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Snake Bites and Children

Pediatric EM Morsels

In the US, the venomous snakes include rattlesnakes , copperheads, cottonmouths/water moccasins , and coral snakes [ CDC, 2021 ] Rattlesnakes live all across the United State s Copperheads inhabit the eastern U.S. as far west as Texas Cottonmouths/Water Moccasins live in the southeastern U.S.

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ToxCard: Acute Organophosphate Toxicity

EMDocs

8 Plasma butyrylcholinesterase (“pseudocholinesterase”) activity Easier to assay and is more widely available Red cell acetylcholinesterase (“true cholinesterase”) activity More accurate and specific Management: Patients require immediate intervention if there is concern for acute organophosphate poisoning. BMC Res Notes. 2013; 6:524.

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Penetrating chest trauma

Don't Forget the Bubbles

They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. in 1:1:2 group; difference, −5.4% [95% CI, −10.4% to −0.5%]; P  = 0.03.).

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Resident Journal Review: Massive Transfusion Protocols (MTPs) in Traumatic Hemorrhage

AAEM RSA

2,3 Here we examine some of the evidence behind the various components of MTPs, specifically calcium and factor VIIa, and the ratios in which the main products of red blood cells, plasma, and platelets should be administered. link] Published October 2014. Holcomb JB, Tilley BC, Baraniuk S, et al. vs. 78.1%, p=0.006). 248(3):447-58.

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Sickle Cell Disease Module

Don't Forget the Bubbles

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. They should be admitted to hospital in case of clinical deterioration to receive ICU treatment. This treatment is usually done in the ICU setting.

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Sepsis Updates Relevant to the Emergency Physician

EMDocs

The first was the suggestion to use balanced crystalloid fluids, such as lactated ringers or plasma-lyte, instead of normal saline. Disposition The SSC guidelines suggest that patients with septic shock or critical illness be moved to the intensive care unit (ICU) within six hours of presentation to the ED. Am J Respir Crit Care Med.

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