration 98

Dehydration CDC Hospitals Wellness 98

EB Medicine

AUGUST 1, 2018

Jeff: Because the current DEA controlled substances schedule designations are based on original chemical names, synthetics have gained popularity as manufacturers are able to produce newer compounds and circumvent DEA designation as well as routine urine drug screening tests. Jeff: And the etiology of CHS is not well understood.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 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. 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.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Ken Grauer, MD

AUGUST 18, 2023

The premature P waves preceding each of the even-numbered beats in Figure-3 are not well seen in the long lead II rhythm strip. PEARL # 4: Twelve leads are better than one. If no easily "fixable" cause is found — further evaluation including chest X-ray and/or Echo may be indicated.

EKG/ECG 195

EKG/ECG Dehydration Wellness 195

Don't Forget the Bubbles

MAY 15, 2023

Previously well child? “ Pregnancy was uncomplicated and he was well after birth. Physical examination: Joey is well-grown. His systemic examination is normal, apart from signs of dehydration. Pregnancy was uncomplicated, and he was well after birth. Granny’s gliclazide? “ Yes, he’s never been sick before.”

Wellness 103

Wellness Seizures Hospitals Dehydration 103

Don't Forget the Bubbles

JULY 17, 2023

Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study. 2023 Jun;182(6):2735-2757 Point-of-care ultrasound to assess degree of dehydration in children: a systematic review with meta-analysis. 2023 Jun;257:113325. Selvaratnam RJ, et al. J Paediatr Child Health. 2023 Jun 9. N Engl J Med.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Mind The Bleep

JUNE 18, 2023

environmental factors, pain, infection, dehydration, electrolyte disturbance, head injury, medication etc) Does the individual have capacity? In a general hospital there are the dementia and delirium team, as well as Liaison Psychiatry who you can refer to.

Psychiatric 52

Psychiatric Documentation/Coding Stroke Fractures 52

Pediatric Emergency Playbook

FEBRUARY 1, 2017

Symptoms – either typical dysuria, urgency, frequency in a verbal child, or non-descript abdominal pain or vomiting in a well appearing child. In a low risk child, with obviously very vigilant parents, who is well appearing, you may choose not to test now, and ensure close follow up. No obvious source? How should I treat UTIs?

Wellness 52

Wellness Dehydration Ultrasounds Pediatrics 52

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Infections, fever, acidosis, hypoxia, dehydration and exposure to extreme temperatures can trigger VOC even though often no cause is identified.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

As for other invasive therapies , intra-aortic balloon counterpulsation (12, 13) appears to work well in non-randomized studies, and this would also make sense: the balloon in the aorta inflates in diastole, increasing diastolic pressure and thus coronary flow. For instance: sepsis, bleeding, dehydration, hypoxia, and mild ACS.

EKG/ECG 52

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 52