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.
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.
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.
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 [...]
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
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 [...]
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 [...]
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 [...]
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 [...]
As a prelude to a more detailed post on high flow (coming tomorrow) I thought that it would be a good idea to brush up on standard oxygen delivery devices and techniques - you know, the ones we use every day. Blow-by Temporary O2 delivery Oxygen tubing, corrugated tubing, or simple mask held at a short distance from the child's face [...]
