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Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage. Get a hold of ENT early as OR management and/or admission are common. Set up suction x2 in the room! Headlamps can also be helpful!

E-9-1-1 286
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REBEL Core Cast 108.0 – Angioedema

REBEL EM

Both conditions can range in severity from benign to life threatening (Wilkerson 2012). of people who take NSAIDs ( Nzeako 2010 ). patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 of people who take NSAIDs ( Nzeako 2010 ).

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The Broselow-Luten System

Pediatric EM Morsels

Rosenburg 2010] B-L system is designed for 12yo and younger, patients up to 80 lbs, height 46-143 cm [Meguerdichian 2012] Estimates the 50%ile weight for height (Length vs Ideal Body Weight). Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Recommended by ATLS and PALS.

E-9-1-1 269
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SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. An oral airway is placed, peripheral intravenous (IV) line started successfully and the paramedic asks her partner if you want to administer IV epinephrine? JAMA 2012 and Cournoyer et al.

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Transfusion Reactions

Core EM

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

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Don’t Forget About the IO in the Critically Ill Patient

REBEL EM

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line.

ALS 105
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Transfusion Reactions

Core EM

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1