Pediatric EM Morsels

JULY 21, 2023

We have mentioned the Glasgow Coma Scale in multiple delicious morsels: Minor closed head injuries in <3 month olds and in the rebaked morsel , Blunt cerebrovascular injury , Cerebral edema in DKA , Pediatric Trauma Pitfalls , and Carbon monoxide poisoning. Predicting outcome in individual patients after severe head injury.

Head Injuries 230

Head Injuries Pediatrics Outcomes Shock 230

RebelEM

MAY 25, 2023

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Ann Emerg Med 2017 [6] This was a retrospective database review of 7521 traumatic brain injury patients SBP target ≥90mmHg resulted in a mortality of 7.8% vs SBP target <90mmHg which resulted in a mortality of 33.4%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

PHEM Cast

FEBRUARY 23, 2017

Early correction of hypotension (especially if blunt trauma / associated head injury) The balances of harms in the context of blunt trauma between the negative effects of infusing saline versus the negative effects of hypotension are unknown and prehospital actions need to be customised to an individual patient and situation.

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

Pediatric Emergency Playbook

JANUARY 1, 2016

Be aware that later stages of malrotation may present as shock – they present in hypovolemic shock due to third-spacing from necrotic bowel and/or septic shock from translocation or perforation. Abusive head injury is the most common cause of death from child abuse. Louwers et al.

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

The Skeptics' Guide to EM

AUGUST 5, 2017

“The Ottawa Rules are a set of clinical decision rules developed by Dr.

Head Injuries 40

Head Injuries Research Shock Hospitals 40

RebelEM

NOVEMBER 20, 2023

Military practice guidelines recommend REBOA for profound shock (SBP <90mmHg) 1 and ACEP along with the American College of surgeons recommend REBOA for traumatic life-threatening hemorrhage below the diaphragm in patients with hemorrhagic shock who are unresponsive or transiently responsive to resuscitation.

Resuscitation 91

Resuscitation Outcomes Operations Hospitals 91

Rural Doctors Net

AUGUST 30, 2013

Check his pupils – any signs of head injury or subdural from flying debris? Our patient will need adequate pre-oxygenation with a bag-mask valve- be aware that not all bag-masks are the same! For the spontaneously breathing patient, there can be significant differences in FiO2. Keep him warm and covered.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

Don't Forget the Bubbles

JUNE 30, 2023

Whilst you were busy managing head injuries and drownings, Ranulf had been out with a group of boys from school this evening. Ranulf went white with the shock. They had been enjoying a celebratory dinner following their safe return from a trip to the Amazon rainforest.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Taming the SRU

JUNE 6, 2023

mg/kg of IBW Seek to match a patient's minute ventilation with TV and RR after intubation Intentionally match patient's intrinsic RR noted prior to intubation Note that healthy lungs can handle 8 mL/kg, based on IBW, if that is useful for compensation Secure your ETT Thomas Tube Holder is a new ETT holder on Air Care for ETT down to size 6.5

Documentation/Coding 59

Documentation/Coding Seizures Wellness Psychiatric 59