PEM Currents podcast on respiratory distress
This edition of PEM Currents is all about respiratory distress. You'll learn about initial management, diagnosis and more!
2015 AHA Guidelines for PALS – Fluid Resuscitation in Septic Shock
Should we restrict fluids in septic shock? Hogwash you say! Well, it might be the right idea in resource limited settings. Learn what my take on the 2105 AHA PALS summary has to say on the matter.
2015 AHA Guidelines for PALS – Medications
The 2015 AHA PALS Guidelines have been released - let's take a look at some of the medication related changes, specifically atropine as a pre-intubation med and the choice of amiodarone or lidocaine for shock refractory ventricular fibrillation and pulseless ventricular tachycardia.
2015 AHA Guidelines for PALS – ABC or CAB?
The 2015 AHA PALS Guidelines have been released - let's take a look at whether or not the rapid cardiopulmonary assessment should be airway, breathing, circulation or circulation, airway, breathing.
Just give the antibiotics already (for sepsis)!
Let's check out another in the top ten articles presented at the recent AAP NCE in San Diego. This study examined the relationship between time to antibiotics and morbidity and mortality in pediatric sepsis. Links PubMed Critical Care Medicine The bottom line Early administration of antibiotics in sepsis reduces mortality. What they did The authors performed a retrospective observational study of 130 children [...]
PEMBlog Shorts: A video on the delivery of oxygen therapy
I can't think of a recent shift in which I haven't placed a patient on oxygen. Given that, I wanted to share a brief teaching video on some of the various modalities for oxygen therapy in use in the Pediatric Emergency Department. Enjoy! http://vimeo.com/101403657
What I’m reading: Dispatcher assisted bystander CPR
CPR can save a life. But, it has to be effective. The recent move to compressions only CPR has simplified matters for the lay provider, but are we actually seeing improved outcomes. Essentially, is asking someone to just "push hard and fast" on the chest of a patient with out of hospital cardiac arrest (OHCA) sufficient? I just read an [...]
What the IV fluid shortage means for you
Spoiler alert... There is currently a shortage of intravenous fluids in the US. This knowledge may come in handy if your ED is beset by dehydrated St. Patrick's Day revelers. Specifically supplies are constrained for both normal saline and lactated ringers, plus 5% dextrose solutions. I shouldn't have to tell you that this is potentially a very big deal. There [...]
Briefs: My baby threw up blood!
Hematemesis in the newborn period can be alarming for parents and doctors. In this edition of Briefs we are going to look specifically at bloody emesis only in the neonatal period - age less than 4 weeks. Obviously the initial questions should focus on the quantity and character of the vomiting. Was it spontaneous? After feeds? Streaks of red versus [...]
Does high flow prevent the risk of intubation in bronchiolitis? Not so fast!
High Flow, High Flow, it's off to work we go. Let's give some CPAP and… stop singing. OK, anyway, as a follow up to yesterday's article on standard oxygen therapy I wanted to dive into High Flow. It entails the delivery of heated and humidified oxygen via special devices (eg, Vapotherm®) providing up to 8 L/min in infants and up to [...]
